Can Perimenopause Cause Hypothyroidism?

You’ve no doubt heard horror stories about the symptoms that may come with perimenopause, the transitional period leading to menopause. But the problems can be far more complex. As if hot flushes, night sweats, insomnia, loss of libido, weight gain and brain fog weren’t enough, you can also develop hypothyroidism ― that is, an underactive thyroid.

It happens to around 26% of women undergoing perimenopause.

Why is hypothyroidism so bad?

For starters, if you have low thyroid function, there’s a good chance you will also find yourself battling depression.

Not only that, but when this little butterfly-shaped gland at the base of your throat malfunctions, it can have huge repercussions for your entire body.

The thyroid produces triiodothyronine (T3) and a larger amount of thyroxine (T4), which is converted to T3. These two hormones affect metabolism. That means they control how your body uses food to produce energy and determine the rate at which your heart, liver, muscles and other organs, including your brain, work. In short, they affect about all your body’s working parts.

One of the most common effects of low thyroid ― when not enough thyroid hormones are being produced or when they’re not working at the cellular level ― is depression.

Why Do Perimenopausal Women Get Hypothyroidism?

Perimenopause occurs in mid-life, normally beginning between your mid-30s and late 40s. That’s the same time when your risk for hypothyroidism greatly increases, so it’s entirely possible that the two simply occur coincidentally.

But it’s equally true that perimenopause and hypothyroidism are often related. As your egg supply diminishes with the onset of perimenopause, your ovaries begin to produce less oestrogen. However, your progesterone level can fall far faster than that of oestrogen, throwing these two hormones out of balance. In other words, your optimal oestrogen/progesterone ratio is disrupted.

This imbalance often results in oestrogen dominance ― a condition when progesterone falls to a level so low that it’s unable to limit the action of oestrogen. When this happens, you can experience symptoms exactly like those caused by low thyroid, including depression, along with weight gain and brain fog.

But it can get worse . . . .

All that low but excessive oestrogen can actually sabotage your thyroid hormones. Even if your thyroid is pumping out sufficient T3 and T4, oestrogen dominance can make them ineffective. And if they can’t do their job, you will develop hypothyroidism.

It can also work the other way. A pre-existing low-functioning thyroid can cause your progesterone levels to plummet. Even if your oestrogen/progesterone balance was initially optimal, the ultimate result can be oestrogen dominance, which further impairs the thyroid and worsens depression.

How Hypothyroidism Leads to Depression

The T3 thyroid hormone acts in the brain to govern three neurotransmitters important to your emotions:

  • Serotonin: Optimal levels of serotonin (called the “feel-good” neurotransmitter) make you feel happy and relaxed
  • Norepinephrine: Improves mood, helps you deal with stress and acts like a natural anti-depressant
  • GABA (gamma aminobutyric acid): Improves mood and relieves anxiety

When the action of the T3 hormone is impeded by hypothyroidism, these mood-stabilising neurotransmitters are effectively taken ‘off-line.’ When that happens, depression gets worse.

Serotonin seems particularly important for maintaining an ‘up’ attitude and good mood, but it can drop precipitously following an abrupt decrease in oestrogen, which can occur in the mid-30s. Shortages of serotonin can worsen symptoms associated with menopause ― hot flushes, insomnia and mood changes ― that can add significantly to depression.

How You Can Relieve Thyroid Dysfunction and Depression in Perimenopause

Diagnosing low thyroid can be tricky. Even though your oestrogen/progesterone levels are unbalanced and affecting your thyroid hormones’ action, a routine thyroid test may show your thyroid hormones are at perfectly normal levels. That’s because your thyroid is putting out hormones that can be measured ― they just can’t do what they’re supposed to do.

Generally speaking, adequate thyroid treatment will reverse thyroid hormone insufficiency and depression. It’s important to be aware, however, that people with hypothyroidism-induced depression are often misdiagnosed and treated as having a psychiatric illness. As a result, they are frequently prescribed antidepressants.

Unfortunately, antidepressants can be addictive. Also, they can have dangerous side effects. They can, in fact, actually worsen depression ― even trigger homicidal or suicidal impulses ― and they won’t fix an oestrogen-dominance problem or a low-thyroid problem.

To reverse low thyroid and depression during perimenopause, you will need thyroid testing, but the standard TSH test doesn’t detect most cases of low thyroid and won’t give you the answers you need.

You need a restorative medicine physician skilled in bioidentical hormone restorative therapy (BHRT) who offers comprehensive, full-panel thyroid testing. That includes total T3 (TT3) and total T4 (TT4) tests, along with a TSH test. He or she will also do full testing of your sex hormones (oestrogen, progesterone and testosterone) in order to assess their status.

With that knowledge, your doctor will prescribe the appropriate treatment to restore optimal balance to your hormones, proper functioning to your thyroid, and a life free of perimenopausal-related depression, as well as other troubling menopausal symptoms.

SOURCES:

Depression: Common Symptom of Hypothyroidism. Hotze Health.
Dowling, C. Menopausal Depression Is Common and Treatable. Women’s Wellbeing and Mental Health.
Kellman, R. Menopause or Low Thyroid ― Is It One, The Other or Both? Huffington Post, THE BLOG. Oct. 30, 2015.
Magnolia. 35 Symptoms of Perimenopause ― Hypothyroidism. The Perimenopause Blog. Oct. 10, 2016.
Northrup, C. Thyroid Disease. DrNorthrup.com.
Perimenopause and Thyroid Problems ― common and confusing. CEMCOR.

Perimenopause: What Every Woman Should Know

It is important that every woman in their 40’s is aware of the perimenopause and the changes it will bring. Even if you feel you are way too young to be thinking about the dreaded M word, learning about the P word will stand you in good stead.

If you understand the vital role hormones have in your health, emotions and overall wellbeing you will be much better prepared to deal with the perimenopause, menopause and ageing process in general.

So in the spirit of forewarned is forearmed, here are 5 things I wish someone had told me when I hit 40!

1. It starts at 40 not 50

Sorry, you probably didn’t want to read that. However, I cannot over emphasise enough how important it is to listen to your body in your 40’s when changes in your hormone levels begin to occur.

You probably know that menopause is when you have not had a period for 12 months. But… you may not know that the six to thirteen years leading up to the menopause are when some of the most difficult symptoms kick in. I’m talking; hot flushes, insomnia, bone loss, mood swings, brain fog, irregular periods, diminished sex drive, breast cancer and unexplained weight gain. This is called the perimenopause. It usually starts in your 40s, but can start as early as your 30s.

Although most women experience the menopause at around the age of 51, it’s very likely you will have suffered some perimenopause symptoms from your 40s onwards.

2. It’s your hormones

Menopause symptoms are your body’s way of signalling that something is wrong, that you have a hormonal imbalance. Hormones regulate every bodily function, from your heartbeat to weight gain. Without them we would slowly but surely fade away and die! Perimenopause is in fact, the earliest stage of this fading process.

In menopause, oestrogen(s) and progesterone levels decline drastically. These female hormones, that are so famous for fertility in our younger days, should not to be ‘left out in the cold’ once we reach menopause, as they are key hormones and play a vital role in bone health; protecting against osteoporosis. They protect our skin, keeping it healthy and glowing; brain function, protecting against dementia; heart health, protecting against heart attack; vaginal and urethral tissues, keeping our sex drive in ‘top’ form!

When there is an imbalance of even just one hormone, it will adversely affect the others and may result in any of several menopausal symptoms.

3. Test your thyroid

After your fortieth birthday, it is important to recognise the symptoms of low thyroid (hypothyroidism). Low thyroid complaints include; joint pain, allergies, carpal tunnel syndrome, high insulin, unexplained weight gain, fibrocystic breast tissue, hair loss, loss of libido, dry skin and headaches to name just a few.

In perimenopause, declining levels of oestradiol (a type of oestrogen) and progesterone (both known as female sex hormones), along with testosterone from our ovaries, may leave a woman with a ‘go-slow’ (underactive) thyroid. Declining levels of female sex hormones may cause thyroid issues such as hypothyroidism. However, these are not true thyroid problems, they occur because female sex hormones are low. When oestrogens and progesterone are restored to optimal levels, in the majority of cases, thyroid issues will be rectified, thus, there would be no need to supplement with thyroid hormones.

However, about 25 per cent of perimenopausal women have some kind of thyroid problem. In the majority of cases it is due to subclinical hypothyroidism which may progress into overt hypothyroidism. Both subclinical and overt hypothyroidism should be treated.

4. There is an alternative to conventional HRT

There is not a one-size-fits-all woman. Therefore, there cannot be a one-size-fits-all pill. We are all different, we all metabolise hormones differently, and our hormonal decline varies from woman to woman. Therefore, we need an individualised treatment. HRT is a one-size-fits-all treatment. Bioidentical hormone restorative therapy (BHRT) is tailored to the patient’s requirements. We are all different – would you go out and buy a size 14 dress just because your friend did, when you’re actually a size 12?

5. Don’t dread the ‘M’ word

Contrary to the conventional menopause stereotypes that we often see in the media, you can have a happy, healthy, strong and sexually vibrant life, well into your forties, fifties and even beyond. The key is to get the right information early on.

 

The Menopause Cure: Hormonal Health. The book is available in good book stores and online at Amazon.

My hot flush! Described by 5 real women.

Describing a hot flush as a ‘sensation of warmth’ just doesn’t cut the mustard, when we know there are woman utterly blindsided by their first attack.

You say hot flash, we say hot flush!

The standard description of the British hot flush is a sudden feeling of feverish heat. In the United States they are more commonly known as a hot flash and described as temporary but recurring episodes of flushing with a sensation of warmth or heat.

What we can all agree on, is for the 75% of women affected during the perimenopause, they can be deeply unsettling, distressing and, on occasion, make life darn near impossible. Women experiencing an abrupt decline in oestrogens often suffer the worst.

So, fans at the ready, we’ve scoured forums and the blogosphere to share the most descriptive accounts of a hot flush on the web. If you are going through hell with hot flushes you may find a little comfort in knowing you are not alone.

And for the lucky ones… read on and be better prepared to help; turn the heating down, keep a spare ice pack at home (and at work) and cover for your girlfriends when they need you too!

We’ve got your back! #WomenRock

Darcey Steinke on wanting to kill the menopause

“Hot flashes are inner apocalypses, singeing the body and the brain. During my first volcanic night sweat, a chaotic force moved through me. Heat rose, busting through the top of the thermometer, and swept through my body like the special effect I’d once seen on the set of a horror movie. Flames spread through a wire and rose up encircling a cabin. It was horrible, but also exquisite. Finally, I thought, God was going to communicate with me physically. Like a biblical character, I felt overwhelmed, scared, and sublime.”

Read the full article, What Menopause Taught Me, on NYMag.com for a wonderfully raw account with a surprisingly uplifting conclusion.

 Lesley Grant Timmins on threading a moving needle

“My first hot flush started with a chill, followed by a roaming band of heat that crawled up my legs to my back, all the way to my scalp. Soon I was drenched in sweat. Within the next few months the pattern took hold, repeating every half-hour to 45 minutes, interrupting every daytime activity and, worse, sleep.”

Read the full blog, Confessions of a hot flush queen, on Alive.com

Girlywhirly answering a plea for help on Mumsnet

“My flushes feel like the blast of heat you get when stepping into a hot sauna, except that the heat is from your inside! I don’t seem to break into a sweat though. The ‘heat’ lasts for about 30-40 secs and subsides. I know what you mean about the duvet! I push the duvet on and off and stick a leg out at the side. DH and I have only a 4.5 tog duvet all winter. I think my neck sweats most at night. In my case, I am interested to note that these ‘flushes’ disappear when a period is due, for a couple of weeks before and after, although this is only twice a year now (age 51).”

Read the full discussion, Please describe a hot flush to me, on Mumsnet.com

Skinny And Single on how the bitch turned

“The wonder of going from cold to roasting in an instant. The wonder of bleeding through 17 layers of cotton, two towels and a mattress. The wonder of my new beard. That’s cool though, people have a new beard fetish lately, I’m good to go. I guess I’m just old, I’m going grey and getting deep wrinkles. I have random pains and the occasional limp. But hey, when I was 23, I had problems too, I’d rather be here, any day. This shit’s a breeze, I got this. PS: I just want my armpits to dry.”

Read the blog, Rest In Peace To My Uterus, on Skinny And Single

Barbara Younger on hot flashes at school

“I could barely respond. I was standing there, in the middle of the circle of students–my favorite format for conducting class– trying to keep my “cool” and remember what I was doing there. I had felt a hot flash mounting up my legs from the very bottom of my feet, increasing temperature as it ascended, until it got to its highest tension in my face and head. It then erupted in visible sweat that flashed my face and made my neck and armpits moist. It was a power surge indeed, and my face was red as a tomato and my consciousness astral travelling. When I was able to finally come back to my senses, I sat down in front of twenty faces that looked at me in horror. And then I calmly said: “It’s a hot flash!”

Read the rest of the blog to find out how she got coped through the class in Friend For The Ride

We’d love to hear more personal descriptions of a hot flush. Have you read one that should be included on our list. Can you share your own experience of a hot flush with us?

September is Menopause Awareness month and we’d really like to get the message out – no more suffering alone. Sharing experiences and tips can and do help.

If you’d like to contribute please leave a comment below.

5 Perimenopause Reads for Menopause Awareness Month 2015

menopause awareness peri-menopause

For Menopause Awareness Month 2015, I am focusing on the perimenopause because it’s vital women are armed with information in their early 40s. Understanding the hormonal changes in your body and the role they play in your health and quality of life is the first step in dealing with the perimenopause, menopause and the ageing process.

Furthermore, I want to turn this life stage, that is traditionally considered negative, into a positive! I wrote the book, The Hormone Cure: Hormonal Health, to share my own experience of the menopause, the difficulties I faced and how I overcame them by restoring my body to optimal hormonal levels. I wish this information had been available to me when I hit 40!

Perimenopause

Let me tackle one misconception about the menopause early on. The menopause is when you stop having your period for one whole year. But… and not every women is aware of this… the six to thirteen years leading up to that are characterised by symptoms such as hot flushes, disturbed sleep, bone loss, irritability, mixed up emotions and mood changes, to name just a few. This period of time is known as perimenopause. It can be a difficult transition, not just for women, but also for their husbands, partners, friends, children, and the entire family.

Be Prepared

Although the menopause is a normal part of ageing, many women are not fully prepared for the symptoms. The symptoms are caused by fluctuating hormone levels. We are all different, so although your friend may experience hot flushes that leave her gasping for breath, you may not. Instead you may have migraines, brain fog or forgetfulness (one of my girlfriends drove off with her handbag on the roof of her car not just once, but almost every morning!)

For others, mood swings are a burden, not just for them but their entire family who have to tiptoe around on eggshells in order to avoid yet another unexplainable, wild tantrum.

It doesn’t have to be this way! Contrary to the conventional menopause stereotypes that we often see in the media, you can have a happy, healthy, strong and sexually vibrant life, into your forties, fifties and beyond. The key is to get the right information early on.

So, get informed now, read my 5 most popular articles on the menopause.

  1. I’m too young for this! Perimenopause is the precursor to the menopause no one tells you about. Read more…
  2. What to expect from the perimenopause. What to expect from perimenopause but more importantly, what you DO NOT have to accept about it! Read more…
  3. The emotional side of menopause. I often hear from women saying that they feel anxious, sad, depressed, or that they have lost something deep down inside, something emotional, something almost heart-rending; is it that they have lost themselves? Read more…
  4. What is oestrogen dominance? In perimenopause both oestrogens and progesterone levels drop. Oestrogens drop by 40% to 60% and progesterone levels can drop to nearly zero. Read more…
  5. Bioidentical Hormones Frequently Asked Questions. Everything you needed to know about Bioidentical Hormones. What is Bioidentical Restorative Hormone Therapy? Also known as Bioidentical HRT or BHRT. Read more…

Don’t forget to check out the signs and symptoms of menopause.

You can find out more about Menopause Awareness Month below.

menopause-awareness-month
Menopause Awareness Month

How do women cope with the menopause at work

Dont’ let it get the better of you.

“I am coming out, and have nothing to be ashamed of! I am stepping out onto the stage of life and shouting it loud and clear, “I am a menopausal women and I am proud of it!” I Am a MENOPAUSAL WOMAN… who restored her body and got her ‘mojo’ back, in its entirety. I got it all back and I can cope with anything. Yes, you heard right, ‘There ain’t no stopping me now’.”

Why is it that we feel we have to hide this fact? Maybe it’s because we don’t feel as good about ourselves as we used to, we are less confident, maybe because most people believe the definition of menopause is the end, old, finished – not so!

Maybe it is because we are less able to cope, and no one should know this. That’s a big one! I am so desperately sad when I hear from women who say they can’t cope, that they can’t keep up with their male counterparts, or younger colleagues.

“How do professional women cope with the menopause? How do women manage their high-flying career when they are suddenly hit with hot flushes, foggy thinking and/or mood swings, together will sleeping disorders?”

This is the question I am constantly asked. This is the question I am going to answer for you!

Hot flushes

What do you do if you are sitting in a meeting with a table full of men and suddenly a hot flush hits you? Do you perspire and suffer in agitated in silence, getting redder and redder, or do you excuse yourself telling your colleagues that nature has just presented you with something that is known as a ‘hot flush’ and you just need to step out and cool down a little.

No way. You hide it, you sit there and perspire, fidgeting in your seat. There’s no need for them to know that you are menopausal, that would just start the ball rolling. We do not have to suffer these embarrassing moments anymore, there is a solution. A safe solution.

Foggy thinking

What if you have to present that all important project that you’ve been working so hard on, and for so long, when you can’t remember your words. Not good when you need a high degree of intellectual control. This is a normal perimenopausal process, but needn’t be so debilitating .

We have a hormonal imbalance and our brain is rewiring. Who wants to lose their thinking power at 40 or 50. Who wants to let go of their experienced, efficient, sophisticate and more mature brain? We are at our peak, we are at the top of our career, why let go? We do not have to, there is a solution, a safe solution!

Emotions

What if you are suddenly overcome with weepiness or even heart-felt sobbing, for no apparent reason, when you are walking through an office full of people. Your professional self-esteem just hit the floor, but it’s not your fault – your hormones are playing tricks on you; you have an imbalance.

Whoever would have thought that hormones could play such an critical role in the body and be such a powerful molecule? They literally make or break us. This is why menopause can break us, our body is suffering withdrawal symptoms, our hormone levels are in a decline, and are no longer at optimal. Our body desperately needs those precious hormones to enable it to function correctly, as we did before we entered menopause.

Sleep

Sleep is so important to our health, without enough sleep we cannot function correctly, we become moody, angry, put on weight, are constantly fatigued, our energy levels drop, and in some case, we may even get depressed.

Without enough sleep our healing hormones cannot regenerate themselves, with insufficient sleep our hormones become imbalanced, with a hormonal imbalance we cannot sleep. How does that sound? It is a vicious cycle. It can work both ways! What we need is to regain balance. We need to restore our body.

Feeling lousy most of the time and having to hide it is not something women want but most of the time they do, either out of embarrassment, or out of fear of being seen as less competent. Would you ever go to HR to discuss this particular problem? Of course not! You’ve just put a black mark on yourself!

Is conventional HRT (synthetic hormone replacement therapy) an option?

In one word, NO!

HRT can help with hot flushes and night sweats, but the consequences (breast cancer, strokes and blood clots) far outweigh the benefits. The WHI study which finished early, in 2002, concluded that HRT did not protect against cardiovascular disease, strokes, cognitive loss, nor did it improve mood or sexual dissatisfaction. Do you consider this an option?

Is Bioidentical Hormones Restorative Therapy an option?

In one word, YES!

When you restore your body you restore yourself and every system in the body; mind, body and soul. Bioidentical hormones are life-giving hormones with no side-effects attached. With the use of restorative medicine you can glide through the menopause and onwards, to a new lease of life. There’ll be no more need to worry about your career.

Your brain will be sharp, quick-thinking and energetic – no more foggy moments. Hot flushes will be gone…forever! Your energy, lust for life and vitality will return to youthful levels – you’ll be better than your younger colleagues; you have far more experience and your brain is mature, remember, you can have it all? There’ll be no more crying or mood swings at inappropriate times – your professional-esteem will pick itself up off the floor. And you will sleep, blissful sleep.

And as an added bonus, you will lose weight and be able to keep it off.

A hormonal imbalance affects your everyday life and your career – it doesn’t have to. Restore your body! There is your answer. Don’t just take my word for it. Read up on the importance of your hormones here.

What to expect from perimenopause

  • What to expect from the perimenopause

    Perimenopause - What to Expect

What to expect from perimenopause but more importantly, what you DO NOT have to accept about it!

Menopause is a difficult stage for almost all women, things don’t just take a ‘pause’ they change. The way I look at it is, menopause is the ‘change’ but perimenopause is the ‘pause’. ‘Pause’ because in perimenopause female hormones drop drastically, so the body then has to take a pause to try and adjust itself to these lower or declining levels of hormones. This, for instance, is why we get hot flushes. Hot flushes only last as long as it takes for the body to adapt to these changes in hormone levels. Once the body adapts itself, it begins to change, it has to change, as it no longer has sufficient fuel (hormones) needed to stay healthy, strong and vital, and the person you once were. In fact, this is when we begin our descent into ageing and its related illnesses – hormones protect us.

It is not always easy to tell if you are experiencing perimenopause, and in fact, some women believe it to be impossible, convincing themselves they are too young. I understand totally, but the sooner you listen to your body the better. So many women live with and suffer from symptoms of perimenopause for years, some for as long as 15, before they seek the correct treatment. Perimenopause can begin about 10 to 5 years before menopause, so you could start noticing symptoms as early as your late 30’s, which can greatly disrupt your life, both at work and at play.

You wake up one morning with a feeling of despair, but don’t know why. You are moody, irritable, and you definitely do not feel as good as you used to – your energy levels have dropped, your positive thinking is hovering on the negative side, and sex drive, it just faded away without you realising (but perhaps your husband or partner did!). Your beloved family are stepping around you carefully so as not to crush the eggshells. You’re tired all the time but just don’t seem to be able to get enough sleep; in fact, you can’t sleep. You gain weight, something you never had to deal with before. You ate like a horse at one time with no problem. But not now. And it seems like you are living in a constant state of PMS, and that’s not far from the truth. Your hormones are playing tricks, you have an imbalance, just like before a period, but only this time they are not going to get any better. Welcome, benvenute, bienvenida, bienvenue, willkommen to my world, to perimenopause, to menopause. It happens to every woman, and is apparently, something that cannot be avoided.

But the wonderful thing now is, we no longer have to face these life-disrupting events. We don’t have to take the menopause lying down, have no energy, face depression, fade away into the background, or be left with a feeling of hopelessness, of where to go, and how to resolve it. Neither do we have to face all the age-related diseases that go with it. We have restorative medicine! When you restore your hormones, you restore your health, your life, you restore you, and you obtain longevity. It’s as simple as that!

To your health!