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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.

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