Is it perimenopause or thyroid disease?

Noticed some symptoms pop up and wondering if it’s perimenopause or a thyroid condition? This is more common than what you might think, as there is a big overlap in many ways. If you’re puzzling over which to investigate, here are some things you need to know about.

Perimenopause vs thyroid disease

The symptoms

The reason that so many women are unsure whether they are experiencing thyroid disease or perimenopause? Symptoms overlap greatly, making it hard to differentiate based on those alone!

Common symptoms associated with perimenopause include:

Irregular periods
Weight gain
Hot flushes
Irritability
Anxiety
Intolerance to stress
Insomnia
Fatigue and lethargy
Brain fog
Dry skin
Thinning hair and hair loss
Digestive symptoms including bloating, gas, constipation and diarrhoea

Signs of an underactive thyroid include:

Fatigue and lethargy
Feeling cold
Constipation
Dry skin
Dry, thinning hair
Irregular periods
Sore, painful or tender muscles/joints
Brain fog
A hoarse throat
Puffy, sensitive face

Signs of an overactive thyroid include:

Irregular periods
Hot flushes
Irritability
Anxiety
Intolerance to stress
Insomnia
Rapid heartbeat
Palpitations
Increased sweating
Brain fog
Hair loss
Diarrhoea

As you can see, there is a massive overlap in the symptoms of perimenopause and thyroid disease.

To make it even more confusing, when it comes to Hashimoto’s, you can experience something that is known as Hashitoxicosis. This is usually the initial stage of the disease where you have symptoms of an overactive thyroid because the inflammation causes excess thyroid hormone to be released for a period of time.

This means that you could tick almost every perimenopausal symptom if you had the early stages of Hashimoto’s.

The timing

Another common factor is the onset of each condition. Perimenopause will typically begin in your early to mid-40s, although some will start as early as late 30s (as it can last up to 10 years!)

Thyroid disease also occurs frequently in mid-life - Graves’ disease has a typical onset age between 40-60 and is more common in women. Similarly, Hashimoto’s is most common for those aged 30-50 years.

Weight gain

For both perimenopause and thyroid disease, weight gain is one of the most common complaints. And there are very real reasons why both can cause issues with maintaining a healthy weight - nothing to do with being lazy or making unhealthy choices!

With thyroid disease, an underactive thyroid slows down your metabolism. This causes you to burn less energy at rest. So even if you’re eating the exact same amount of calories as you did before the thyroid condition developed, you’ll slowly tip the energy equation and start putting on weight.

With perimenopause, there is a bit more at play. Oestrogen fluctuations can increase insulin resistance, leading to stubborn weight gain. The reduction in progesterone can also drop the amount of free thyroid hormone in your blood, dropping your metabolism.

It can be both!

The important thing to take away is that it may not be a case of thyroid disease OR perimenopause. In many cases, it can be both.

This is why I always encourage women with perimenopausal symptoms to investigate and rule out thyroid disease. Otherwise, the two conditions can exacerbate each other and make life a nightmare for years!

WHAT SHOULD I DO IF I CAN’T FIGURE OUT WHICH IS THE PROBLEM?

Stay tuned for some future articles with some further insight and advice. But in the meantime, I highly recommend finding a healthcare practitioner who has experience in thyroid disease & perimenopause.

They will be able to assess your symptoms, recommend further investigations as needed and get you some answers.