The Complex Relationship Between Female and Thyroid Hormones
Fatigue. Weight gain. Brain fog. Hair loss. Constipation. Mood changes. Trouble sleeping. Feeling cold one minute and hot the next.
Welcome to menopause…or is it?
Yes, it’s easy to blame perimenopause and menopause for nearly every symptom that plagues women over 40. But just because something has feathers and webbed feet doesn’t mean it’s always a duck. And let’s not forget that birds often function in flocks—just like your hormones.
Thyroid hormone is just as important as female hormones, and women over 40 are much more prone to developing thyroid problems. The problem is that many of the symptoms associated with an underactive—or occasionally overactive—thyroid can look remarkably similar to those associated with perimenopause and menopause. That’s why thyroid hormone is often the neglected “step-hormone”—even though it’s looking for equal attention.
Hormone Family Dynamics
Just like you’re a member of a family—with its often complicated dynamics—so are your hormones. They’re interconnected, in each other’s business, and sometimes have their own opinions about how things should go.
In women, estrogen is almost always the alpha female—and many of the members of your Happy Hormone Family look to her for guidance on where and when to show up. But estrogen has superpowers beyond its ability to directly affect other hormones. It can also influence how much of certain hormones are available by affecting the proteins that transport them through your bloodstream.
Thyroid hormone is a perfect example. As estrogen levels change, so can the proteins responsible for carrying thyroid hormone through your bloodstream. That can change how much thyroid hormone is bound to those proteins and how much is freely available for your body to use. In other words, when estrogen starts changing the family dynamics, your thyroid hormones may get pulled into the drama too.
That becomes particularly relevant during perimenopause, when estrogen levels can bounce all over the place, and later in menopause, when estrogen settles at much lower levels. These changes don’t necessarily cause thyroid disease, but they can influence thyroid hormone availability and thyroid test results—especially in women already taking thyroid medication.
And estrogen isn’t the only thing changing. Thyroid function itself can shift as we age, while thyroid disorders become increasingly common. Put all those family dynamics together, and it becomes much easier to understand why your thyroid deserves a little extra attention during the menopausal years.
Your Immune System May Crash the Party
There are countless triggers—like chronic stress, environmental toxins, and gut gridlock—that can aggravate your otherwise protective immune system and make it go rogue. And when it targets your thyroid gland, Hashimoto’s thyroid disease may complicate an already complex scene.
Women are far more susceptible to autoimmune thyroid disease than men—probably because estrogen and the female immune system are frenemies. While changing estrogen levels haven’t been shown to directly cause autoimmune thyroid conditions, estrogen does influence immune activity. So when estrogen begins fluctuating during perimenopause and eventually settles at much lower levels after menopause, those changing hormone dynamics may have their hands in the autoimmune cookie jar.
Meet Janet
Janet was a 56-year-old menopausal woman dealing with fatigue, weight gain, hair loss, and chronic constipation. She was also dealing with hot flashes, night sweats, and low sex drive. She went to see her practitioner, who did some baseline hormone testing—including estrogen, progesterone, testosterone, and TSH levels—and diagnosed her with…drumroll…menopause! She was prescribed HRT and sent on her way.
But a few months later, Janet was still experiencing fatigue, weight gain, and hair loss. Her constipation had marginally improved. Plus, she was now having to wear extra clothing because she felt cold compared to everyone else around her—and her eyebrows were thinning.
At this point, her practitioner correctly started to suspect thyroid hormone issues, so a more complete thyroid panel was ordered. Bingo was its name-o. Her results showed some mild thyroid hormone imbalances, but nothing significant enough to warrant thyroid medication. Autoimmune thyroid conditions were also ruled out. Given that Janet was still adapting to HRT and undergoing some significant hormonal changes, the decision was made to support her thyroid with lifestyle modifications and a few natural supplements while continuing to monitor her symptoms and thyroid levels.
After a few months, Janet’s body had enough time to adapt to HRT, she’d made some positive lifestyle changes, and her symptoms and thyroid levels improved. Her thyroid supplement support was then gradually discontinued.
The Bottom Line
While female hormones tend to steal the symptom spotlight in women over 40, there are equally important hormones whose pleas for help are silenced by the bigger players. If you’re dealing with symptoms that are typically tied to perimenopause and beyond, it doesn’t mean it’s time to stop digging and call it a day.
I’ve worked with many women whose entire symptom menu was blamed on fluctuating female hormones—and thyroid hormone imbalances and thyroid gland problems were totally missed. If your practitioner’s buck stops with your female hormones, it’s time to have an intelligent conversation. And make sure your other hormones—especially thyroid hormone—aren’t being ignored.