How to Tell the Difference Between Thyroid Issues & Menopause

3 minute read

By: Alloy Staff|Last updated: May 10, 2022
Medically reviewed by: Sharon D. Malone

The beginning of menopause can be a confusing time. You’re experiencing symptoms that come seemingly out of nowhere, and you’re trying to figure out what to do about them. It’s natural, but it’s not often fun.

Even more confusing, menopause symptoms aren’t necessarily limited to menopause—your thyroid also produces hormones, and when it’s producing too much or too little you’ll likely have symptoms such as hot flashes and night sweats.

Do those sound familiar? Yep, you’re right. A thyroid disorder can produce the same symptoms as menopause. So how do you figure out which one you’re dealing with? 

Below we’ll discuss both the similarities and differences between thyroid disorders and menopause and how they’re diagnosed and treated.

What Is Menopause?

While every woman experiences menopause uniquely, it is medically defined as the time when a woman has no menstrual cycle for 12 consecutive months. Once a whole year has passed without a period, you are officially in this new stage of life.

Symptoms of Menopause

Once menopause has become part of your life, your body will produce less estrogen. The symptoms of menopause can vary for everyone, and there are a number of things that could happen at any point in your menopause journey. Some of the most common menopause symptoms include:

  • Hot flashes

  • Mood swings

  • Night sweats

  • Weight gain

  • Headaches

  • Painful joints

  • Hair loss

  • Anxiety

  • Fatigue

What Is Your Thyroid?

The thyroid gland is a small organ located in the front of the neck that is responsible for creating and producing thyroxine or thyroid hormone. While it’s not something you often think about, if something goes wrong you’ll know it. Hypothyroidism or hyperthyroidism both throw your hormone levels out of whack and can produce symptoms that mimic those associated with menopause.

What Is Hypothyroidism?

Hypothyroidism is a condition in which the thyroid gland isn’t producing enough thyroid hormone. This causes the metabolism to slow down, resulting in unwanted weight gain, hair loss, skin changes, and menstrual irregularities. Sounds familiar, right? 

Hypothyroidism is relatively common and for the most part is diagnosed in younger women. So a good rule of thumb would be if you’re experiencing these symptoms in your thirties, you are more likely to have a thyroid problem than menopause. But if you’re in your forties or fifties, menopause is the more common culprit. Either way, a simple blood test can distinguish the two. 

Symptoms of Hypothyroidism

Hypothyroidism won’t usually happen all at once, with symptoms developing gradually over time. Some of these symptoms include:

  • Fatigue

  • Weight gain

  • Muscle soreness or weakness

  • Higher than normal cholesterol levels

  • Numbness or tingling in the hands

  • Feelings of depression

  • Feeling more forgetful

  • Decreased sexual interest

What Is Hyperthyroidism?

Just as it’s possible for your thyroid to produce too little thyroid hormone, it can also produce too much. This is known as hyperthyroidism. It is a rarer condition than hypothyroidism, with about 1% of people in the United States being diagnosed with overactive thyroid disease. 

Symptoms of Hyperthyroidism

Hyperthyroidism has many symptoms, but not everyone experiences them all. Some may also experience many symptoms at the same time. The symptoms of hyperthyroidism include:

  • Weight loss

  • Increased appetite

  • Vision changes

  • Heart palpitations

  • Muscle weakness

  • Sleep issues

  • Intolerance to heat

  • Hair loss

  • Diarrhea

What Are the Similarities and Differences Between Thyroid and Menopause Symptoms?

You may be looking at the symptoms of menopause and the symptoms associated with thyroid disorder and think, “How am I supposed to tell the difference?” We get it—they’re very similar and can be difficult to distinguish. When in doubt, just like with underactive thyroid, a simple blood test can distinguish between menopause and overactive thyroid. But eating more and still losing weight is a big clue that it is a thyroid problem and not a menopause issue.

Symptom Overlap

Your ovaries produce estrogen, progesterone, and testosterone and your thyroid produces thyroid hormones.  Although they have some overlap in symptoms, they are biologically distinct hormones with different functions within the body.  When in doubt, see your doctor and an accurate diagnosis can be made relatively quickly with some simple blood tests.  It’s important to distinguish between them because the treatment for each hormone deficiency or overactivity is different.

Hot Flashes

Hot flashes are one of the most common symptoms of menopause.  Estrogen and thyroid hormones both affect the area of the brain responsible for temperature regulation.  Hot flashes are linked to low estrogen hormone levels (menopause), but hot flashes triggered by the thyroid are associated with very high thyroid hormone levels (hyperthyroid). Low thyroid levels (hypothyroid) are associated with feeling cold, not hot. So it is possible not only for different hormones to affect the same organ differently, but also for the hormones to affect the same organ in different directions.

Weight Gain

As we age, our metabolism naturally slows and muscle mass begins to decrease. When combined with the hormone changes of menopause and the thyroid, some women may experience increased weight gain over time. This is completely normal either way and can be managed with a more balanced diet and regular exercise.

Irregular Periods

Inconsistent cycles, heavy bleeding, light bleeding, and occasional spotting can be symptoms of perimenopause and thyroid problems. The hormones estrogen and progesterone are responsible for regulating your period when you are premenopausal. When hormone levels change due to either perimenopause (the time leading up to menopause) or thyroid complications, it can turn your anticipated monthly menstrual cycle into a frustrating waiting game or a debilitating flood.


Being a little tired at the end of the day is one thing, but feeling constantly fatigued is another beast entirely. While healthy sleep habits are an effective way to fight exhaustion, there’s only so much you can do when your hormones are keeping you from getting a good night’s rest. Menopause and an irregular thyroid can cause insomnia, which leaves you feeling fatigued.


Speaking of insomnia, menopause and a faulty thyroid can make falling and staying asleep much more difficult. This can turn once restful nights into a fight with the mattress. Overactive thyroid mimics anxiety symptoms–nervousness, restlessness, and difficulty sleeping.  Unfortunately, no amount of readjusting your position or sleeping on the cold side of the pillow can fix these problems when hormone irregularities are the culprits. Hormonal issues need hormonal solutions.

Symptoms Unique to Menopause 

No one really wants to experience many of menopause’s symptoms, but if the state of your thyroid is any concern, there are symptoms unique to menopause that should give you some relief about any further medical issues.

Vaginal Dryness

As estrogen declines during menopause, the natural lubrication of your vagina may begin to decrease, and the tissue that lines the vaginal walls can start to thin. This can be a completely normal, but unpleasant, symptom of menopause. Context matters. Vaginal dryness coupled with hot flashes usually spells perimenopause or menopause not a thyroid problem.   

Painful Intercourse

On the same note, because menopause can cause vaginal dryness, it can lead to painful intercourse as well. The increased sensitivity and loss of lubrication can make even the slightest friction feel highly uncomfortable, and although the thyroid hormones have a wide-reaching effect, menopause more specifically affects estrogen and its ability to keep skin smooth and elastic.

Mood Swings

As the name suggests, mood swings are rapid changes in mood that can come unexpectedly. Something might suddenly make you inexplicably angry, or you’ll find yourself bawling your eyes out for no reason. This is caused by fluctuations in estrogen similar to puberty, just in reverse, and it’s rarely associated with a thyroid issue.

Bone Density Decrease

Just as the loss of muscle mass is normal as we age, loss of bone mass can happen as well. Menopause can also contribute to this loss in bone density, and in some cases can lead to osteoporosis. Because a greater loss of bone density will often happen within the first few years after your final menstrual period, it’s a better indication of menopause than a thyroid issue.

How Your Doctor Can Tell Whether It’s Your Thyroid or Menopause

If you want to stop playing the guessing game between your thyroid and menopause, seeking the help of your doctor can help you get the answers you need. All your doctor needs to do is conduct a simple blood test to see if your hormone levels are normal.  If they are, then you’ve likely started your menopause journey.

If You Suspect You’re in Menopause, Alloy Can Help

If your doctor has ruled out a thyroid disorder, it’s likely that you’ve entered menopause. We’re here to help. Alloy’s menopause-trained doctors are experts in identifying and treating menopause symptoms so that you can rebalance your hormones and find relief.

If you’re experiencing menopause symptoms and need a helping hand through this rite of passage, trust Alloy to create a menopause hormone therapy plan that will help deliver the peace of mind you deserve. We make it easy—just take our quiz or choose a product, complete our medical intake form, and start a conversation with our doctor.

Menopause, above all else, is a journey. We’re here to make that journey as simple as possible.


“Hypothyroidism.” Cleveland Clinic.

“You Think It’s Menopause, but Could It Be Your Thyroid?” Cleveland Clinic.

Written by:

Alloy Staff

Who is Alloy? Alloy exists to help women age healthfully and feel like their best selves. We approach women’s health with radical honesty. We fuse together powerful medical expertise, science backed treatments, and the support of a community that knows how you feel. We don’t just get you - we are you.

Medically reviewed by:

Sharon D. Malone

Dr. Sharon Malone is among the nation’s leading obstetrician / gynecologists with a focus on the specific health challenges associated with menopause.