How to Recognize Thyroid Disorders in Women

At BionwoRx, we regularly see many people with diagnosed thyroid conditions or discover thyroid issues while working with them. Although we actively treat numerous men with thyroid disorders (especially hyperthyroidism), women make up most of our thyroid patients.

Research shows that women develop thyroid disorders 5 to 10 times more frequently than men.

This gender difference happens partly because many thyroid disorders (like Hashimotos and Graves disease) are autoimmune in nature. Scientists believe autoimmune diseases affect women more often because estrogen and progesterone directly impact the immune system.

Both men and women share many common signs of thyroid dysfunction. However, Women often experience thyroid symptoms differently due to the reciprocal interaction between thyroid hormones and female reproductive hormones. Therefore, the main differences stem from this two-way relationship between thyroid and reproductive hormones in women.

Some of the common symptoms of thyroid dysfunction include:

• Fatigue and weakness persist even after adequate rest
• Weight fluctuates unexpectedly, resulting in gains or losses
• Thyroid disorders impact mood, contributing to depression, anxiety, irritability, or mood swings
• Hair becomes dry and brittle, falls out (including from outer eyebrows), while skin turns dry, pale, or itchy
• Body struggles to tolerate cold temperatures (hypothyroidism) or feels overly warm and sweaty (hyperthyroidism)
• Heart beats irregularly, palpitates, or races unexpectedly
• Thyroid gland enlarges, creating a goitre that causes visible neck swelling and complicates swallowing or breathing

The manifestations of thyroid dysfunction that specifically affect women frequently arise from how thyroid hormones influence menstrual patterns and reproductive capability.

An uncontrolled thyroid condition actively causes stress across the hormonal system, thereby impacting the hormones of the female reproductive system. Both hypothyroidism and hyperthyroidism can trigger the following menstrual changes:

• Heavy menstrual bleeding (menorrhagia): Hypothyroidism primarily leads to prolonged and heavy menstrual periods. This occurs because low thyroid hormone levels actively interfere with the balance of oestrogen and progesterone, consequently causing the uterine lining to build up excessively and resulting in heavier bleeding.
• Light menstrual bleeding: Conversely, hyperthyroidism often creates lighter periods. The high levels of thyroid hormones actively shorten the menstrual cycle and subsequently decrease the amount of menstrual bleeding.
• Irregular periods (oligomenorrhoea): Furthermore, women with thyroid disorders frequently experience irregular menstrual cycles, wherein periods become infrequent, unpredictable, or occur with extended intervals between them.
• Anovulation: Additionally, when a thyroid disorder impacts the menstrual cycle, it actively prevents ovulation (anovulation), which then causes menstrual irregularities and ultimately contributes to infertility.
• Absent periods (amenorrhoea): Moreover, in more severe cases of hypo or hyperthyroidism, periods may stop altogether.
• Shortened luteal phase: Finally, the luteal phase (the time between ovulation and the start of the menstrual period) actively shortens in hyperthyroidism, thus affecting fertility.

It’s worth recognizing that numerous menstrual issues may stem from conditions other than thyroid dysfunction, including polycystic ovarian syndrome, uterine fibroids, or hypothalamic amenorrhoea.

Thyroid disorders (both hypo and hyperthyroidism) directly impact ovulation, which consequently affects fertility and conception ability, because ovulation must occur for conception to happen. Moreover, when left untreated, these disorders disrupt reproductive hormone balance, which then damages the uterine lining quality and possibly egg health, further reducing conception chances.

Pregnancy causes several unique changes in maternal thyroid hormone metabolism, including a decline in body iodine levels. In regions where people lack iodine, this can actively trigger maternal hypothyroidism and goiter. Moreover, women typically have lower median iodine levels than men and face a higher risk of deficiency. However, in parts of the world with enough iodine, these pregnancy changes rarely affect thyroid function. Unfortunately, Americans’ faces iodine deficiency risks because many people now eat fewer iodine-rich foods like seafood and seaweed.

Both hyperthyroidism and hypothyroidism can develop after childbirth due to thyroiditis. Specifically, postpartum thyroiditis represents a temporary form of autoimmune thyroid dysfunction that usually appears within 3 to 6 months after giving birth.

At BionwoRx, we frequently work with women experiencing perimenopause or menopause, and we always consider examining thyroid function based on their symptoms. Because perimenopause brings such significant hormonal changes, it naturally increases the risk of developing thyroid disorders during this time. Importantly, many perimenopause symptoms actually overlap with thyroid disorder indicators.

For instance, symptoms like menstrual irregularities, mood changes, excessive sweating, weight gain, and sleep problems can stem from either fluctuating estrogen and progesterone levels or from an emerging thyroid condition. Therefore, we need to carefully evaluate what’s really causing these challenging symptoms.

Diagnosing a thyroid disorder definitely requires an extensive thyroid panel. Unfortunately, most medical settings only test one thyroid marker, TSH (thyroid stimulating hormone). However, this single marker reveals just part of the thyroid story, and we often can’t detect thyroid dysfunction by examining this one marker alone.

When we suspect the thyroid contributes to a patient’s health concerns, we actively order a comprehensive thyroid panel that includes all other important thyroid markers such as T3, T4, reverse T3, and thyroid antibodies.

Additionally, when we’re looking into menstrual cycle symptoms, we’ll often combine this with a DUTCH test (Dried Urine Test for Comprehensive Hormones) to get a more complete picture.

If you’ve been feeling off lately with symptoms like menstrual cycle changes, unexpected weight shifts, or ongoing fatigue, your thyroid might be trying to tell you something. Thyroid issues commonly affect women and can easily masquerade as other conditions. So please reach out to your healthcare provider to chat about your symptoms and consider getting a thorough thyroid check-up.