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35 Symptoms of Perimenopause – Hypothyroidism

Posted Apr 28 2010 12:00am

One of the more eye-opening revelations I’ve had in my quest to understand and cope with my hormonal issues has been the link between perimenopause and hypothyroidism.¹

Though I had certainly heard of hypothyroidism, it never occurred to me that I would or even could have issues with it.  I had always associated hypothyroidism with excessive weight gain. Since I have always been a naturally lean person, it didn’t seem like a plausible explanation for any of my symptoms.

Imagine my surprise then, when I did my latest book review on Hormones, Health, and Happiness: A Natural Medical Formula for Redescovering Youth with Bioidentical Hormones , by Dr. Steven F. Hotze, to learn that not only can perimenopause lead to hypothyroidism, but that many of the symptoms that I had previously attributed to perimenopause could very likely be secondary symptoms associated with hypothyroidism. Talk about a double whammy.

What is Hypothyroidism?

The Greek prefix “hypo” means beneath, below or under. When we speak of hypoglycemia for example, we  are speaking of low blood sugar. Medically speaking then, hypothyroidism is a low functioning thyroid gland, producing low or inadequate levels of much needed thyroid hormones.

The thyroid has a relatively simple but enormously important function in our body. Particularly as it relates to energy level and the general quality of physical well being.

The thyroid produces two important hormones, triiodothyronine (T3) and thyroxine (T4).  Though the thyroid produces a higher quantity of T4, it is actually converted to  T3 which is then used to produce energy in our cells.¹

The pituitary gland, located at the base of the brain, monitors the levels of T4 & T3 in our bodies.  If at any time, there is an imbalance or inadequate levels in the bloodstream, the pituary gland responds by secreting another hormone called TSH (thyroid-stimulating hormone). TSH then responds by stimulating the production of thyroid hormones.¹

What are the Symptoms of Hypothyroidism?

The more commonly known symptoms of hypothyroidism are weight gain, low basal body temperature, brittle fingernails with ridging, cold intolerance and cold extremities, like your hands and/or your feet.

However, the list of symptoms that can be associated with hypothyroidism is actually quite long, varied and can include symptoms that most women might attribute to perimenopause, such as: fatigue, muscle and joint pain, menstrual irregularities, hair loss, loss of libido, infertility, weight gain, decreased mental sharpness (brain fog), fluid retention, depression and/or mood swings.

How Does Perimenopause Affect Thyroid Function?

In normal monthly menstrual function, a woman’s estrogen levels rise at the beginning of her cycle in preparation for possible pregnancy. Around mid-cycle, the progesterone levels also rise to prepare for implantation of a fertilized egg. If pregnancy and implantation does not occur, the levels of progesterone will drop dramatically and menstruation occurs.

As women  begin to enter perimenopause the ovaries produce decreasing amounts of progesterone which in turn, leads to estrogen dominance which causes the symptoms of perimenopause such as severe menstrual cramps, heavy periods with clotting, irregular cycles, anxiety, depression, breast tenderness, decreased libido, mood swings, infertility and weight gain, just to name a few.

If that were not enough, the excess estrogen also causes the liver to produce increasing levels of a protein called TBG (thyroid-binding globulin). This protein attaches to the thyroid hormones (T4 & T3) and prevents our cells from absorbing them.

Under normal conditions only .05% of thyroid hormones are circulating in the bloodstream with the rest remaining unavailable to cells in the body.

So, in effect what can happen is that women can not only be dealing the symptoms associated with perimenopause, but also with the excess TBG causing even less of the necessary thyroid hormones to be absorbed by the body.

To compound the problem, blood levels can still show normal ratios of T4 & T3, indicating normal thyroid function.  But the body is still unable to absorb them properly because of the excess estrogen.

Is it any wonder then that women often feel like they are going crazy with their symptoms?  We know we feel awful and exhausted and that something is “just not right’, yet our lab work shows everything to be normal.

What Can We Do About It?

Restoring a healthy balance to our hormones should be our primary goal.  For some of us, like myself, who are closer to actual menopause it is still advisable to restore the natural hormone balance that is lost as we age.

As I have continued to blog, read and learn about perimenopause and maintaining optimum hormonal health, I have come to a very strong conclusion that bio-identical hormones are the healthier choice.

In the short term, women can purchase over-the-counter progesterone creams to use during her monthly cycle to help balance the estrogen dominance that causes so many nasty and debilitating symptoms.

In the long term, however, a medical evaluation which may include blood work, saliva tests and/or other measures of your hormone levels is desirable.  A personalized prescription of  bio-identical hormones compounded just for you is certainly going to help you feel better than a one-size fits all approach.

If there are no physicians in your area that can provide the necessary evaluations to help you get a prescription for bio-identical hormones, you can purchase home tests from Virginia Hopkins Health Watch .  I would strongly advise, however, that you take the time to read about each of tests before you purchase them to make sure you are getting the appropriate one. is also an excellent website to help find physicians in your area who prescribe bio-identical hormones.  Go to the front page of the site and there is a section where you plug in your zip code.  It will give you a list of physicians that are in and around your area.

Finally, be sure and check out .  Dr. Hotze’s site is chock full of great information on perimenopause, bio-identical hormones, more information on hypothyroidism and guidance to help you understand what is happening to your body.

And don’t forget to pick up his book as well if you want to read more about hypothyroidism and perimenopause.  Remember ladies! We don’t have to take this lying down!


¹Hotze, Dr. Steven F. (2005). Hormones, Health & Happiness: A Natural Medical Formula for Rediscovering Youth with Bioidentical Hormones. Houston, Texas: Forrest Publishing.( pp 64 – 82; 100 – 101)

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