Thyroid vs menopause – how to spot the difference

 

As you reach a certain stage of life, it isn’t uncommon to start noticing changes that can affect your mood, weight, or energy levels. But what could they signal? Are these changes the first signs of perimenopause or is something else going on? 

From reduced sex drive to difficulty sleeping, many of the symptoms of menopause and thyroid conditions can overlap and affect your mental and physical health. So, there’s no wonder that symptoms of a thyroid condition can be incorrectly put down to menopause (or even stress).  

If you're edging towards your fabulous 40s or 50s, or have surpassed the sweet 60s, let’s look at how to spot the signs of a thyroid condition, menopause, or perimenopause.  

In this blog, we discuss:   

• What are menopause and perimenopause?
• Can menopause symptoms be mistaken for a thyroid condition?
• What are the main symptoms of a thyroid condition?
• How do the symptoms of a thyroid condition and menopause overlap?
• Is there a link between menopause and a thyroid condition?
• How to tell the difference between a thyroid condition and menopause
• Can you take HRT if you have a thyroid condition?
• Where to get support

What are menopause and perimenopause?

 

Menopause is when your periods stop due to lower hormone levels, while perimenopause (meaning around menopause) is the transition period before you reach menopause. 

You’re likely to go through menopause between 45 and 55 years old, but it can happen earlier, either naturally or due to other reasons like having a hysterectomy. Perimenopause can start up to ten years before you go through menopause. 

A menopause diagnosis is made once you haven’t had a period for more than 12 consecutive months.  

The first signs of perimenopause include: 

• Irregular periods 
• Hot flushes and sleep problems 
• Mood changes 

For more information, read our article explaining all you need to know about perimenopause. 

Can menopause symptoms be mistaken for a thyroid condition?

 

Yes, it’s not uncommon for menopause symptoms to be confused with those of a thyroid condition because some symptoms of an underactive or overactive thyroid are like those during the transition to menopause.  

Read our article for a detailed guide to menopausal symptoms.

To make it even more confusing, a thyroid condition may not develop until you’ve hit menopause [2] as thyroid conditions are more common in women over the age of 60 [3]. 

What are the main symptoms of a thyroid condition?

 

There are two types of thyroid conditions – hyperthyroidism (overactive thyroid) and hypothyroidism (an underactive thyroid).  

Your thyroid hormones are vital for your [4]:  

• Metabolism   
• Growth   
• Development 

Underactive and overactive thyroid conditions can display different symptoms. However, there are common signs and symptoms that overlap between the two.  

Common signs of both hyperthyroidism and hypothyroidism include [5], [6]:   

• Tiredness  
• Loss of libido   
• Mental health conditions, such as depression and mood swings   
• Difficulty sleeping  
• Muscle aches and weakness  
• Irregular periods  

How do the symptoms of a thyroid condition and menopause overlap?

 

Some symptoms of a thyroid condition and menopause may present in similar ways. It’s quite common for women going through menopause to experience changes in body temperature (such as hot flushes and night sweats), changes in energy, or feel fatigued. And it wouldn’t be uncommon for someone with a thyroid condition to feel tired all the time or experience changes in body temperature (feeling hot or cold when everyone else is comfortable).   

This table shows how the symptoms of a thyroid condition and menopause overlap.  

Is there a link between menopause and a thyroid condition?

 

Perimenopausal and postmenopausal women are at increased risk of developing a thyroid condition, but there’s no straightforward evidence to suggest that menopause can cause a thyroid condition or vice versa [7].  

However, there's some evidence to suggest that symptoms of menopause can be worse if you have a thyroid condition [7]. If that applies to you, managing and treating your thyroid condition may help to manage menopausal symptoms [8].   

How to tell the difference between a thyroid condition and menopause

 

There's only one way to distinguish a thyroid condition from menopause with any certainty, and that’s through a blood test.  

To help detect a thyroid condition, you need to test your thyroid hormones.  

Thyroid hormone biomarkers include:  

• TSH  
• T4   
• T3 (though this is not routinely tested for)  

With our Advanced Thyroid Function Blood Test, you can take a detailed look at your thyroid function, including antibodies and thyroid nutrition. This can help you to investigate several causes of thyroid-related symptoms.  

While there's no specific test to diagnose menopause, you can check certain hormonal biomarkers alongside your symptoms.  

Menopausal test biomarkers include: 

• Oestradiol  
• FSH  
• LH  

With our Menopause Blood Test, you can test for all the above female hormone biomarkers plus the main thyroid function markers. Our doctors will interpret your results alongside your medical information and any symptoms you’re experiencing to let you know the best next steps. 

The latest guidance from European Menopause and Andropause Society (EMAS) continues to highlight that thyroid problems and menopause can overlap significantly in symptoms and notes that this overlap can make diagnosis challenging. It recommends a personalised approach when assessing women in midlife. It also highlights that biotin supplements, often taken for hair and nails, can interfere with some thyroid blood tests, so it is worth mentioning any supplements before testing [10].

Can you take HRT if you have a thyroid condition?

 

In most cases, you can still take hormone replacement therapy (HRT) if you have a thyroid condition, but it is worth knowing that oral oestrogen tablets can affect thyroid hormone levels in the blood and may mean your medication needs reviewing. By contrast, transdermal HRT such as patches, gels, or sprays is less likely to affect thyroid treatment in the same way. If you have hypothyroidism and start or change HRT, it is sensible to have your thyroid function monitored so any medication adjustment can be made if needed [9].

Women with thyroid problems can still benefit from menopause treatment, but the best approach is an individual one based on symptoms, test results, and the type of HRT used.

Where to get support

 

If you're over 50, your doctor may diagnose you with menopause without any further testing. However, if you suspect a thyroid condition is the cause of your symptoms, you may need further investigation. 

Have a look through our Thyroid Blood Test buying guide, thyroid guide, or at our Menopause Blood Test.  

We also recognise that sometimes you may just need a friendly chat or support from others, so we have listed a few organisations below that are here to help.  

Thyroid support  

• Thyroid UK – Thyroid UK has a fantastic online community and information for everyone, including undiagnosed people.  
• British Thyroid Foundation – The BTF have a whole area for support that includes patient stories, forums, and a list of support groups and telephone contacts.  

Menopause support   

• My Menopause Centre - Offers expert, evidence-based support to help women understand their symptoms, explore treatment options, and find an approach that feels right for them. 
• The Menopause Charity – Their website is full of information on HRT (hormone replacement therapy), menopause, and how to manage symptoms. There's also a community section that shares others' individual experiences.  
• The British Menopause Society – Offers support to anyone going through either perimenopause or menopause. You can find an NHS or private menopause specialist through the British Menopause Society website.

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  References 

1. Patil N, Rehman A, Jialal I. Hypothyroidism. In: StatPearls [Internet]. StatPearls Publishing; 2020. Updated August 10, 2020. (Accessed 24 March 2026)   
2. Cleveland Clinic. 2022. Thyroid Disease: Causes, Symptoms, Risk Factors, Testing & Treatment. [online] (Accessed 24 March 2026).   
3. Gietka-Czernel, M., 2017. The thyroid gland in postmenopausal women: physiology and diseases. Menopausal Review.  
4. InformedHealth.org. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. How does the thyroid gland work? (Accessed 24 March 2026)
5. nhs.uk. 2022. Underactive thyroid (hypothyroidism) - Symptoms. [online] [Accessed 24 March 2026]. 
6. nhs.uk. 2022. Overactive thyroid (hyperthyroidism) - Symptoms. [online] [Accessed 24 March 2026]. 
7. Lu, Y., Li, J., & Li, J. (2016). Estrogen and thyroid diseases: an update. Minerva medica, 107(4), 239–244.
8. Santin, A. and Furlanetto, T., 2011. Role of Estrogen in Thyroid Function and Growth Regulation. Journal of Thyroid Research.
9. British Thyroid Foundation. 2022. Thyroid and menopause. [online] [Accessed24 March 2026]. 
10. Mintziori, G., Veneti, S., Poppe, K., Goulis, D.G., Armeni, E., Erel, C.T., Fistonić, I., Hillard, T., Lindén Hirschberg, A., Meczekalski, B., Mendoza, N., Mueck, A.O., Simoncini, T., Stute, P., van Dijken, D., Rees, M., Duntas, L. and Lambrinoudaki, I. (2024) ‘EMAS position statement: Thyroid disease and menopause’, Maturitas. (Accessed 24 March 2026)