35 Symptoms of Perimenopause – Hypothyroidism

by Magnolia on April 28, 2010

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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.

What Role Does the Thyroid Play in the Body?

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.

Bodylogic.com 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 Drhotze.com.  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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{ 21 comments… read them below or add one }

Terri Coburn April 29, 2010 at 5:09 pm

As always Magnolia, a great blog post! Thank you for writing about this important subject. :)


Tara June 11, 2010 at 5:26 pm


Have you ever known of anyone to have symptoms of this nature. This past week I started my period with the most horrible headache that I have ever had. I was in bed for 4 days, I could not do anything and nothing gave me relief. My stomach is so bloated I can hardly breath and I feel so weak as if I have the flu or something. I know I don’t have a virus or flu. Have you ever known of anyone during perimenopause to be so weak that they have to keep lying down after doing a few minutes of anything. I also feel almost nausiated from my stomach being so bloated. My headache is finally gone as is my period. But I am just so weak and nasal cavity is sore from the hormonal headache. Are these symptoms of perimenopause. I have felt like I wanted to die for the past 4 days.



Magnolia June 11, 2010 at 6:07 pm

Hello Tara,

Sure. Everything you’ve described is highly possible with perimenopause. But, here’s the thing……you could be having a variety of different things going on. It could be hormonal imbalance of estrogen/progesterone (which is primarily what we think of when we are talking perimenopause)

You could also be having issues with your thyroid which, along with perimenopause, can make you feel extremely weak. Crashing fatigue is the term that is often used.

Nausea is not uncommon either. In fact, I remember flying into a rage during one of my more intense perimenopause moments and I broke out into a sweat, my heart started racing, I was gasping for breath, I was dizzy AND nauseated. I thought I was going to throw up.

So, yes, dear. All of the above can most definitely be due to perimenopause. Have you seen a physician? I don’t remember if you have told if you have or not.



Tara June 12, 2010 at 12:04 am

No, I have not seen a doctor yet. I finally found a doctor in my town that specializes in hormones and bioidentical hormone treatments. My appointment is on Monday, I’ve just had to wait to get in. I can’t wait to go to this doctor and dicuss all of these things that have been going on with me. But in the meantime, you have no idea how much it means to have someone to ask questions to and to just have someone reasure you that you are really feeling these things, until I can get to a Dr. Thank you so much for being there for all of us.



Magnolia June 12, 2010 at 7:57 am

Hi Tara,

Excellent. I hope things go well with you and your physician. The one thing I would like to say (and it is advice I didn’t take for myself but now wish that I did) is, remember it will take some time before you feel better.

There are no magic, quick fixes when our hormones are out of whack. Taking the time that you need is important to feeling better. Whatever your doctor decides to do, will take a couple or maybe three or four months before everything evens out and you actually begin to notice a difference in how you feel.

And finally, remember that “this too shall pass”. When I was in the thick of my perimenopause symptoms, my whole world was crashing down around me and I felt like it would NEVER end or I would NEVER feel better.

Now, almost all of my symptoms are gone. I still have the occasional hot flash and night sweat, but the crazy, raging mood swings are gone. the deep dark depression is gone. The heart palpitations, vertigo, insomnia is gone. The only thing I’ve had a problem with are heavy, flooding, gushing periods.

But, since I started using the Oasis Serene Plus progesterone, that has stopped too.

So, I want you to realize and keep telling yourself, that this is NOT forever. There really is light at the end of the tunnel. You just have to hang on and do everything you can to help yourself.

And always feel free to come by here and vent and dump your emotions, frustrations or whatever.

This is a judgment free zone. Any and all things said here will be heard with a supportive and helpful ear. Promise. :)



Jeanne July 11, 2010 at 8:58 am


Thank you for sharing your experiences – your blog is encouraging. Few sites actually focus on perimenopause after the age of 50. I also checked out your blog at the Wellsphere site and I read that you are from Bellbrook, OH – are you aware of any perimenopause or menopause “support groups” in the Dayton, OH area? It seems human interaction is especially healing and much needed during this time in our lives. Thanks being a support for women.


Magnolia July 11, 2010 at 9:06 am

Hello Jeanne,

Thanks for stopping by. No, I haven’t checked out any support groups. I tend not to be a support group kind of person, though I do agree that interacting with others and sharing your experiences certainly helps in coping with whatever may be our issue.

I guess that’s why I blog. It’s my way of coping with my own issues and symptoms while hopefully providing something that is also helpful for others. While I do not see myself as a caregiver or provider to others so much, I am a very compassionate person who likes to reach out to others. (hmmm, maybe I’m more of a caregiver than I think I am)

Thanks for stopping by my blog and please do come back.



peggy September 28, 2010 at 5:39 am

please help answer some questions . i have been having severe anxiety ,numbness and tingling all over my body . mild agoraphobia ,dizziness ,headaches ,feeling a little confused ,and feeling like i could just scream out and cry . i have had these problems since i had my tubes tied 20yrs ago ,but since i turned 40 it is only getting worse . my doctor says i might be perimenopausal but didnt do any test to make sure and has offered no type of medicine for my problems . does it sound like peri to you ,or am i losing my mind slowly ? please i need advice


peggy September 28, 2010 at 5:40 am

btw i am 46 now


Magnolia September 28, 2010 at 7:25 pm

Hello Peggy,

I’m sorry I’m so slow getting back to you. Deadlines, deadlines, deadlines. :)

When you had your tubes tied 20 years ago, did you begin any kind of hormone therapy? I’ve done a little reading on tubal ligation and some women have problems.

You can check out an article here at Web MD for more information if you would like to read about it.


But, speaking simply to the symptoms you are having, I would say “yes”, it does sound hormone related. Especially if things are getting worse as you get older.

I would highly recommend you find another physician if you are not feeling comfortable with the medical advice (or lack thereof) you are getting with your current physician.

Remember, you have to take charge of your health. If you do not feel you are being heard, please find someone who you feel WILL listen to you.

Feel free to ask anymore questions.



Vivian Franklin February 15, 2011 at 10:24 pm

The “fuzzy thinking” is driving me crazy!!!!!!!!!!! I am back in school at age 53 and it is sooooo frustrating. I have a history of breast cancer 13 years ago so my doctor does not want me to take any type of hormone therapy. Do you know of any alternatives?


Magnolia February 16, 2011 at 8:30 am


Can I recommend that you visit the websites of Dr. Steven F. Hotze and Dr. Erika Schwartz? Both are physicians trained in menopause/perimenopause issues. They may be able to give you some good advice. their websites are excellent resources for many issues. You might gain some insight there.


Thanks for stopping by. If I can do anything else for you, please let me know.



gardengirl November 21, 2011 at 11:20 pm

My 2nd night on this blog and now I find out Hypothyroidism can be related to perimanopause also! Why doesn’t the OBGYN give us a guidebook to prepare us for all this crap that happens to us! I kept thinking these were “aging” symptoms since my Thyroid tests just came back abnormally low for the 1st time ever. This blog has given me more information than I’ve gotten anywhere else! Thank you so much for taking the time to inform us!


Magnolia November 22, 2011 at 6:20 am

Well, Gardengirl,

Your comment makes me want to keep on blogging. That’s exactly what I decided to talk about this. And you ask a good question….”Why are they not giving us the information?”

And I love the idea of a guidebook. You have just given me a light bulb idea for a book. I hope you don’t mind if I steal your phrase as part of the title. :)

Please come back often. After the holidays, I will be more active.



Gille April 25, 2014 at 1:07 pm

Sorry to bring up an old post but I just saw this while researching peri and hypothyroidism. This may seem like an obvious question but how do I know which is the issue?
My doctor suspected perimenopause due to cycle changes (shorter and not as heavy, my cramps have gotten that much worse) but my hormone levels are back and it shows my TSH has jumped from 1.9 last month to 3.7 this month though my T4 is fine. How do I know if it’s just my thyroid acting up and not peri? Should I seek out bio identical meds and then wait and see? My mother went into menopause in her 40s. I just turned 28. I have another week before my consultation but I’m trying to put together questions to ask her so I know what to do.
Thank you Magnolia.


Gille April 25, 2014 at 1:09 pm

I forgot to mention that my estrogen was a little elevated as well.


tania love July 9, 2014 at 6:40 pm

Hello, I am tania love. I am 54 .I have not had a peroid for over a year and a half.I have cold feet,heart papitations memory problems and fuzzt thinking. MY doctor said my number for my throid test was funny, but will check it again in a couple of months.I can go for a while without the papitations then they come back help.I had surgery a year ago and my heart was check out. so i dont know.


donna August 17, 2014 at 7:17 pm

Hello magnolia three months ago I was diagnosed with a under active thyroid I dealt with the symptoms a about a year before going to the doctor. My question is do you think this could cause one leg and foot to swell. I have mentioned it to my doctor a couple of times because I am still having to go back on a monthly bases till my thyroid gets regulated. He doesn’t seemed concerned I mention to him I hope its not a blood clot all he said was I would have some discomfort if I did. I do not have any discomfort he says maybe its due to my thyroid.


Teresa May 31, 2015 at 11:51 am

Hello. Back in 1995…I was diagnosed with premature ovarian failure. The Dr said it was caused by my thyroid antibodies gor really high. I was only 34 years old. They check my thyroid every year and say it’s normal. The articles I’ve read say the antibodies can cause the thyroid to become sluggish and even damage it. My question is are the tests always accurate? I’ve got other symptoms that make me think it could be my thyroid.


Michelle July 5, 2015 at 4:39 pm

Reading this blog just brought me to tears!! I have been having a horrible time with my health for the last 3 or more years. I have been having increased palpitations, wooziness, headaches, strange body sensations, hair loss and the list goes on. I have gone farad to have an MRI thinking that I must have a tumor and am dying, as some days I’m convinced that I am dying!! I have had countless vials of blood drawn and thyroid tests showing everything to be completely normal. I’m told I’m extremely healthy, but I don’t feel it! My dr did diagnose me with Anxiety, I have terrible mood swings and feel like someone else!
I finally was referred by a friend to a kinesiologist who immediately told me that my symptoms are all from hidden Hypothyroidism and that my adrenals are shot! Who would have thought, I finally have an answer.
I have been taking whole food thyroid and adrenal supplements and calcium for the palpitations. There I days when I feel amazing and like my old self but others where my palpitations throw me into sheer panic. I know I am getting better and hat it might be a long process, but I know that I’m finally on the right path to feeling normal again!


Athena Middleton July 22, 2015 at 11:25 am

I love this site. Some very interesting articles.

I will be 54 this year and still have my period in full blast (usually 5-6 days with clots sometimes) and starting to hate it. Most of my friends my age are done.
My concern though is that I was diagnosed with a kind of Hypothyroidism. my weight is consistent so no issues there. But in reading the symptoms here, I found that I have majority of it listed. I have been feeling so much anxiety and tired. Heart is pumping like crazy and i can’t walk up 5 steps without feeling very tired after. Is there some over the counter meds I could purchase now. Doctor’s appointment is not till the 11th of August.


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