Menstrual Problems and Thyroid Disease

The Effects of Hypothyroidism and Hyperthyroidism on Menstruation

by Mary Shomon

Many menstrual problems may be symptoms of undiagnosed thyroid conditions. Girls who have either very early or very late menstruation should be evaluated for a potential thyroid problem, as thyroid problems can frequently be a cause of early or delayed puberty and menstruation. In addition, any change in menstrual patterns – such as more or less frequent periods, the onset of substantially heavier or lighter periods, or the lack of periods entirely, should trigger a thyroid evaluation by your physician.

Thyroid disease is frequently the reason behind problems with a woman’s menstrual cycle.

The linkage between thyroid disease and the menstrual cycle is not well understood by medical professionals, but there are some established linkages between menstruation and thyroid disease that are well-established.

Early Menstruation / Precocious Puberty: Hypothyroidism in girls may trigger very early menstruation, i.e., before the age of 10. This early puberty is known as “precocious puberty.” Occasionally, if hyperthyroidism occurs very early during puberty, menstrual periods may also begin earlier than usual.

Late Menstruation / Delayed Puberty: Hyperthyroidism in a teenage girl can delay the onset of puberty and onset of menstruation into the mid-teens, in some cases after the age of 15.

Lighter Periods: Lighter than normal periods are frequently associated with hyperthyroidism.

Infrequent or Sporadic Periods: Infrequent or sporadic periods are frequently associated with hyperthyroidism.

Absent Periods / Amenorrhea: Hyperthyroidism can cause menstruation to stop for longer periods, a condition known as amenorrhea.

Heavy Periods / Menorrhagia: Menorrhagia is defined as excessively heavy or prolonged menstrual bleeding, for example, soaking through pad every hour for several hours. Hypothyroidism is associated with menorrhagia.

More Frequent, Longer Periods: Hypothyroidism is known to cause periods to come more frequently – for example, some women will find their 28 day cycle shortens to a 25 day cycle, and their normally 5-day long menses lasts 6 or 7 days.

Painful Menstruation, Dysmenorrhea: Hypothyroidism is associated with painful menstrual periods, known as dysmenorrhea. Dysmenorrhea can include an achy or stabbing low backache, nausea, leg aches, feelings of fullness, headaches, and bowel disturbances.

When to See the Doctor

You should see the doctor:

If heavy bleeding lasts for over 24 hours
If your period regularly lasts more than seven days
If periods are coming less than 21 days apart
If periods have stopped for more than three months
If periods are accompanied by much greater level of pain than usual
Key Steps

Even when considered treated for hypothyroidism or hyperthyroidism, some women still report that menstrual symptoms continue.

If you are hypothyroid, be sure that you are optimally treated, as symptoms such as menstrual problems may persist if you are not at the optimal TSH and on the proper thyroid drug for you.

If you are hyperthyroid and taking antithyroid drugs, find out your TSH level, as too low a TSH level may be triggering menstrual-related symptoms.

Women who are having menstrual irregularities should have their doctor conduct a thorough hormonal evaluation at several points in their cycle, looking at estrogen, progesterone, follicle stimulating hormone, and luteinizing hormone levels, among others, to evaluate whether the hormonal cycle is normal. Significant irregularities in hormonal levels may warrant hormone treatment, or may warrant further evaluation and diagnosis.

In the absence of any particular medical diagnosis behind the menstrual irregularities, there are some alternatives that might be pursued. (Please note: It’s always best when herbal remedies and supplements are pursued under the guidance of a trained herbalist, naturopath or nutritionist.)

Calcium supplementation is known to help reduce painful menstruation.
Some women with extremely heavy periods, can benefit from iron supplementation during the menstrual period. A typical dosage may be approximately 100 mg of iron per day. Note: if you are on thyroid hormone replacement, allow for at least 4 hours between taking thyroid hormone and iron.
Some herbs may help bring on a delayed menstrual period, including parsley, ginger, yarrow, sage, and feverfew.
Some herbs that are thought to help with painful menstruation include chamomile, red raspberry, lemon balm, red clover, catnip, and comfrey root.