Perimenopause or Thyroid? How to Tell the Difference | McCall McPherson

If I'm a 45-year-old woman listening to the show right now and I'm experiencing weight gain and I'm having trouble sleeping or, you know, I've got some brain fog, What clues will help me understand whether it's my thyroid or whether it's hormones?

Yeah.

So I want to look at it in two different ways.

The first is let's kind of talk about symptoms for each, right? I think so many women, some of the most prominent symptoms we have in perimenopause are associated with low progesterone or elevated estrogen, what's called estrogen dominance.

And that's like the classic perimenopause rage.

So anxiety, irritability, agitation, insomnia, kind of swings in our mood and our ability to restore and wake up and feel like ourselves.

And that is most prominently due to lower levels of progesterone.

And those symptoms are honestly pretty segregated from the overlap of thyroid.

Estrogen can be too high.

The exact same symptoms as low progesterone.

Think about it like a seesaw.

We're trying to balance that seesaw.

If your progesterone is too low, the seesaw tips like this.

If your estrogen's too high, the seesaw tips like this.

And so, or both, obviously the same outcome.

Those have to be, and very easily can be fixed.

And in a short time, women in perimenopause can dramatically improve their quality of life.

It's one of the most life-changing things I see in medicine.

Low estrogen, usually in perimenopause, comes sort of in waves, right? Because of our cycles, they're not consistent.

That usually leads to a little hot flash now and then.

Maybe you notice you're waking up at night and you're sweaty.

Vaginal dryness, just kind of discomfort vaginally, pain with intercourse, and maybe some hair and skin changes.

Hair and skin changes might overlap with thyroid, but the rest, again, pretty unique.

The one kind of hormone deficiency that does overlap with thyroid a fair amount is lower levels of testosterone.

And those lead to fatigue, loss of motivation, engagement.