August 4, 2011
When you are experiencing menstrual irregularities, you may not need to look any further than your thyroid for the cause. Some studies have reported that as many as three out of four women with thyroid conditions have some form of menstrual problem – a rate that is two to three times higher than for women without thyroid problems.
Here is an overview of some of the menstrual problems that can affect you if you’re hypothyroid.
Many women experience premenstrual syndrome – also known as PMS – but thyroid patients are at a greater risk, and often experience more intense or debilitating symptoms. PMS is typically related to the hormonal changes that take place in the week to 10 days before your period starts. Some common PMS symptoms include:
* bloating, fluid retention
* breast tenderness
* fatigue
* insomnia
* headaches
* cramps
* food cravings
* tension, irritability
* anxiety, depression
* trouble concentrating
Dysmenorrhea is the medical term for painful periods. Primary dysmenorrhea means that there’s pain, but no traceable reason. Secondary dysmenorrhea is painful periods, but with a physical cause, such as endometriosis. The main sign of dysmenorrhea is cramps. Severe dysmenorrhea, which affects 1 in 10 women, and appears to be more common in thyroid patients, can include nausea, vomiting, dizziness and diarrhea. Typically, dysmenorrhea begins in the several hours before the period starts, and lasts no more than around 3 days.
Oligomenorrhea refers to cycles that are repeatedly longer than 35 days — or only 4 to 9 periods per year.
Polymenorrhea refers to repeated cycles of less than 21 days, or menstruation at 2 to 3-week intervals.
Metrorrhagia refers to bleeding at irregular intervals, such as between menstrual periods. Metrorrhagia can range from light spotting, to continuous bleeding for weeks. While occasional spotting in women is not unusual, frequent metrorrhagia needs evaluation, and it should always be evaluated in pre-pubescent girls, women who are post-menopausal and not on hormone therapy, and women who have had a hysterectomy.
Menorrhagia refers to a very heavy or excessive period. Excessive means soaking through at least a pad or tampon an hour for several consecutive hours. Sometimes the term hypermenorrhea is used, and it refers to a more than 20% increase in the heaviness of the menstrual flow. Women with menorrhagia also frequently pass large blood clots, and may have excessive tiredness, fatigue or shortness of breath that could point to anemia due to excessive blood loss.
Evaluation of menstrual problems requires a multi-step evaluation by your doctor. Your doctor should take a complete medical history, focusing particularly on your personal and family reproductive history, your menstrual cycle, as well as thyroid and hormonal history.
A complete physical examination should look for obvious thyroid signs, including goiter or neck enlargement, swelling in hands, feet and face, hair loss (especially the outer edge of the eyebrows), and slowed reflexes.
The examination is also likely to include a pelvic exam, to look for evidence of structural or anatomic abnormalities, inflammation, polyps, cysts, tumors, infection, or other gynecologic conditions. Typically, a Pap test, and (if pre-menopausal), a pregnancy test, are also done. Your doctor will want to rule out structural, viral and other potential causes of menstrual irregularities.
The doctor should also consider other symptoms and issues that you might have, including:
* breast discharge
* hot flashes
* facial hair
* headaches
* vision problems
* recent gynecologic procedures
* weight, diet or exercise changes
Finally, blood and/or saliva tests to evaluate various hormone levels – including thyroid, estrogen, FSH, LH, and prolactin — may be run.
Because hypothyroidism is so often the culprit when it comes to irregular or problematic periods, it’s essential that your doctor know how to diagnose and effectively treat an underactive thyroid. For some women, simply getting properly diagnosed and optimal treatment for the thyroid problem – often for the first time in their lives – will restore their menstrual cycles and flow levels to a more normal pattern!
If undiagnosed or undertreated thyroid problems are not at the root of your menstrual irregularities, or thyroid treatment fails to normalize your menstrual cycles and resolve problems, your doctor’s next steps will be to perform additional tests. In some cases, doctors order imaging tests such as ultrasound, MRI or CT scans, to help pinpoint the cause. Ultimately, your doctor should be able to recommend an effective treatment plan for you.
(June 2006)
Mary Shomon is an internationally-known thyroid patient advocate, and is author of a number of best-selling health books, including Living Well With Hypothyroidism and The Thyroid Diet. Since 1997, she has run the Internet’s most popular thyroid patient sites: About.com Thyroid Site and Thyroid-Info.com.
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Missed period 8mnths no sexually contact ,no any other pain weight gain
Missed period 9-10 months nosexual contact weight gain ,no other pain having hypothyroidism what to do
Dear Veronica,
Thank you for reaching out to us. Our doctors are experts at diagnosing and treating hypothyroidism. Please contact our Wellness Consultants for a complimentary wellness consultation at 281-698-8698. We will be happy to help you!
To your health,
Hotze Team
I’ve been suffering from irregular periods since I was 10. I bleed for more than 10 days at a time, and have needed a transfusion after bleeding for almost 4 months. I had been put on Levothyroxine (50mcg), and instantly started bleeding like I never had before. I was on 90mg Armour thyroid during my last pregnancy, and once my child was born, my medication was reduced by my doctor. My body started back in with the heavy (pad+ per hour) bleeding, and my doctor simply put her head in her hands, said I was giving her a headache, and told me to see a naturopath. I’m at a loss as to what to do. I increased Armour, but now my hair is falling out AND I’m still bleeding. Is a hysterectomy my only option? Would a naturopath be able to help? I did have thyroid antibodies show up in my bloodwork, and my right side (thyroid) is swollen.
Any words of advice?
Dear Michelle,
We are so sorry to hear what you have been going through. Hypothyroidism can be a cause of irregular periods, as well as low progesterone. If you are still having hypothyroid symptoms, then you are not on the right dose of thyroid for your body’s needs. No, a hysterectomy is not your only option. You need to get your hormones balanced and get your body back on track.
Levothyroxine, or Synthroid, is synthetic thyroid that only contains T4, the inactive thyroid hormone, so your body has to be able to convert it to T3, the active thyroid hormone, in order to be effective. Desiccated thyroid, which is identical to the thyroid hormones made by our body, contains both T4 and T3. We find that people on Synthroid usually still have symptoms of hypothyroidism and it is not as effective. We’ve had great success in treating patients with desiccated thyroid.
Here is an article on why desiccated thyroid is more effective than Synthroid: http://makeshift-worm.flywheelsites.com/2017/03/synthroid-was-supposed-to-stop-my-hypothyroid-sym/
Please contact our wellness consultants for a complimentary consultation at 281-698-8698. Please don’t lose hope. We will be happy to help you get your health back.
To your health,
Hotze Team
I struggle so bad with my periods and have for years. My synthroid doesn’t seem to help it at all.
Sometimes I will go for months without bleeding. Sometimes I bleed for several months and during these months pass numerous and very large blood clots. Also there have been times that my cramps were so bad I almost went to the hospital.
Dear Angie,
We are so sorry to hear about your painful, irregular periods. We find that many patients still have symptoms of hypothyroidism while taking Synthroid, because it is only the inactive form of the thyroid hormone, T4. If your body can’t convert it to T3, the active thyroid hormone, then it won’t resolve your symptoms.
Here is a great article and video by our doctors on why Synthroid isn’t the best treatment for low thyroid function. We have had great success with desiccated thyroid, which has both T3 and T4:
http://makeshift-worm.flywheelsites.com/2018/01/synthroid-was-supposed-to-stop-my-hypothyroidism-symptoms/
A progesterone deficiency/estrogen dominant scenario can also cause irregular periods. Here is an article that explains the connection: http://makeshift-worm.flywheelsites.com/2017/07/causes-of-irregular-periods/
Our symptom checker quiz can be helpful in identifying the possible causes of your symptoms:http://makeshift-worm.flywheelsites.com/symptom-checker/
If we may be of service to you, please contact our wellness consultants for a complimentary wellness consultation at 281-698-8698.
To your health,
Hotze Team
Dear Angie,
We are so sorry to hear about your struggle with your menstrual cycle. One thing we would recommend is that you talk with your doctor about switching to desiccated thyroid. We find that Synthroid is not effective – is it synthetic thyroid that only contains T4, the inactive thyroid hormone. If your cells can’t convert it to T3, the active thyroid hormone, then you will still experience symptoms of hypothyroidism. Please read this article and watch the video of our doctors as they explain this: http://makeshift-worm.flywheelsites.com/2016/01/myth-synthroid-is-the-best-treatment-for-hypothyroidism/
A progesterone deficiency can also contribute to problems with your menstrual cycle. Please take our symptom checker quiz to find out what other symptoms you have that can be caused by a hormone imbalance: http://makeshift-worm.flywheelsites.com/symptom-checker/
If we may be of service to you, please contact our wellness consultants for a complimentary wellness consultation at 281-698-8698. We will be happy to help.
To your health,
Hotze Team
Dear Hotze Team, I attempted to complete the symptom checker quiz at the website http://makeshift-worm.flywheelsites.com/symptom-checker/, but I received an error a the end. I resubmitted my answers three separate ties, and received the same error stating, “Errors are highlighted below.”
Hypothyroidism leads to mensuration problems. But how does this condition leads to mensuration problems?
Hello, I was diagnosed with hashimoto thyroiditis when i was around 19(ish). I am 44 now and have never had a problem with my period. Religiously every 28 days, lasting for 4-5 days all my life, except now. Got my period Dec 5th and I still have it two weeks later!!! It’s not heavy but my pad is stained by the end of the day. Could this be due to the Hashi? or menopause? I got my period when I was 9 years old 🙁
Thanks for your help!
Dear Annie,
Thank you for your question. Our hormones decline and fall out of balance as we age. A decline of progesterone can cause problems with the menstrual cycle. Here is an article that may be helpful:
http://makeshift-worm.flywheelsites.com/2017/07/causes-of-irregular-periods/
Please take our symptom checker quiz that will help you identify what could be causing your symptoms: http://makeshift-worm.flywheelsites.com/symptom-checker/
If we may be of service to you, please contact our wellness consultants for a complimentary wellness consultation at 281-698-8698.
Merry Christmas!
To your health,
Hotze Team
Please help! I am 46 years old. I haven’t had a menstrual cycle in over a year. I was diagnosed with hypothyroidism and given 50mcg of levothyroxin about 6 months ago. About 3 months ago, I started bleeding. At first it was light,but then suddenly it went into extreme bleeding. I was changing ultra sized tampons every hour cause I leaked.When I removed tampon, a huge amount of blood and clots came out. This lasted about 10 days. Then it went to what I would consider a normal period for a few days and then extreme again. This has been a non stop cycle for 3 months. Now today, I am back to the heavy bleeding with a lot of clots, but there are severe cramps that literally had me curled up in ball till my muscle relaxers started working. (on Christmas to be laid up most of the day due to cramping I have not had in a long time. I do have multiple disorders, the biggest being RA, crohns disease, Lupus & fibro. Is this normal for someone with all these conditions. My dr does not have any available apts till mid feb.
I have a problem of my period always i felt pain 2weeks before my period but i have no problem with my thyroid. However, this following 3 months alarms me because my period is unusual to me for it only takes 2 -3days from 3-5 days before. What would me the possible cause of this?
Dear Myn,
Thank you for your question. There are many factors that can lead to irregular periods – a common one being low progesterone. Here is an article to help explain what could be causing your menstrual irregularity: http://makeshift-worm.flywheelsites.com/2017/07/causes-of-irregular-periods/
Please take our symptom checker quiz to help you identify what symptoms you have and what could be causing them: http://makeshift-worm.flywheelsites.com/symptom-checker/
Dr. Hotze is hosting a Wellness Summit tomorrow morning at The Westin Galleria Hotel. It’s a great opportunity to learn more information about hormone imbalance. Please visit this link to register: http://makeshift-worm.flywheelsites.com/summit We would love to see you there!
To your health,
Hotze Team
hi.. i have thyroid since i was 3 years old but never faced any period problems but this week i dont know what went wrong. i started having my period 2 days back but it was really light.. till now i should have got my proper flow of period but i cant see it anywhere on my pad.. I can only see it when i wipe it off on the tissue.. i dont really feel any period pain as well which i always used to get..
could you please help me and tell me what do you think is happening?
It is my 3rd day today and normally on my 3rd day i get heavy periods with period pain which i didnt get this time..
please help me with this please
Hi.. Im under treatment for hypothyroidism… N for the last blood test tsh was about 2.5. But for this month i missed my periods.. Im sure that im not pregnant. I got this thyroid problem when i was pregnant.. Now my baby is 10month old..
Dear Reshma,
There are many reasons that women experience menstrual problems. Hypothyroidism is one, and low progesterone is another very common cause. Here is a helpful article that explains how childbirth can affect your hormones: http://makeshift-worm.flywheelsites.com/2018/02/how-childbirth-affects-hormones-estrogen-dominan/
Here is a good article that explains the progesterone connection: http://makeshift-worm.flywheelsites.com/2017/07/causes-of-irregular-periods/
Please take our symptom checker to discover what could be the cause of your symptoms: http://makeshift-worm.flywheelsites.com/symptom-checker/
If we may be of service to you, please contact our wellness consultants at 281-698-8698 who will be happy to schedule a complimentary wellness consultation. Thank you!
To your health,
Hotze Team
Hi ,I have regular periods with hypothyroidism TSH is 35.my doc suggested to increase dosage from 25mg to 50 mg.it’s been 45 days am using 50 mg along with iron supplements due to iron deficit. This month no period but brown spotting from 3 days with upper back pain.am confused whether it’s because of medicines or implantation bleeding.please help me .thank you .
I have been getting periods with a gap of just 15 days for past 5 months n I have been gaining weight since a year. A whitish nipple discharge has also been spotted. Can thyroid be the cause?
Dear Drish,
Thank you for reaching out to us. A progesterone deficiency and low thyroid function could be possible causes, however it would be best to be evaluated by a doctor. Please take our symptom checker to find out if you have symptoms of low progesterone and low thyroid function: http://makeshift-worm.flywheelsites.com/symptom-checker/
Here is an article that may be helpful: http://makeshift-worm.flywheelsites.com/2018/07/2-common-causes-of-irregular-periods/
If we may be of service to you, please call our Wellness Consultants for a complimentary wellness consultation at 281-698-8698. It would be our privilege to serve you.
To your health,
Hotze Team