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The Missing T

 
 

Thyroid Awareness Month 1999

Thyroid Hormone Missing From Menopause Discussion for Millions of Women

Many Women Treated for Menopause Symptoms May Also Have Underlying Thyroid Disorder

New York, NY - January 13, 1999 - Millions of American women with unresolved menopausal-like symptoms, even many of those taking estrogen, may actually be suffering from undiagnosed thyroid disease, according to the American Association of Clinical Endocrinologists (AACE). Although frequently associated with menopause, symptoms such as fatigue, mood swings, depression and sleep disturbances may actually be a sign of an often-overlooked disease involving the small, butterfly-shaped thyroid gland. Despite the signs, symptoms and potential long-term health complications of thyroid disease, a new survey finds many women are not aware of the pivotal role of the thyroid hormone, especially during menopause.

A new survey released today by AACE finds that only one in four women who have discussed menopause with a physician were recommended to be tested for thyroid disease. Perhaps even more astounding, one third of women 40 years of age and older surveyed did not discuss menopause at all with their physician. AACE is urging all women experiencing peri-menopausal and menopausal symptoms to also add thyroid hormone to the list of hormones they discuss with their physicians. "Because many of the symptoms of thyroid disease and menopause overlap, it is easy to see why the role of the thyroid hormone is often overlooked," says AACE President Helena Rodbard, M.D., F.A.C.E. "As women approach menopause, many symptoms may be quickly attributed to this milestone in a woman's life without complete discussion of other easily treatable disorders, such as thyroid disease, that often mimic or accompany menopause."

Menopause: A Hormonal Milestone

Signaling the end of a woman's reproductive life, menopause has a profound effect on body function. From puberty to menopause, two sex hormones - estrogen and progesterone - help regulate a woman's menstrual cycle and prepare her uterus for pregnancy. Like all hormones, these chemical messengers circulate throughout the body, interacting with other hormones and body systems, including the mucous membranes, urethra, breasts, bones and skin.

In the years just before and during menopause, the ovaries begin to produce less of these hormones, which in turn impacts menstruation and accelerates the natural aging processes of certain organs - notably, the cardiovascular system and bones. Specifically, the decrease in hormone levels increases blood cholesterol levels, which can lead to heart disease, and accelerates bone loss, which increases the risk of developing osteoporosis. To help counter these effects and relieve some peri-menopausal or menopausal symptoms, many women choose to take hormone replacement therapy (HRT), which traditionally includes some combination of estrogen and progesterone.

An estimated one third of women 40 years of age and older on HRT for symptoms of menopause continue to experience such symptoms as mood swings, depression and sleep disturbances, according to the AACE survey. For these women, an underlying medical condition may be playing a critical role in their health. This role is even more important to note as the incidence of thyroid disease increases with age.

"As endocrinologists and hormone experts, we are very concerned that the patient-physician dialogue on menopause be broadened to include discussion of thyroid hormone," explains past-president of AACE, Stanley Feld, M.D., M.A.C.E. "Fewer than 25 percent of the nearly 50 million women reaching menopause are on HRT, and we know that as many as 1 in 3 of these women continue to experience symptoms which could be a direct result of an underlying thyroid disorder. Consider the fact that the incidence of thyroid disease increases to almost 20 percent for women over the age of sixty, and one can understand the seriousness of this situation."

Thyroid: The Missing Hormone

Like the hormones active during menopause, thyroid hormones play a vital role in the overall body function. Although relatively small, the thyroid gland produces a hormone that regulates the body's overall metabolism - the rate at which the body produces energy from nutrients. It influences the heart, brain, liver, kidneys and skin and affects muscle strength, reproductive functions and appetite. If left untreated, thyroid disease can lead to decreased quality of life, worsening osteoporosis and increased risk for heart disease. Approximately 13 million Americans have thyroid disease, yet more than half do not know it. "As a woman is affected simultaneously by an onset of menopause, the increased risk for thyroid disease and the natural aging process, the need for hormone management is essential," says Dr. Rodbard. "By recognizing the signs and symptoms of these processes as they appear, patients and doctors can reduce the long-term health risks that threaten women."

Check Your Neck

AACE is encouraging patients who may be experiencing menopausal symptoms, even if they are currently on HRT, to perform a simple self-examination called a "Thyroid Neck Check." To perform the Neck Check, an individual stands before a mirror and drinks a glass of water while looking for signs of an enlarged or irregular thyroid gland. A pamphlet made available by AACE provides step-by-step instructions for performing this simple self-examination. "While menopause is generally treated symptomatically, the Neck Check is an important first step in identifying a thyroid condition, which may need further examination and testing by an endocrinologist," explains Dr. Feld. "With a simple blood test called a TSH [thyroid-stimulating hormone] test, physicians can detect even slight abnormalities in thyroid function and discover whether an underlying thyroid condition may be causing or complicating the symptoms of menopause."

Patients who find an enlarged thyroid gland as a result of the self-examination may have a thyroid abnormality. The most common thyroid disease is chronic thyroiditis, which leads to an underactive thyroid, or hypothyroidism. This results when the thyroid fails to produce enough hormone. Less frequently, an overactive thyroid, or hyperthyroidism, occurs when the thyroid produces more thyroid hormone than is needed. Additionally, people on thyroid replacement therapy may be taking excessive doses, which can result in hyperthyroidism or sub-clinical hyperthyroidism. If properly treated, patients with thyroid disease can lead normal, active lives.

Thyroid Awareness Month and the Year of the "Missing T"

This month, AACE is launching a year-long public education initiative to teach both physicians and patients about the symptoms of thyroid disease during the peri-menopause and menopausal years. This year's campaign, titled "Thyroid: The Missing T in HRT" is designed to bring thyroid into the HRT discussion and heighten awareness of the symptoms that may suggest the presence of an underlying thyroid disorder.

The American Association of Clinical Endocrinologists (AACE) is the country's largest professional organization of clinical endocrinologists. Its membership consists of 3,200 practicing clinical endocrinologists devoted to improving the care of patients with endocrine disorders. The association's mission is to improve the public's understanding and heighten its awareness of endocrine diseases and the added value of the clinical endocrinologist in the treatment of these diseases. Additional information about AACE, including a copy of the "Thyroid Neck Check," can be obtained on the association's website at www.aace.com.

 

Previous Thyroid Awareness Month Campaigns

Thyroid Awareness Month is supported through an unrestricted grant from Abbott Laboratories.
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