According to the American Thyroid Association, thyroid disease is up to 10 times more common in women than in men. Most of the symptoms of thyroid disease are the same in women and men. However, certain other symptoms of thyroid disorders are unique to women. Please continue reading to find in what ways a thyroid condition can manifest in women.

What happens when you have too much or not enough thyroid hormones?

The thyroid produces hormones called triiodothyronine (T3) and thyroxine (T4). The pituitary gland in the brain controls thyroid function through a hormone called the thyroid stimulating hormone (TSH).

When the thyroid gland makes either too much thyroid hormone or not enough thyroid hormone, it results in a thyroid disorder. 

Thyroid hormones affect various functions in the body such as metabolism, regulation of body temperature, heart and brain function, digestion, bone and muscle development, and mood. As a result, thyroid disease can cause a wide range of symptoms related to various organ systems.

How does your body feel when you have thyroid problems?

How you feel depends on the type of thyroid problem you have. Here are some of the symptoms associated with common thyroid disorders.

Hypothyroidism (Underactive Thyroid Gland)

Hypothyroidism or underactive thyroid gland is a condition in which thyroid hormone production is lower than normal. A common cause of hypothyroidism is Hashimoto's disease. It is an autoimmune disorder in which the immune system attacks healthy cells. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDKD), this autoimmune disease runs in families and affects women up to 10 times more frequently than men. Therefore, a family history and gender are risk factors for Hashimoto’s disease and hypothyroidism. 

Symptoms of severe hypothyroidism in women and men include weight gain despite a healthy diet and exercise routine, hair loss, dry skin, feeling cold, constipation, fatigue, muscle aches, joint pain, mood changes, memory problems, high blood pressure, and enlargement of the thyroid gland.

Hyperthyroidism (Overactive Thyroid)

Too much thyroid hormone can result in hyperthyroidism or an overactive thyroid gland. A common cause of overactive thyroid is Graves' disease. This is an autoimmune disorder that is up to 8 times more common in women compared to men. 

Signs and symptoms of hyperthyroidism in women and men include weight loss, increased appetite, feeling hot, palpitations, fast heartbeat, irregular heartbeat, excessive sweating, tremor (shaking), nervousness, anxiety, fatigue, sleep disturbances, muscle weakness, and an enlarged thyroid gland.

Thyroid Nodules and Goiter

When the thyroid is chronically inflamed, such as in Hashimoto’s disease, it can lead to the formation of thyroid nodules. Multinodular goiter is an enlargement of the thyroid gland that occurs due to iodine deficiency. Women are up to 4 times more likely to develop these thyroid disorders than men.

Common signs and symptoms of a large goiter or thyroid nodules include a swelling in the neck and difficulty breathing or swallowing. Other symptoms can include hyperthyroidism symptoms (if the nodules produce excess thyroid hormones) or hypothyroidism symptoms (if there is inflammation of the thyroid gland).

Thyroid Cancer

Cancer of the thyroid gland occurs when there is an uncontrolled growth of thyroid cells. It is approximately 3 times more common in women than in men. 

Signs and symptoms of thyroid cancer include a lump in the neck, discomfort with tight collars, voice changes, problems with swallowing, throat pain, and enlarged lymph nodes in the neck.

What happens when a woman has thyroid problems?

As mentioned above, women are at significantly higher risk of developing thyroid disease than men. One in eight women develop thyroid problems at some point in their lives. Some of the signs and symptoms of thyroid diseases that are unique to women include:

• Irregular menstrual periods: The thyroid gland helps to regulate the menstrual cycle. Too much or too little thyroid hormones can cause light, heavy, or irregular periods. Thyroid disease can also lead to amenorrhea (lack of periods) for several months. If thyroid disease is due to problems with the immune system, it can affect the ovaries and cause early menopause in women younger than 40 years old. 
• Fertility issues: Thyroid issues in women can make it harder to get pregnant. This is because the hormones produced by the thyroid affect the menstrual cycle and ovulation. 
• Health problems during pregnancy: Untreated thyroid disease can lead to problems during pregnancy such as miscarriage, premature birth, and stillbirth.
• Postpartum thyroiditis: This is an inflammation of the thyroid that occurs after delivery. It is an autoimmune disorder and results in hyperthyroidism. However, hyperthyroidism treatment can ultimately lead to permanent hypothyroidism. 

Keep in mind that many of the signs and symptoms of thyroid disease in women are non-specific. For instance, several conditions can cause you to lose weight or gain weight. Also, thyroid symptoms can be mistaken for menopause symptoms. 

Proper diagnosis and treatment of thyroid disease can significantly improve your symptoms. 

How is a thyroid disorder diagnosed?

If you suspect that your thyroid gland is not functioning properly or you have the early warning signs of a thyroid issue, talk to your healthcare provider. Depending on your symptoms, medical history, and exam, they may order blood tests and imaging studies to find out what’s going on. Tests to diagnose a thyroid disorder can include:

• A blood test to check thyroid hormone levels.
• A thyroid scan or radioactive iodine uptake (RAI-U) test.
• An imaging test such as ultrasound, CT scan, or MRI.

How do doctors treat thyroid diseases?

The treatment for thyroid disorders depends on whether you produce hormones in excess (hyperthyroidism) or not enough hormones (hypothyroidism).

Hypothyroidism is treated with thyroid hormone replacement. Examples of hormone therapy include levothyroxine (Synthroid, Levothroid, Levoxyl, Unithroid, Tirosint), which is a synthetic T4 thyroid hormone; liothyronine (Cytomel), which is synthetic T3; and desiccated thyroid extract (DTE), which has both T3 and T4. 

Hyperthyroidism is treated with antithyroid medications, such as propylthiouracil and methimazole (Tapazole). Other treatment options include radioactive iodine ablation or radiation therapy to destroy thyroid tissue or thyroidectomy (thyroid removal or thyroid surgery). Hyperthyroidism treatment can ultimately lead to permanent hypothyroidism, which may require treatment.

References:

1. https://www.womenshealth.gov/a-z-topics/thyroid-disease