Breaking News: Estrogen, Menopause and Thyroid, with Richard & Karilee Shames

In this article, Drs. Richard and Karilee Shames, authors of Thyroid Power, share their thoughts about the April, 2002 news about estrogen replacement therapy...

The news is in, as described in the New York Times. A report called "The International Position Paper on Women's Health & Menopause" from the National Institutes of Health and scientists from Italy, Sweden, Switzerland, and Australia, have given us the word on estrogen replacement for menopause woes. The benefits of estrogen have been overplayed, and its risks have been minimized.

Not only have valid studies found that estrogen replacement therapy replacement has less protective value for heart disease, Alzheimer's, depression, urinary incontinence, and especially osteoporosis, but in addition, the latest studies are confirming its increased cancer potential. In other words, its preventive powers are much less than the drug companies have been saying, and its risks are greater.

This is especially important information for any woman concerned about her thyroid health. Perhaps the biggest potential for mischief in the whole thyroid field is in the arena of women’s health and menopause. Everything from minor vaginal irritations to repeated miscarriages have been shown to be thyroid-related in a certain percentage of sufferers. Menopause is not an illness, but it can sure begin to feel that way if your thyroid is low or borderline at the time of your change.

Women in this frustrating circumstance are often told "It's just your menopause," as if they should expect to feel awful for years because of a natural reduction in estrogen. Without an accurate diagnosis of low thyroid, these women are simply given estrogen and their symptoms linger. The ovaries and uterus need proper amounts of thyroid hormone as much as any other organ or system.

Despite increased awareness in the medical community about the issues and interventions surrounding menopause, tremendous numbers of women still suffer from menopausal difficulties. They expend a great deal of time, money, and heartache on hormone replacement therapies. Frequently, neither the synthetic nor the natural hormones provides complete relief.

This is often because the underlying problem is undiagnosed low thyroid. By age 50, one in every twelve women has a significant degree of hypothyroidism. By age 60, it is one woman out of every six.

This runaway thyroid epidemic seems to be striking menopausal women harder than any other group of patients. Fortunately, much can be done to help them. The standard maneuver for perimenopausal patients who consult gynecologists is to provide a handful of estrogen samples. We have heard too many stories of women in their late 40's and early 50's who were given these hormones to take without any blood testing at all.

The compliant patient will follow the doctor’s advice. But, in those cases where women have been put on estrogen, and the symptoms of hot flashes, insomnia, irritability, palpitations, and "fuzzy thinking" are still quite annoying, the addition of thyroid hormone can be a godsend.

For those symptomatic menopausal women not wanting or benefiting from estrogen, we advocate thyroid blood testing first, perhaps followed by a clinical trial of thyroid hormone, even if their blood tests are in the normal range.

Frequently the underlying hypothyroidism is such a controlling factor that simply correcting it returns the whole system to fairly normal functioning. Menopause continues, but it is a more mild, gradual, and comfortable process. If your thyroid is low, your hot flashes will be much more pronounced, much more frequent, and more disconcerting. This is because thyroid is your energy throttle, your gas pedal. You need energy to go through the change gracefully.

How much energy people have, how well they get up in the morning, how well they sleep, and how much stamina they have for the day is directly related to their levels of thyroid hormone. When your level is too low, you don’t have the energy to cope adequately with anything, much less the additional stress and emotional lability associated with the menopausal years.