Health Topics

Symptoms of Thyroid Problems in Women

By Lynn Pattimakiel, M.D.

Feeling tired, gaining or losing a few pounds, or having trouble sleeping? If so, you have plenty of company. These common complaints can be symptoms of a myriad of conditions, including disorders of the thyroid, a butterfly-shaped endocrine gland. So how do you know whether or not to be concerned?

In women, changes to the menstrual cycle can be an indicator of a thyroid problem, but many things can influence the menstrual function.

How Common are Thyroid Disorders?

The answer is very, with more than 20 million Americans infected. That exceeds the number of people who suffer from asthma or heart disease. Since many of the individual symptoms of thyroid disorders are extremely common, many people suffering from thyroid conditions remain undiagnosed because it is hard to pinpoint the problem.

Some of the most common thyroid disorders are related to the levels of hormones produced by the thyroid, an organ that weighs about 10-30 grams and is located at the front of your neck, below your Adam’s apple. The hormones produced by the thyroid control the body’s metabolism. Frequently seen disorders include;

  • Hyperthyroidism (when the thyroid produces too many hormones)
  • Hypothyroidism (too few thyroid hormones)
  • Growths such as thyroid nodules or thyroid cancer develop


Patients with hyperthyroidism may experience the following symptoms:

  • nervous
  • irritable
  • shaky
  • racing heart
  • excessive sweating
  • heat intolerance
  • frequent bowel movements
  • thinning of the hair
  • weight loss
  • irregular periods

These symptoms may accompany a goiter (enlargement of the thyroid gland).


Symptoms of an under active thyroid, or hypothyroidism, include:

  • slowing of body function
  • slower thinking
  • depression
  • coldness
  • constipation
  • muscle weakness
  • abnormal periods
  • slowing of the metabolism leading to moderate weight gain

Some patients also have goiters. However, many patients with hypothyroidism do not have symptoms, so screening with a blood test is important.

Thyroid Nodules

Most nodules (lumps in the thyroid) are painless, so they usually are discovered by a doctor feeling a patient’s neck during a routine physical exam. Larger nodules – typically noticed while shaving or putting on makeup – may cause difficulty swallowing and breathing, or hoarseness. In rare cases, nodules may cause hyperthyroidism.

Thyroid Cancer

In cases of thyroid cancer, patients usually do not experience any symptoms, and the cancer is found as a lump or nodule on examination of the neck or when an imaging test such as an ultrasound, CT scan or MRI is performed for an unrelated condition. In rare cases, thyroid cancer will cause pain, difficulty swallowing or hoarseness.

Women are much more likely than men to develop thyroid cancer. Most types of thyroid cancer can be completely removed with surgery, and survival rates are quite high.

Most people who have a goiter aren’t aware of it until the goiter becomes large enough that they can feel or see it. Goiters can grow to an enormous size before they cause symptoms such as difficulty breathing or swallowing, or a change in voice.

The good news is thyroid disorders are easy to treat with thyroid medication, or, in some cases, simple surgery.

Pregnancy and Thyroid Conditions

In pregnant women, or those with a known thyroid condition (or a family history of them) thyroid issues should be discussed with your obstetrician. While pregnancy itself does not cause thyroid disease, the ramped-up hormone production in pregnancy can impact the thyroid.

After pregnancy, many women are noted to develop thyroid dysfunction. These women often will have circulating antibodies against the thyroid gland.

The thyroid can also enlarge during pregnancy due to the fact that iodine can be expelled through the urine at a greater rate than normal, which causes the thyroid gland to enlarge to compensate.

Menopause and Thyroid Disorders

Many women in the transition of menopause have similar symptoms of an overactive or under active thyroid. This includes irregular menstrual periods, decreased libido and an increased sensitivity to fluctuations of the brain’s thermostat resulting in hot flashes, due to low estrogen levels. Women suffering from night sweats may often feel fatigued, sleep deprived and depressed as a result. Also around menopause, metabolism tends to slow down, therefore many mid-life women complain of weight gain. These symptoms are often confused with thyroid disorders and should be evaluated and appropriately treated.

Women with thyroid conditions may tend to undergo menopause earlier than the average population. Fortunately, at Cleveland Clinic, many experts in the field of thyroid disorders are on staff. Clinic doctors from throughout the enterprise work collaboratively to provide total patient care for this and a long list of other conditions.

See your primary care physician if you suspect you may have a problem with your thyroid.

Lynn Pattimakiel, MD, is a women’s health specialist with the Ob/Gyn and Women’s Health Institute. Her areas of specialization are hormone therapy, menopause and osteoporosis. She can be reached at 216.444.4HER.