TOPLINE:
A new position paper of the European Menopause and Andropause Society (EMAS) highlights diagnostic and therapeutic challenges involved in treating women with thyroid disease in perimenopause. Its aim is to increase awareness among endocrinologists, gynaecologists, general practitioners, and internists about thyroid disorders and menopause-related conditions, and to assist clinicians and patients in shared decision-making regarding therapeutic options.
METHODOLOGY:
- Literature review and consensus of opinion from EMAS executive board members and experts in menopause and thyroid disease.
TAKEAWAY:
- Healthcare professionals should be aware of potential overlap in symptoms of menopause and thyroid dysfunction, including menstrual irregularities, mood disorders, increased sweating, sleep disturbances, and hair loss.
- Consumption of biotin, present in some cosmetic products, can lead to false thyroid function immunoassay readings. Physicians should assess both prescription and over-the-counter medications women are taking, and advise those using biotin products to discontinue taking them 2-3 days prior to thyroid hormone assessments.
- Women with surgical menopause, early menarche, and late natural menopause should be evaluated for thyroid nodules, and if detected, followed up as per general population guidelines.
- Lipid metabolism should be evaluated in menopausal women and those with thyroid function disorders.
- The prevalence of nonalcoholic fatty liver disease (NAFLD) is increased in menopausal women.
- Menopausal hormone therapy (MHT) is safe for treating women with menopausal symptoms and thyroid conditions.
- Levothyroxine supplementation and MHT may improve NAFLD.
IN PRACTICE:
"All clinicians must scrupulously check for the presence of menopause-related conditions or thyroid diseases and treat them if detected. Clinical decisions on the treatment of both conditions should be made with caution and attention to the specific characteristics of this age group, adopting a personalised patient approach," the authors wrote.
SOURCE:
Statement authored by Gesthimani Mintziori, MD, of the Unit of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece, and a multinational panel. It was published online on April 23, 2024, in Maturitas.
LIMITATIONS:
Expert opinion was not commissioned or peer-reviewed.
DISCLOSURES:
No funding was sought or secured for the preparation of this position statement. Gesthimani Mintziori reported no disclosures, but several co-authors reported relationships with industry.
