perimenopause or thyroid

I am a 47 year old female.  I've never had children.  I had a 1 day period in June and a 5 second period in November.  I am tired, have gained weight especially in the waist area, growing the odd chin hair, and diminished sex drive.  I have high thyroid antibodies, just had a 2nd biopsy on a solid nodule that was 2.2cm and is now 2.6cm.  Thyroid blood tests are normal.  I get test results from the biopsy in January.  Not sure if it's possible I'm going through menopause or my thyroid is creating problems.  What blood work should I have done to see if I'm going through menopause?

[Machelle Seibel, MD]

Women who have high thyroid antibodies usually end up with a low level of thyroid hormone which can cause many of the symptoms you are experiencing. They can also eventually have antiovarian antibodies because the antibodies often attack the hormone producing cells of the body, which includes the ovary.

Ask your doctor to check your FSH level as suggested above. If elevated, it will suggest that you are approaching menopause. There is no exact test level for menopause per se. Also talk with your doctor about checking your testosterone level and other "male" hormone levels such as androstenedione. He/she can also test you for adrenal function by testing a DHEA-S level and an early morning cortisol if the syptoms (symptoms) suggest other hormone problems. Also, talk to your doctor about going on a low dose of thyroid hormone to see if he/she feels that will be helpful to you. Often the blood test TSH is slightly elevated in this situation. It should be possible to sort this out and help you feel better with more testing and treatment.
Machelle M. Seibel, MD

[mamajulie]

Have your doctor do a FSH level. From what I am learning they can go side by side. When I had estrogen dominance, my thyroid is extremely high. When my thyroid is low, my estrogen levels are low. I am now in the menopause at 38 with my FSH levels at 58 which is pretty high indication that I am in the menopause.