What role does TSH Schilddrüse play in Wechseljahre?

The thyroid gland and thyroid-stimulating hormone (TSH) play a complex but often overestimated role during menopause. In perimenopause and menopause, estrogen and progesterone levels drop dramatically, which can indirectly affect thyroid function. Estrogen increases thyroxine-binding globulin (TBG); as estrogen declines, less TBG is bound, potentially altering free thyroid hormones (fT3, fT4) and the TSH feedback loop. Many women report fatigue, weight gain, and mood swings during menopause – symptoms that overlap with hypothyroidism. Elevated TSH may indicate incipient hypothyroidism, which becomes more common with age and around menopause. However, evidence for a direct causal link between menopause and TSH rise is limited; most studies show weak associations. Importantly, a single TSH test is insufficient – fT3, fT4, and antibodies (TPO, Tg) should be measured. Interpretation must consider symptoms and age. A TSH in the upper normal range (2.5–4.5 mU/L) in older women does not necessarily require treatment. The evidence is predominantly observational and not strongly causal.