Is TSH useful for menopause?

TSH (thyroid-stimulating hormone) is not a primary marker for menopause. Menopause diagnosis relies on FSH (follicle-stimulating hormone) and estradiol levels, not TSH. However, thyroid dysfunction (hypo- or hyperthyroidism) can cause symptoms like hot flashes, fatigue, weight gain, or mood changes that mimic menopause. Therefore, a TSH test can be useful to rule out thyroid issues as a cause of these symptoms, especially in perimenopausal women. The evidence is moderate: guidelines (e.g., from the German Society of Gynecology) recommend thyroid testing when symptoms are unclear, but not as routine screening for menopause. A normal TSH does not rule out menopause, and an elevated TSH does not indicate menopause is imminent. In summary, TSH is useful for evaluating thyroid disorders but not for diagnosing menopause. Evidence: mixed – clinically reasonable but not a specific menopause marker.