Is FT3 useful for Wechseljahre?

Whether FT3 (free triiodothyronine) is useful during menopause cannot be clearly affirmed based on current evidence. FT3 is a thyroid hormone primarily used to assess hyperthyroidism or hypothyroidism. Menopause involves changes in estrogen and progesterone, which can indirectly affect the thyroid axis—for example, through altered binding proteins. However, no robust studies recommend routine FT3 testing for menopausal symptoms such as hot flashes, sleep disturbances, or mood swings. Clinical guidelines on menopause (e.g., from the German Menopause Society) focus on FSH, estradiol, and possibly TSH, not FT3. FT3 testing might only be justified if there are specific signs of thyroid disease (e.g., abnormal TSH, nodules, symptoms like weight loss or palpitations). Without such indications, the test is not medically indicated and may lead to unnecessary anxiety or misinterpretation. The evidence is therefore rated as unclear to mechanistic: a biological link exists, but clinical validation for use in menopause is lacking.