Evidence check: TSH in the context of Wechseljahre

TSH (thyroid-stimulating hormone) is commonly measured during menopause because symptoms like fatigue, weight gain, and mood changes can overlap with hypothyroidism. The evidence is moderate: some studies suggest a slight age-related TSH increase, but menopause itself does not cause thyroid disease. However, estrogen decline and altered iodine metabolism may affect thyroid function. TSH testing is useful to rule out hypothyroidism, but it should not be interpreted in isolation. Caveat: a normal TSH does not exclude thyroid issues, and a mildly elevated TSH may not require treatment. Combining with fT3, fT4, and antibodies (TPO, Tg) along with clinical symptoms is essential. Evidence: human-moderate.