Periods have become heavy, or have stopped coming on time. You feel exhausted, your hair is falling, or you are trying for a baby and nothing is happening. Someone at home says, “get your thyroid checked”, and you wonder whether one small gland in your neck could explain it all.
It can, but these changes often have other causes too. For what thyroid disorders are, how they are tested and how they are treated, see our thyroid guide on symptoms, tests and treatment. For the general symptom list that applies to everyone, see thyroid symptoms in adults.
Why thyroid problems are more common in women
Women get thyroid problems more often than men. Most thyroid disease is autoimmune, meaning the immune system attacks the gland by mistake, and the main autoimmune thyroid conditions are more common in women. Pregnancy, the year after delivery and the menopause years add further times of risk.
- Autoimmunity. National Health Service (NHS) says Hashimoto’s disease, the main cause of an underactive thyroid, is most common in women and usually starts between 30 and 50. An overactive thyroid is about 10 times more common in women than men, typically between 20 and 40.
- Pregnancy and the year after delivery. Pregnancy raises the body’s need for thyroid hormone, and postpartum thyroiditis, an inflammation of the thyroid after childbirth, affects about 5% of women by the American Thyroid Association (ATA)’s estimate.
- The menopause years. The US Office on Women’s Health (OWH) says thyroid disease, especially an underactive thyroid, is more likely to develop after menopause.
The Indian numbers point the same way. In a 2011 study of 5,360 adults in eight Indian cities, 15.86% of women had an underactive thyroid against 5.02% of men, and rates were highest at ages 46 to 54. The study covered only city adults, so treat it as a strong signal rather than a national figure.
Thyroid symptoms in females at each life stage
The same thyroid problem can look different at 25, during pregnancy and at 48. Only a blood test can tell it apart from the look-alikes.
| Life stage | Thyroid signs to notice | Look-alike causes |
|---|---|---|
| 20s and 30s, not pregnant | Heavy or irregular periods, tiredness, weight gain, feeling cold (underactive); lighter or fewer periods, weight loss, palpitations, anxiety (overactive) | Polycystic ovary syndrome (PCOS), high prolactin, iron-deficiency anaemia, stress, crash dieting |
| Trying to conceive | Irregular cycles, missed periods, no pregnancy after months of trying | PCOS, high prolactin, problems in either partner, age |
| Pregnancy | Often none that stand out; tiredness, weight gain, feeling hot or a fast pulse overlap with normal pregnancy | Normal pregnancy changes such as feeling hot, poor sleep, breathlessness and a slightly faster pulse; anaemia |
| First year after delivery | Anxiety, poor sleep, palpitations and weight loss in the first months; later tiredness, weight gain, dry skin, constipation and low mood | Lack of sleep with a new baby, “baby blues”, postpartum depression, anaemia after blood loss |
| 40s and perimenopause | Tiredness, weight gain, low mood, poor concentration, period changes, feeling hot or a racing heart | Perimenopause, depression, anaemia, poor sleep, too much chai or coffee |
| After menopause | Tiredness, weight change, low mood, dry skin and hair; an overactive thyroid can also weaken bones | Ageing, menopause itself, depression, side effects of other medicines |
Hair fall runs through every stage. NHS lists dry hair or hair loss among underactive-thyroid symptoms, but iron deficiency, stress and illness are also common causes; our guide to blood tests for hair fall covers what to check.
Thyroid and periods: heavy, irregular or missed
Yes, a thyroid problem can change your periods, and in opposite directions depending on the type.
- Underactive thyroid: NHS lists irregular or heavy periods; OWH describes more bleeding than usual.
- Overactive thyroid: OWH describes fewer and lighter periods than normal.
- Either type: OWH says periods can stop for several months or longer.
OWH adds that an underactive thyroid can make the body produce more prolactin, the breastmilk hormone, which can stop ovulation. That is one reason a doctor checking period problems often orders thyroid-stimulating hormone (TSH) and prolactin together.
A missed period always needs a pregnancy test first. After that, thyroid is one of several causes worth ruling out; our guide to irregular periods and when to worry covers the others. Diet and exercise changes will not correct periods disturbed by a thyroid problem; that needs the thyroid itself treated.
Trying to conceive: can thyroid stop pregnancy?
A thyroid problem can make it harder to get pregnant, but it is usually found with a simple test and treated. OWH explains that both an underactive and an overactive thyroid can upset the hormones that control ovulation.
In an Indian infertility clinic in Ludhiana, 23.9% of 394 women attending for the first time had a TSH above 4.2. It was a single clinic with no comparison group, so it does not show that thyroid caused the infertility. The ATA recommends a TSH test for all women seeking care for infertility, a weak recommendation based on moderate-quality evidence.
If you have a thyroid condition and are planning a pregnancy, tell your doctor before you start trying. The ATA advises checking TSH before conception in women on thyroid hormone tablets, because the need usually rises in pregnancy.
Thyroid in pregnancy: is a test needed?
Yes, for most Indian women it is worth asking for one. NHS says an untreated underactive thyroid can increase the chance of serious pregnancy complications, including pre-eclampsia (high blood pressure in pregnancy), premature birth and miscarriage, and that treatment usually helps prevent them. OWH notes that thyroid hormone is necessary for the baby’s brain development.
Indian and international guidance on who to test
- Government of India (2014): “Screening for hypothyroidism is recommended in high risk PW [pregnant women].” Its list of risk factors includes past thyroid problems, a family history, goitre, autoimmune diseases such as type 1 diabetes, a body mass index (BMI) of 30 or more, past miscarriages or preterm births, infertility, and living in an iodine-deficient area.
- Indian Thyroid Society: “All pregnant females should be screened at 1st antenatal visit by measuring TSH levels.” It prefers this test before pregnancy or as soon as pregnancy is confirmed.
- ATA (2017): “There is insufficient evidence to recommend for or against universal screening for abnormal TSH concentrations in early pregnancy.” It advises TSH testing when any risk factor is present, and its list includes being over 30 and having had two or more pregnancies.
Which applies to you? The two Indian bodies agree that any woman with a risk factor should be tested; the Indian Thyroid Society goes further and tests everyone. Our view for Indian readers: ask for a TSH test before pregnancy or at your first antenatal visit, and let your obstetrician decide what follows. TSH ranges are lower in pregnancy and the cut-offs differ between guidelines; our guide to reading your thyroid report explains the pregnancy ranges.
If you take thyroid medicine and are pregnant or planning a pregnancy, contact your doctor promptly. The dose often needs to change, but do not change it on your own; follow only a plan your doctor has already agreed with you. The Indian Thyroid Society also states that a thyroid problem in the mother is not, by itself, a reason to end a pregnancy.
Thyroid after delivery: postpartum thyroiditis
In the first year after delivery, the thyroid can become inflamed, probably from an autoimmune reaction, even in women who had no thyroid problem before. The ATA puts this at about 5% of women, with studies ranging from 1.1% to 16.7%; the Indian Thyroid Society guideline says up to 10% of pregnancies. It can also follow a miscarriage.
The ATA describes two phases, though only about a third of women go through both:
- An overactive phase 1–4 months after delivery, lasting 1–3 months: anxiety, poor sleep, palpitations, tiredness, weight loss and irritability. It is often put down to the stress of a new baby.
- An underactive phase 4–8 months after delivery, which may last up to 9–12 months: tiredness, weight gain, constipation, dry skin and low mood. This is when most women are diagnosed.
Most women regain normal thyroid function within 12–18 months of symptoms starting, but about 20% of those with an underactive phase stay underactive, the ATA says. The risk is higher with thyroid antibodies, type 1 diabetes or postpartum thyroiditis in an earlier pregnancy, which comes back in about 20% of later pregnancies. Because the risk of a permanent underactive thyroid stays raised for years, the ATA recommends a yearly TSH test after an episode.
The ATA recommends that anyone with depression, including postpartum depression, be screened for thyroid problems, and the Indian Thyroid Society agrees. A thyroid test does not replace care for the depression itself.
In your 40s and around menopause: thyroid or hormones?
Thyroid problems and perimenopause share many symptoms, so one is easily mistaken for the other. National Institute for Health and Care Excellence (NICE) tells doctors to be aware that in menopausal women, symptoms of thyroid dysfunction may be mistaken for menopause.
- Tiredness, sleep and mood: an underactive thyroid causes tiredness and low mood, an overactive one poor sleep and irritability; perimenopause can cause all of these.
- Weight: both can add weight around midlife. Thyroid-related weight gain is usually modest, as the thyroid hub’s symptoms section explains.
- Heat and a racing heart: hot flushes can feel like the heat intolerance and palpitations of an overactive thyroid.
- Periods: both can make periods heavier, lighter or irregular.
OWH adds two points. Autoimmune thyroid disease can sometimes involve the ovaries and lead to early menopause, before 40. And an overactive thyroid raises the risk of weak bones, especially after menopause. If symptoms in your 40s are put down to “just hormones”, ask whether a TSH test has been done. Our menopause guide covers symptoms, tests and care in this stage.
Thyroid or PCOS? Where the symptoms overlap
An underactive thyroid and PCOS share irregular periods, weight gain, hair thinning, low mood and difficulty conceiving, which is why the 2023 international PCOS guideline lists a TSH test among the checks to rule out other causes before diagnosing PCOS.
Some features lean one way: excess facial or body hair and acne towards PCOS; feeling cold, constipation and dry skin towards an underactive thyroid. None of these settles the question. A normal TSH does not rule out PCOS, and a PCOS diagnosis does not rule out a thyroid problem. Our guide to PCOS symptoms one by one covers the PCOS side.
When to see a doctor
Our hub has the full list of thyroid warning signs.
Emergency: get help now (call 112)
- Difficulty breathing with a swelling in the neck.
- Palpitations with chest pain, breathlessness or fainting.
- Thoughts of harming yourself or your baby. Call 112, or contact Tele Mental Health Assistance and Networking Across States (Tele-MANAS), the Government of India’s mental-health helpline.
- Bleeding that soaks through a pad soon after you put it on, or heavy bleeding with dizziness or fainting.
Prompt review: within days to a few weeks
- Pregnancy, suspected pregnancy or planning one while on any thyroid medicine.
- Palpitations, shaking, weight loss or severe anxiety in the months after delivery.
- Low mood after delivery that does not lift or affects caring for yourself or your baby.
- No period for three months or more when you are not pregnant.
Routine review
- Heavy, irregular or lighter periods, lasting tiredness, hair fall or unexplained weight change.
- Trying to conceive without success, or planning a pregnancy with a thyroid history or other risk factor.
- A yearly TSH test if you have had postpartum thyroiditis.
Not sure who to see? Our guide to which thyroid doctor to consult explains when a physician, gynaecologist or endocrinologist fits best.
How Disha can help
Disha is an AI health coach that chats and calls in Hindi, English and Hinglish. It does not replace your doctor, and it does not diagnose, read thyroid reports, prescribe or change medicine, or provide emergency care. After an onboarding call of about 15–20 minutes with Disha, the AI, it can help with the daily routines around your care: meals, movement, sleep, and a steady routine for tablets and test days. Read how Disha coaching works.
This is not medical advice. This page is general education for adults (18+), not a diagnosis or treatment plan. Symptoms alone cannot confirm a thyroid problem. Do not start, stop or change any thyroid medicine, hormone or supplement because of it. If you are pregnant, breastfeeding or have a current or past eating disorder, get individual advice before changing how you eat or exercise. In an emergency, call 112.
Frequently asked questions
What are the symptoms of thyroid in women?
An underactive thyroid can cause tiredness, feeling cold, weight gain, constipation, low mood, dry skin, hair loss and heavy or irregular periods. An overactive thyroid can cause palpitations, anxiety, heat intolerance, weight loss and lighter or fewer periods. In women these can also appear as difficulty conceiving or problems after delivery. Many symptoms overlap with anaemia, PCOS and menopause, so a TSH blood test is needed to confirm.
Can thyroid cause irregular periods?
Yes. An underactive thyroid can make periods heavy or irregular, and an overactive one can make them lighter and less frequent. Either can stop periods for months. An underactive thyroid can also raise prolactin, which can stop ovulation. Irregular periods have many other causes, especially PCOS, so do a pregnancy test first and then ask your doctor about TSH and other tests.
Can a thyroid problem stop you from getting pregnant?
It can make pregnancy harder by disturbing ovulation, and it is simple to test for. The ATA recommends a TSH test for every woman seeking care for infertility. Treatment for an underactive thyroid is recommended for women with infertility who want to conceive. Both partners should be checked, because many causes of infertility have nothing to do with the thyroid.
Is a thyroid test needed in pregnancy?
Ask for one. The Indian Thyroid Society advises a TSH test for every pregnant woman at the first antenatal visit, while the Government of India’s 2014 guideline tests women with risk factors such as a thyroid history, family history, BMI of 30 or more or past miscarriage. If you already take thyroid medicine, contact your doctor as soon as pregnancy is confirmed and do not change the dose yourself.
Can thyroid cause hair fall in women?
Yes. Both an underactive and an overactive thyroid can cause hair loss, and NHS lists dry hair or hair loss among underactive-thyroid symptoms. But hair fall in women has many other causes, including iron deficiency, stress, illness and PCOS. A TSH test is a reasonable part of the check-up, usually alongside a blood count and iron studies your doctor chooses.
What happens to the thyroid after delivery?
In about 5% of women, the thyroid becomes inflamed in the first year after delivery. It may first run fast, causing anxiety, poor sleep and palpitations at 1–4 months, then slow down, causing tiredness, weight gain and low mood at 4–8 months. Most women recover within 12–18 months, but about 20% of those with a slow phase stay underactive, so a yearly TSH test is advised.
Sources
- Indian Thyroid Society (chair Jayakumar RV). Guidelines for Management of Thyroid Dysfunction During Pregnancy. Undated; endorsed by the Endocrine Society of India. Supports: overactive-thyroid symptoms that resemble normal pregnancy (heat intolerance, breathlessness, poor sleep, a slightly raised pulse); TSH screening of all pregnant women at the first antenatal visit, ideally before pregnancy or as soon as it is confirmed; thyroid dysfunction not by itself an indication for termination; postpartum thyroiditis in up to 10% of pregnancies and after miscarriage; raised risk of permanent hypothyroidism after postpartum thyroiditis; screening women with postpartum depression for hypothyroidism.
- Maternal Health Division, Ministry of Health and Family Welfare, Government of India. National Guidelines for Screening of Hypothyroidism during Pregnancy. December 2014. Supports: screening recommended in high-risk pregnant women at the first antenatal visit; the list of high-risk factors, including BMI of 30 or more, infertility, past miscarriage and iodine-deficient areas.
- Alexander EK, Pearce EN, Brent GA, Brown RS, Chen H, Dosiou C, Grobman WA, Laurberg P, Lazarus JH, Mandel SJ, Peeters RP, Sullivan S. 2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum. Thyroid, 2017 (doi:10.1089/thy.2016.0457). Supports: insufficient evidence for or against universal screening; TSH testing with risk factors, including age over 30 and two or more prior pregnancies; TSH testing for all women seeking care for infertility (weak recommendation); treatment of overt hypothyroidism in infertile women; preconception TSH in women on thyroid hormone; prevalence of postpartum thyroiditis about 5% (1.1–16.7%); thyroid screening in depression including postpartum depression; yearly TSH after postpartum thyroiditis.
- American Thyroid Association. Postpartum Thyroiditis. Current patient page. Supports: autoimmune cause; risk with antibodies, type 1 diabetes and previous episodes, with 20% recurrence; timing and symptoms of the overactive and underactive phases; about a third having both phases; recovery within 12–18 months and about 20% remaining underactive.
- Office on Women’s Health, US Department of Health and Human Services. Thyroid disease. Page last updated 2026. Supports: women more likely than men to have thyroid disease, especially after pregnancy and menopause; light, heavy, irregular or absent periods; effects on ovulation and higher prolactin; early menopause with autoimmune thyroid disease; symptoms mistaken for menopause; bone risk with an overactive thyroid after menopause; thyroid hormone needed for the baby’s brain development.
- NHS. Underactive thyroid (hypothyroidism) and Overactive thyroid (hyperthyroidism). Current patient guidance. Supports: irregular or heavy periods, dry hair or hair loss and other underactive-thyroid symptoms; Hashimoto’s most common in women and starting between 30 and 50; pregnancy complications of an untreated underactive thyroid; an overactive thyroid about 10 times more common in women, typically at 20 to 40.
- National Institute for Health and Care Excellence (NICE). Thyroid disease: assessment and management (NG145). 2019, updated 2023. Supports: awareness that thyroid symptoms in menopausal women may be mistaken for menopause.
- Unnikrishnan AG, Kalra S, Sahay RK, Bantwal G, John M, Tewari N. Prevalence of hypothyroidism in adults: An epidemiological study in eight cities of India. Indian Journal of Endocrinology and Metabolism, 2013. Observational study. Supports: 5,360 urban adults; hypothyroidism in 15.86% of women versus 5.02% of men; highest prevalence at ages 46 to 54.
- Verma I, Sood R, Juneja S, Kaur S. Prevalence of hypothyroidism in infertile women and evaluation of response of treatment for hypothyroidism on infertility. International Journal of Applied and Basic Medical Research, 2012. Observational single-clinic study. Supports: 23.9% of 394 infertile women in Ludhiana with TSH above 4.2.
- Teede HJ, Tay CT, Laven JJE, Dokras A, Moran LJ, Piltonen TT, et al. Recommendations From the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. Journal of Clinical Endocrinology and Metabolism, 2023. Supports: TSH among the tests used to exclude other causes before diagnosing PCOS.
Related reads
- Thyroid disorders in India: symptoms, tests, treatment and daily care: the overview this page sits under, with causes, tests, treatment and the full warning-sign list.
- Thyroid symptoms in adults: the general symptom guide for men and women, sign by sign.
- TSH, T3 and T4: how to read your thyroid report: normal ranges, common patterns and pregnancy cut-offs.
- Which thyroid doctor to see: physician, gynaecologist or endocrinologist, and when.
- Menopause and perimenopause support: symptoms that overlap with thyroid problems in your 40s and 50s.
- PCOS symptoms one by one: the other common cause of irregular periods and weight change.
- All thyroid articles: every Disha thyroid guide in one place.
- BMI calculator with Indian cut-offs: a screening number, not a thyroid test.
