By the time perimenopause begins, fatigue, stubborn weight changes, irregular cycles, low progesterone, low mood, and fertility struggles can all be folded into the same explanation: hormones are changing. But what if some of the symptoms women are taught to expect during this transition are also pointing to a gland that rarely gets included in the conversation?
Most women hear about the thyroid in relation to metabolism, yet its reach extends through the cycle, ovaries, ovulation, progesterone, fertility, and the wider endocrine system. In this episode of The Ovary Club, I sit down with Dr. Amie Hornaman to uncover why thyroid dysfunction can be hidden inside what looks like perimenopause, why having the thyroid checked is not always the same as having it fully evaluated, and what women may be missing when every symptom is treated as a separate problem. We also examine the surprising research connecting long-term hormonal contraceptive use with thyroid risk and the overlooked overlap Dr. Amie calls thyropause.
Dr. Amie Hornaman is a functional medicine clinician, founder of the Advanced Thyroid and Hormone Clinic, host of the top-rated The Thyroid (and Hormone) Fixer Podcast, and author of The Thyroid Fix. Through her clinical work, she helps women investigate persistent symptoms, understand the thyroid markers that standard testing may leave out, and explore more individualized approaches to thyroid and hormone care.
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What's Discussed
(03:40) Why the thyroid belongs in the conversation about cycles, progesterone, fertility, and perimenopause.
(05:50) The first thyroid question Dr. Amie asks when hormone symptoms do not fully add up.
(09:13) The surprising link between long-term hormonal contraceptive use and thyroid risk.
(13:59) What can happen when the body is not converting thyroid hormone efficiently.
(19:18) What "thyropause" means and why it can overlap with perimenopause.
(29:31) Why some women continue to struggle even after starting thyroid treatment.
(34:41) The thyroid markers that may reveal what a basic panel leaves unanswered.
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The Lab Request Checklist: Struggling with hormonal issues that you just can't figure out? Get the exact labs to ask your doctor for so you can measure progress instead of guessing. alisavitti.kit.com/
Learn more about Alisa Vitti:
Instagram: @alisa.vitti
Website: alisavitti.kit.com/
Learn more about Dr. Amie Hornaman
Website: dramie.com
The Thyroid Fix book: thyroidfixbook.com
Instagram: @dramiehornaman
Facebook: facebook.com/groups/dramie
YouTube: youtube.com/dramiehornaman
TikTok: @dramiehornaman
7-Day Thyroid Healing Kickstarter: fixyourthyroid.com/7daykickstarter
