I never expected perimenopause at 35. But after being diagnosed with hypothyroidism, my body started signalling changes that felt unusual for my age – irregular cycles, heart palpitations, fatigue, mood swings, fluctuating energy levels and night sweats. Suddenly, I was navigating symptoms that most women don’t face until a decade later.

At first, I felt completely off balance, worrying about heart attacks, depression, and second-guessing everything. But I soon realized that hypothyroidism wasn’t the end of vitality, and perimenopause, even early, is manageable with awareness and intention.

Understanding the Risk

Hypothyroidism can accelerate perimenopause symptoms because thyroid hormones influence metabolism, energy, and mood regulation. Low thyroid function can worsen fatigue, irritability, anxiety, and sleep disturbances, all of which are risk factors for depression. Recognizing the link between my thyroid health and emotional wellbeing was the first step toward taking control.

Taking Charge of my Mental & Physical Wellbeing

Here’s what helped me, and I hope, can help others in similar situations stay resilient, emotionally and physically balanced:

1. Monitor your thyroid health (who to see and how)
Hypothyroidism and perimenopause share many overlapping symptoms – fatigue, mood changes, weight gain, palpitations, and heat intolerance – so working with the right specialist is essential.

I was diagnosed at 35 and placed under the care of Prof. Sum Chee Fang at Gleneagles Hospital (now Head of the Diabetes Centre at Admiralty Medical Centre). In the early years, I saw him every three months with twice-yearly thyroid ultrasounds. The choice then was early lifelong medication or close monitoring with lifestyle support. I chose careful monitoring.

Today, I’m under the care of Dr Vanessa Au at Changi General Hospital, and I take Levothyroxine. As my results stabilized, my follow-ups reduced from twice yearly to once a year, with an annual ultrasound and blood work.

A specialist in London once told me that thyroid disorders and perimenopause are often mistaken for each other. That insight stayed with me: don’t assume – test and monitor.

What this looked like in practice:

• Endocrinologist review: every 3–6 months initially, then yearly once stable
• Thyroid ultrasound: 1–2 times a year to check on nodules (irregularity and growth) and results
• Regular blood tests (TSH and related markers)
• Medication only when clinically necessary

Alongside medical care, I had to accept that weight would be the hardest symptom to manage. Instead of chasing diets, I focused on cutting sugar, eating only when hungry, and listening closely to my body’s cues. This gentle, responsive way of eating helped me maintain stability without adding stress to an already sensitive system.

Even now, I only see my endocrinologist for thyroid care and manage the rest of my symptoms through movement, mindful eating, and annual health checks.

2. Prioritize sleep: Hormonal shifts and hypothyroidism can disrupt sleep. I created a nightly routine: cool, dark room, no screens before bed, and relaxation (breathing) exercises. Sleep became non-negotiable, because tiredness magnifies mood swings.

3. Move your body consistently: Walking, cycling, light strength training at the gym, aerobics, and dancercise (my fav!) stabilized my energy and improved my mood. My focus was not on intensity, but on consistency. Even 20 to 30 minutes a day made a difference. Often this was broken into small pockets — brief morning chair yoga with light weights, short daily walks, and longer outdoor movement a few times a week. I didn’t follow a strict routine or step target; I moved in ways my body could tolerate.

4. Nourish your brain and body: I focused on foods that support both thyroid and emotional health: protein, omega-3s, whole grains, and plenty of fruits and vegetables. Reducing sugar and ultra-processed foods helped stabilize my energy and mood.

5. Talk openly: Sharing experiences with friends, support groups, and mental health professionals prevented isolation. Silence only magnifies anxiety and low mood – connection is protective. For me, this wasn’t a formal group — it was a trusted circle of medically informed friends, family, and women going through the same stage of life. If you prefer structured support, Singapore has excellent menopause support groups such as KKH’s “Dynamite Daisies”, Surety’s Menopause Support Group, and Women Like Me.

6. Redefine Strength: Real strength is not about pushing through exhaustion. It’s listening to your body, setting boundaries, and asking for help when needed. Early perimenopause taught me to recalibrate priorities without guilt.

Early Perimenopause Is Manageable

If you’re facing early perimenopause due to hypothyroidism:

• Know you are not alone.
• Depression is not inevitable.
• Awareness, intentional self-care, and professional support are your strongest tools.

Menopause may start earlier than expected, but it doesn’t have to disrupt your life. With knowledge, action, and self-compassion, you can navigate this phase with resilience, clarity, and confidence. I did, and it changed my perspective entirely.