This review explores the complex relationship between thyroid function and menopause, focusing on physiological interactions, clinical implications, and diagnostic challenges associated with thyroid dysfunction in postmenopausal women. Drawing on recent studies and current understanding, it examines how menopausal hormonal changes influ­ence thyroid health, increasing the risk of conditions such as hypothyroidism, hyperthyroidism, and subclinical thyroid disorders. Overlapping symptoms, including mood changes, sleep disturbances, weight fluctuations, and reduced libido, complicate diagnosis, as they can be attributed to both menopause and thyroid dysfunction. Hormonal shifts can also impact bone mineral density, cardiovascular health, and metabolism, while prolonged estrogen exposure and surgical menopause are linked to an elevated risk of thyroid cancer. Diagnostic complexity is heightened by age-related changes, comorbidities, and potential interferences in thyroid function tests. Routine thyroid assessment is recommended for women with surgical menopause or other risk factors. Personalized management, including meno­pausal hormone therapy (MHT), can address overlapping symptoms and mitigate skeletal and cardiovascular risks. A patient-centred approach is crucial, with treatment tailored to individual health profiles. Further research is needed to clarify the interactions between menopause and thyroid function to improve clinical care.