Updated July 31, 2026

The symptoms often develop gradually, with fatigue being one of the most common. Some women may also notice changes in their hair, nails or skin along with other nonspecific symptoms that can easily be attributed to everyday factors such as stress, diet, aging or a busy lifestyle.

For women balancing work, family and other responsibilities, these subtle changes may not stand out at first. As a result, an underactive thyroid can go undetected for some time, and a diagnosis—particularly when it is linked to thyroid cancer—may be unexpected.

Leila J. Mady, M.D., Ph.D, M.P.H., associate professor of Otolaryngology–Head and Neck Surgery at The Johns Hopkins Hospital, discusses how thyroid cancer affects women.

Who is at risk for thyroid cancer?

Patients most diagnosed with thyroid cancer are women between the ages of 30 and 60 — with the highest risk in the reproductive years. Other risk factors include a family history of thyroid cancer, and certain inherited genetic conditions.

Thyroid nodules (growths) affect up to 80 percent of women, but only 5 percent to 15 percent of those lumps and bumps are cancerous.

Why is thyroid cancer more common in women?

Thyroid disorders are more common in women, likely related to the roles of hormones like estrogen and progesterone, as well as differences in immune system function that make women more susceptible to autoimmune conditions affecting the thyroid.

Because symptoms such as fatigue, changes in weight, mood shifts and hair loss can overlap with hormonal changes related to pregnancy, perimenopause or menopause, thyroid conditions may be overlooked or mistaken for other common health concerns. It is important for women to speak with their doctor if these symptoms persist or if they notice a lump or swelling in the neck.

Diagnosing Thyroid Cancer

If a woman notices a lump in the base of her neck, or if a doctor notices a lesion on the thyroid during imaging studies performed for unrelated reasons, the next diagnostic test is usually lab work, followed by an ultrasound.

Doctors may recommend watchful observation of small nodules. Larger growths may be tested with fine-needle aspiration, in which the doctor collects a sample of cells from the nodule with a needle and looks at them under a microscope.

Treatment for Thyroid Cancer

“Malignant” and “cancer” are scary words, but Mady says that most thyroid cancer is very treatable, even when the cancer cells spread to nearby lymph nodes, which occurs frequently. “It’s usually a slow-moving disease. There’s a 98 to 99 percent survival rate at 20 years,” she says.

Surgery

The most common treatment is surgery to remove the thyroid and any affected lymph nodes. Afterward, the patient will take thyroid hormones to cover the loss of the gland and radioactive iodine to treat any remaining cancer cells.

Are there alternatives to surgery for thyroid cancer?

Surgery is the standard treatment for most thyroid cancers, but it is not the only option, and causes a scar on the throat. In selected cases, particularly for very small, low-risk thyroid cancers, doctors may recommend active surveillance, using regular imaging and follow-up appointments to monitor the tumor rather than removing it immediately. Other treatments, such as radioactive iodine therapy, targeted drugs or external-beam radiation may be used. Talk to your doctor about the options that are best for you. 

Thyroid Cancer, Fertility and Family Planning

For most women, thyroid cancer treatment does not prevent future pregnancy. However, treatment can affect family planning timelines. Women who undergo thyroidectomy will need lifelong thyroid hormone replacement, and those who receive radioactive iodine treatment are generally advised to avoid becoming pregnant for several months afterward.

It's important for women to discuss their plans for pregnancy with their care team. Many women go on to have healthy pregnancies after thyroid cancer treatment. With appropriate follow-up and hormone management, long-term fertility is usually preserved, and pregnancy outcomes are generally excellent.

Thyroid Cancer Outlook

Although being diagnosed with thyroid cancer can be frightening, most cases are highly treatable and have excellent long-term outcomes. Early evaluation of thyroid nodules and ongoing communication with a care team can help women make informed treatment decisions.

Medically reviewed by Leila J. Mady, M.D., Ph.D, M.P.H.