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What Causes Night Sweats in Menopause?

Cassie Hart

Written by Cassie Hart

Cassie Hart

Written by Cassie Hart

If you’re pre, peri or postmenopausal, and you’ve woken up at night feeling uncomfortably hot and drenched in sweat, you’ve most likely experienced the common menopause symptom known as night sweats.

Night sweats can severely disrupt sleep and contribute to other symptoms such as fatigue and irritability, and, as mentioned, they commonly affect women experiencing changes in their hormones – more specifically, those in perimenopause and menopause.

Night sweats can’t always be prevented, but it’s helpful to know what causes them and how to minimize their potential to disrupt your daily quality of life.1

Hot Flashes vs. Night Sweats

Night sweats occur when the body excessively sweats at night, during the sleep cycle. Menopausal night sweats aren’t caused by environmental factors, such as a warm evening or a hot room, but can instead be a physiological symptom, triggered by internal body functions and hormonal fluctuations.

The sinister sister of night sweats are hot flashes—a similar symptom experience that occurs during the day. The only real difference between hot flashes and night sweats is that night sweats occur overnight, during sleep.2

Night sweats (and hot flashes) are classified as vasomotor symptoms (VMS) and are commonly experienced during perimenopause and menopause. They may begin as early as age 40, and they affect up to 80% of women.3 According to the Study of Women’s Health Across the Nation (SWAN), night sweats can continue for seven to 11 years – and for longer in some women. Women affected by night sweats for this long, however, are often current or former smokers, and are overweight, stressed, or anxious. The average length of time most women experience night sweats during menopause is about 7.4 years—but they can persist up to 15+ years for some in the categories mentioned above.4

What Causes Menopausal Night Sweats?

Like many menopause symptoms, night sweats are triggered by fluctuating hormones. Estrogen levels drop significantly in menopause, as the ovaries produce less estrogen, and increase the production of follicle-stimulating hormones (FSH). This hormonal clash causes the hypothalamus—the part of the brain that controls temperature—to struggle to regulate the body’s "internal thermostat." The result is sudden, random temperature changes, which the body responds to by sweating excessively in order to cool down.5

Night sweats aren’t always tied to menopause, however. About one-third of pregnant women experience them (remember, you can become pregnant until the menopause transition is complete), as do many women with premature ovarian insufficiency, a condition where the ovaries stop functioning before age 40. Other causes of night sweats during menopause may include anxiety and stress, some infections, as well as certain medications, including:6

  • Aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen
  • Antidepressants
  • Cortisone and some other corticosteroids
  • Treatments for diabetes (e.g., hypoglycemic agents)

If you think a medication you’re taking could be contributing to your night sweats, it’s best to contact your healthcare provider to review your active prescriptions and/or dosage. 

How Can I Prevent Night Sweats?

Night sweats can affect your mental health, and your sense of wellbeing. Research presented at the Northern American Menopause Society’s (NAMS) annual meeting showed that night sweats often result in a high level of stress for women in menopause. Women who struggle with night sweats may also be at greater risk for depression, so it’s important to have the appropriate tools on hand to help manage any potential fallout from severe sleep disruption.7

Because night sweats are the result of internal changes in the body during menopause, it may not always be possible to prevent them. However, it may be helpful to reduce some dietary triggers, such as avoiding excess alcohol, caffeine, and spicy foods.

Other tips that may help reduce menopause night sweats include:8

  • Keeping the bedroom temperature cool by running a fan, opening windows, or turning up the air conditioning at night
  • Taking a cool shower before bed
  • Avoiding or limiting spicy foods or large meals before bed
  • Exercising regularly and maintaining a healthy weight

Managing Menopausal Night Sweats

Even if your night sweats can’t be completely prevented, it’s possible to ease discomfort—and potentially reclaim some much-needed sleep. Here are a few things you can try:

Water

Run cold water over your wrists (or apply an ice cube to this area) after waking from night sweats. Because blood vessels lie close to the skin’s surface at your wrists, the cool water or ice may help lower the temperature of your blood and restore your normal body temp faster.9

Hormone Replacement Therapy

Hormone replacement therapy (HRT) is a common treatment for many menopause symptoms, including night sweats. HRT works by restoring lost estrogen, and is available in various formats, including pills, creams, patches, rings, gels, or implants. This treatment option is often paired with progestin, a synthetic hormone mimicking progesterone.  While HRT may be an effective treatment for many, hormone replacement isn’t ideal for everyone.

If you have a uterus and no concerning personal or family history of hormone dependent cancer, your healthcare provider may prescribe hormone therapy containing estrogen with progesterone. If you've had a hysterectomy and have no contraindications to hormone therapy such as uterine or breast cancer, estrogen only therapy may be appropriate.10

Your provider may also recommend hormone-free treatments depending on your health history, in the event hormonal options aren’t right for you.

Dietary Supplements for Night Sweats

Some women may prefer a more natural approach to managing night sweats during menopause. Many types of herbal, over the counter supplements are available, such as black cohosh and red clover. However, these supplements are considered to be phytoestrogens – meaning they may interact with hormonal pathways in the body and can potentially cause hormonal side effects. They may also interact with medications, so always let your healthcare provider know if you are taking or are interested in trying these types of supplements.11

There are some hormone-free, phytoestrogen-free supplements available over the counter as well, which have been shown to be helpful for reducing the frequency and intensity of menopausal night sweats. An example of this type of supplement is Bonafide’s Relizen®, which has been clinically studied and shown to provide effective relief for menopause night sweats without the use of hormones or steroids.*

Night sweats can be considered a hallmark symptom of menopause, so it’s helpful to have some methods on hand to manage them in the event you’re struggling to stop tossing and burning. You may even sleep better just knowing you’re better prepared!

 Resources:

  1. https://www.hopkinsmedicine.org/health/wellness-and-prevention/did-i-just-have-a-hot-flash-im-44 
  2. https://www.webmd.com/menopause/guide/8-causes-of-night-sweats
  3. https://whatsvms.com/
  4. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2110996
  5. https://www.everydayhealth.com/menopause/surprising-facts-about-night-sweats/  
  6. https://www.sleepfoundation.org/night-sweats/women  
  7. https://www.everydayhealth.com/menopause/surprising-facts-about-night-sweats/
  8. https://thriva.co/hub/womens-health/night-sweats-and-the-menopause
  9. https://thriva.co/hub/womens-health/night-sweats-and-the-menopause  
  10. https://www.breastcancer.org/risk/risk-factors/using-hormone-replacement-therapy
  11. https://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/natural-remedies-for-hot-flashes

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* These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

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