What Causes Night Sweats?

June 29, 2020.
One of the most common menopause symptoms experienced by women is hot flashes. Indeed, around 75% of women will have this frustrating symptom during perimenopause, and at least a quarter of these women will seek medical treatment. Hot flashes can be extremely disruptive and sometimes unnerving. And they don’t only happen during your business meeting or picking your kids up from school. They also can occur at night, which can completely interrupt your precious sleep.
Night sweats can be an unnerving experience. You go to sleep feeling seemingly ordinary and wake up to soaked pajamas and sheets. It can undoubtedly raise the alarm in your already anxiety-prone head: Am I sick? Is my thyroid okay? What the hell is going on?! Let’s answer your questions of “what are night sweats a sign of?” and “how can night sweats be managed?”.

What Are Nights Sweats, You Ask?

Night sweats (also known as hyperhidrosis) are a state of excessive perspiration (or sweating) while a person sleeps. Both men and women can experience night sweats, and it is surprisingly common in both sexes. You can experience night sweats here and there, often, or even every single night.
Hyperhydrosis is a result of temperature dysfunction. Our body’s temperature regulation is highly complex and is a result of multiple body systems working together. For example, thermoregulators in your skin and periphery send messages to your hypothalamus (your internal thermostat that resides in your brain), which releases hormones that control body temperature. When your hypothalamus senses that body temperature is too high, it signals over 3 million sweat glands (also called eccrine glands) to secrete clear fluid so heat can escape through evaporation.
Many internal and external factors can affect body temperature. When there is no obvious explanation for night sweats, such as too many bed covers or a hot bedroom, night sweats are often the result of hormonal imbalance. While the connection between night sweats are hormones is well known, the relationship is not well understood.

I Woke In A Pool Of Sweat Last Night. What Are Night Sweats A Sign Of?

We know that night sweats can often be the result of hormonal imbalance. Frequently, women experience night sweats during pregnancy at certain intervals in their menstrual cycle, and especially in perimenopause and menopause.
During these periods in a woman’s life, estrogen levels can fluctuate. Perimenopause, in particular, is a phase where estrogen levels vary erratically. This is because your ovaries become less functional as you get closer to menopause. Your hypothalamus is highly sensitive to estrogen fluctuations, which can cause vasomotor symptoms such as:
  • A sudden increase in blood flow to your face, neck, and chest
  • Feeling extremely hot
  • Profuse sweating

What are night sweats caused by aside from hormonal imbalance?

  • Infection – Night sweats can be the result of fevers from illnesses such as tuberculosis, HIV, and bacterial and viral infections
  • Thyroid Disease – The thyroid gland is considered the metabolic powerhouse of the body. When thyroid hormones or too high or too low, it can cause temperature dysfunction.
  • Anxiety – People with mild to severe anxiety can experience night sweats related to recurrent worrisome thoughts and subconscious processing of fears.
  • Medication – Some medications have a side effect of perspiration, including some antidepressants, steroids, and diabetic medications.
  • Other causes include drug addiction, some cancers, autoimmune disorders, adrenal gland tumors, sleep disorders, and stroke.

So, I Can Expect Night Sweats In Menopause. What Else Should I Look Forward To?

There are three distinct stages of menopause: Perimenopause, menopause, and postmenopause.
Perimenopause refers to the years leading up to menopause where you can experience menopause symptoms due to erratic fluctuations in estrogen and progesterone.
Menopause is diagnosed when a woman has been period-free for at least 12 months.
Postmenopause usually starts 1-3 years after a woman reaches menopause and lasts the rest of a woman’s life.
There are 34 symptoms of menopause, which can include physical and mental symptoms. These symptoms can be experienced throughout a woman’s menopause journey, but they usually start in perimenopause. Some of the most common perimenopause symptoms include:
  • Irregular periods
  • Hot flashes and night sweats
  • Vaginal dryness
  • Low libido
  • Anxiety
  • Depression
  • Weight Gain
  • Fatigue
  • Insomnia
  • Mood swings
  • Headaches
  • Digestive issues
  • Joint pain
For a complete list of the 34 symptoms of menopause that you can experience, click here.

What Are Night Sweats Caused By In Menopause? Usually, hormone fluctuations. What Can I Do To Manage And Even Prevent Night Sweats?

Focus on your sleep environment by turning down the thermostat and turning up the fan before getting into bed. If you share a bed with someone else, remind them to dress warmer as you will not be able to tolerate many covers. Some fabrics are better at wicking heat and sweat from your body, so consider sweat-wicking materials or toss the pajamas altogether. Often, layering both your pajamas and bedding is a great way to control your temperature as you may have cold flashes as well. (Does the fun ever end?)
Your diet may worsen your night sweats if you eat certain foods at dinner, especially in larger quantities. Spicy food, caffeine, and alcohol may exacerbate hot flashes and night sweats. Certain foods may help increase estrogen naturally including berries, tofu, and yams.
Quit smoking, and if you need help cutting this habit, meet with your doctor to discuss how to stop.
Reduce stress as it can worsen anxiety and reduce your quality of sleep. Try to implement stress-reducing practices each day, including mindfulness, meditation, and yoga. Controlling your anxiety is also essential in reducing stress. Many people who are feeling anxious report changes in body temperature, along with an increased heart rate. For strategies on how to treat anxiety,
Daily exercising may help curb night sweats and keep your weight in check,
If making some lifestyle and environmental changes do not improve your night sweats, consider using supplements or hormone replacement therapy to stabilize your hormone fluctuations. According to the North American Menopause Society, hormone replacement therapy is the most effective tool that most healthy women can use for managing vasomotor symptoms in perimenopause, including night sweats. As always, if you are concerned about your night sweats or are struggling to manage because of your perimenopause symptoms, seek medical advice from your doctor.
Disclaimer: This is not medical advice, does not take the place of medical advice from your physician, and is not intended to treat or cure any disease. Patients should see a qualified medical provider for assessment and treatment.

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Julia Walker
perry expert Julia (RN, BSN, BA) is a registered nurse based in Colorado. Julia's nursing background in women’s health has ranged from neonatal and postpartum care to labor and delivery, to outpatient gynecological medicine for both adolescent and adult populations. She specializes in helping women optimize their health during perimenopause and beyond.

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