Symptom Guide: Night Sweats
What are night sweats?
Waking up in the middle of the night drenched in a sweaty tangle of sheets? Night sweats (also called “vasomotor symptoms”) are sudden waves of extreme heat in your body that cause you to sweat profusely. They’re hot flashes at night, and the reason you may be feeling like you ran a marathon (or two) in your bed.
What’s the cause?
Night sweats are caused by the fluctuation and decline of your hormones, mainly estrogen. You might have experienced them post-pregnancy or be experiencing them now in your 40’s and 50’s as you approach menopause.
Certain factors can make them worse, including stress, smoking, and being overweight. An individual night sweat episode can be triggered by factors like caffeine, alcohol, spicy foods, exercise before bedtime, stress, heavy blankets on your bed, tight clothing or a warm room temperature. Pretty much everything! Sheesh.
What’s happening inside your body?
Normally, when your body gets too warm, the hypothalamus (the part of the brain that modulates body temperature) signals your blood vessels to open up to release heat. This causes blood to flow more quickly to your face, neck and chest. It also makes your sweat glands open and your heart pump faster.
As you approach menopause, lower estrogen levels cause your hypothalamus to set off this sweat-fest at random, which is why you might wind up wide awake in the middle of the night with your clothes and sheets clinging to your body.
What does the research say?
- A recent analysis of the Study of Women’s Health Across the Nation (SWAN) found that vasomotor symptoms - like night sweats - typically last between 5 and 13 years. On a zero (meaning none) to three (meaning severe) scale, most women rated them moderate-to-severe.
- A 2006 analysis of SWAN looked at vasomotor symptoms by ethnicity and determined that African American women experience them the most often, while Asian women got them less frequently.
- Another 2006 study found a correlation among night sweats, depression, sleep disturbances and diminished libido in perimenopausal and early postmenopausal women.
How are night sweats diagnosed?
A doctor will diagnose you based on your description of symptoms.
What are effective treatments?
- Estradiol: The most effective and safe treatment available - estradiol is both natural and FDA-approved. It’s scientifically proven to eliminate night sweats in up to 75% of women and to reduce the frequency and severity in the remainder. Estradiol works by replenishing the exact form of estrogen that your ovaries are no longer producing.
- Paroxetine: An FDA-approved SSRI (selective serotonin reuptake inhibitor), Paroxetine may be prescribed for women who aren’t candidates for estrogen or choose not to take estrogen. It acts by inhibiting the reuptake of serotonin by your neurons, thus increasing the level of serotonin within your brain.
- Venlafaxine: An SNRI (serotonin norepinephrine reuptake inhibitor), Venlafaxine may be prescribed off-label to women who aren’t candidates for estrogen therapy or choose not to take estrogen. It acts by inhibiting the reuptake of serotonin and norepinephrine by your neurons, thus increasing their levels in your brain.
- Gabapentin: A prescription seizure medication, Gabapentin is also believed to act on a mechanism that helps control body temperature. It’s therefore used off-label for night sweats and has a calming effect, which can be good for sleep.
- Clonidine: Clonidine is a high blood pressure medication prescribed off-label to treat hot flashes by lowering blood pressure.
What are some non-medical treatments?
While less effective than the medical treatments, some women find that these help:
- Sleep environment: Setting your bedroom temperature somewhere between 60 and 68 F, investing in a cooling mattress and cooling pillow (pro tip: you can also place a cold pack under your pillow and flip it before sleeping!), using sheets with breathable material like cotton or linen and running a bedside fan can all help with body temperature. Keeping a glass of cold water nearby can help cool you down if you wake up during a night sweat.
- Nutrition: Phytoestrogens (like those found in soy) can mimic estrogen within your body. While soy is one of the most well-known phytoestrogens, other sources include yams, flax, and lentils.
- Supplements: Some women find that using black cohosh, vitamin E, and dong quai can help reduce their hot flashes and with them, night sweats. However, studies are inconclusive. Vitamins B6 and 12 are also occasionally used to help with anxiety related to hot flashes and the night sweats that follow.
- Breathing exercises: Deep breathing exercises and mindfulness meditation can help you manage the duration of your hot flashes and associated night sweats by calming your anxiety, thereby reducing heart rate and blood flow.
- Daily physical exercise: Sustained physical exercise can help your body to more effectively regulate temperature and release heat, which helps mitigate hot flashes throughout the day. That said, try not to exercise right before bed. This can raise your body temperature and increase the chance of night sweats.
What to do next:
- Connect with an OBGYN who treats menopause: Many doctors will list their specialties/areas-of-interest on their website, or you can ask when making your appointment.
- Determine your options: Collaborate with your doctor to identify and understand the treatment options available to you given your medical history.
- Decide what works for you: You know your body best. Select your treatment and keep working with your doctor to make sure it’s working optimally for you.
Hot flashes are the most common symptom of the menopausal transition. The average age of menopause is 51 and hot flashes often start for women in their 40s.
Learn More:
Are you experiencing other symptoms that you want to better understand and learn how to treat and manage them? Check out our following guides:
This article was reviewed by Emily Hu, MD
