Night Sweats in Women: Causes and Treatments

In menopausal women, night sweats can happen several times during the night, disrupting your sleep and leaving you exhausted. Let’s look at why they happen and how they can be treated.

What are night sweats?

Night sweats are known in medical terms as ‘sleep hyperhidrosis’. Usually they are not serious in themselves, but as anyone who has spent the night waking up, soaked through with sweat can tell you ⸺ they can affect your quality of life.

During a night sweat you may feel a sensation of heat through your body, followed by excessive sweating and then, once it’s passed, a chill.

For women experiencing menopause, night sweats are severe hot flashes that occur while you’re sleeping, a common symptom of this life stage.

Women experience night sweats in different ways. Some may only have mild sweats while others may wake several times a night to find their clothes and sheets soaked with perspiration, leading to significantly disturbed sleep.

This regular sleep disturbance can have a major impact on your quality of life and you may experience:

• Mood disturbances
• Insomnia
• Increased fatigue
• Difficulty concentrating
• Irritability

Why do we sweat at night?

Sweating is the body’s method of regulating our core temperature to avoid overheating. Essentially, when you’re laying in bed asleep at night, your body mistakenly assumes it’s too warm, triggering a chain reaction to cool you down.    

When your body registers your body temperature rising, blood vessels in your upper body expand and then contract to increase your blood flow and spread your body’s heat across the skin. This is when you feel a flushed sensation, your skin reddens, your heart rate increases and you sweat.

As the sweat evaporates from your skin, it releases heat as energy and your body cools down.

This cooling mechanism is regulated by a small area of the brain called the hypothalamus, which controls over two million sweat glands that release the water and other chemicals to cool the skin.

Causes of night sweats in women

So why do we start sweating at night? It’s got less to do with having too many sheets and covers and more to do with your body’s reaction to your brain thinking it’s overheating (even when it’s not).

Night sweats in women are most commonly the result of hormonal imbalances during menopause and perimenopause. Perimenopause means ‘around menopause’ and is the transitional period before menopause. This period usually occurs between ages of 40 and 50. Menopause is signaled when a woman has not menstruated in 12 months, and the average age of the onset of menopause is 51.

As levels of estrogen fall in menopausal and perimenopausal women, this changes how the hypothalamus (an important area within the brain) regulates body temperature. The hypothalamus becomes far more sensitive to slight changes in temperature and can become trigger happy when initiating the body’s cooling processes ⸺ activating your night sweats.

Other causes of night sweats in women

Not menopausal, but experiencing night sweats? Night sweats in women may also occur for non-menopausal reasons too, such as:

Hormonal imbalances

Night sweating may be caused by medical conditions associated with hormonal imbalances, such as:

• Hyperthyroidism: overproductions of thyroid hormones
• Carcinoid syndrome: excessive hormones due to tumors of the lung or gastrointestinal system
• Adrenal gland tumors.

Idiopathic hyperhidrosis

Idiopathic hyperhidrosis is a medical condition involving abnormally excessive sweating, usually unrelated to body temperature or exercise. This condition causes sweating without an identifiable medical cause.

Neurological disorders

In rare cases, neurological conditions may result in increased sweating and cause night sweats. These include:

• Autonomic neuropathy: damage to nerves
• Autonomic dysreflexia: a syndrome causing high blood pressure
• Stroke: damage to the brain due to interrupted blood supply
• Post-traumatic syringomyelia: a disease in which a fluid-filled cyst forms in the spinal cord, following a spinal cord injury.

Diabetes

Night sweats in women may also be a sign of diabetes, as low blood sugar (hypoglycemia) during the night can cause excessive sweating. Night sweats may also be caused by medications to treat diabetes such as insulin or sulfonylureas, which lower blood sugar levels. In addition, excessive sweating can also occur due to obesity, which often occurs with diabetes.

Cancer

In rare cases, night sweats may be an early warning sign of some cancers. These include leukemia (cancer of blood-forming tissues) and lymphoma (cancer of the lymphatic system). People with an undiagnosed cancer may also experience other symptoms such as unexplained weight loss and fever.

If you’re concerned about night sweats being a sign of something more serious, make an appointment with your doctor to talk about your night sweat symptoms. They can help you find the right diagnosis.

Obstructive sleep apnea

Obstructive sleep apnea is a sleep disorder in which breathing repeatedly stops and starts. Research suggests that night sweats are up to three times higher in people with this condition than the general population.

Infection

Several bacterial and viral infections may cause night sweats. These include:

• Tuberculosis
• Human immunodeficiency virus (HIV)
• Endocarditis:  infection of the heart valves
• Osteomyelitis:  infection in a bone.

Gastroesophageal reflux disease (GERD)

Gastroesophageal reflux disease (GERD) is a stomach problem in which stomach acid and bile irritate the lining of the esophagus and is sometimes associated with night sweats and sleeping difficulties.

Medications

Several medications may cause flushing and night sweats as a side effect, such as:

• Aspirin: a common drug for relieving aches and pains
• Niacin: an important nutrient for the body taken as a dietary supplement
• Tamoxifen: an anti-estrogen drug
• Hydralazine: a medication used to treat high blood pressure
• Sildenafil (Viagra): a medication used to treat erectile dysfunction
• Cortisone: a steroid hormone used to relieve pain and inflammation.

Psychological conditions

Increased sweating and night sweats are a common side effect of stress and psychological conditions such as anxiety and depression. In particular, some research has linked night sweats to social anxiety.

When should you see a doctor?

During menopause, night sweats aren’t usually something to worry about, though you may wish to seek treatment to improve your quality of sleep and quality of life.

Other kinds of night sweats in women are also generally considered harmless, however, in some cases (as we saw above) they may be a sign of another underlying medical condition that requires treatment.

It’s important to see your doctor anytime you notice changes in your body that are out of the ordinary for you. Especially if it’s affecting your sleep and quality of life.

Treatment for night sweats in women

How you treat your night sweats, will depend on the cause. For women experiencing night sweats during menopause, there are a few different approaches.

Lifestyle changes

Making changes to your bedroom environment and lifestyle may help to reduce night sweats by reducing the likelihood your brain will mistakenly register your body as overheating.

Lifestyle changes may include:

• Wearing thin, loose-fitting clothing in bed
• Avoiding foods at night that are known to cause night sweats such as caffeine, spicy foods and alcohol
• Lowering your stress levels, through breathing exercises, meditation, yoga or hypnosis.

Cooling blankets, air conditioning and ice packs won’t reduce the frequency or duration of your night sweats, and may cause you to chill afterwards. Try to keep a stable temperature and avoid any food or drink triggers before bed.

Hypnotherapy

Hypnotherapy for menopausal hot flashes has been shown to reduce night sweats by up to 74%, showing it to be as effective as hormone replacement therapy in treating this symptom, but with no known side-effects.

Hypnotherapy has also been shown to improve symptoms of mild depression, anxiety, hormonal mood changes and hot flashes, which you may also experience during menopause.
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While it may be difficult to access specialized services for menopause hypnotherapy, and there may be high per-session costs, there are some at-home options available, including apps⸺developed in conjunction with leading hypnotherapy clinicians.

Hormone Replacement Therapy

Hormone replacement therapy (estrogen, or estrogen in combination with progestin) is an option that was commonly used for many years.There are well documented risks and benefits to using hormone replacement therapy (HRT).

Because of the underlying natural loss of estrogen, HRT has been shown to treat the symptoms of menopause, and may also help with bone loss and vaginal dryness. However, it can be risky to those with certain conditions such as cardiovascular disease or breast cancer, and less effective for those already in the menopausal phase.

To find out if this therapy is appropriate for you, it’s important to discuss your options with your doctor. There may be other, less risky options more suitable for you at this stage of life.

Antidepressants

Antidepressants have been shown to only have a modest impact on hot flashes and night sweats in women.

They are around 30% less effective than hormonal treatments and may produce unwanted side effects such as insomnia, diarrhea, dry mouth and loss of ability to achieve orgasm. Your doctor can discuss the risks and benefits for you and your personal situation.

The Wrap Up

While there are many causes of night sweats, they most commonly occur in women in menopause or perimenopause. For some women, night sweats can have a serious impact on their quality of sleep and quality of life.

The good news is that there are several treatments available to help you manage your night sweats and reclaim your sleep. These include hormone replacement therapy, in-home or in-person hypnotherapy, and making alterations to your lifestyle.