What are night sweats?

Night sweats, or nocturnal hyperhidrosis, are episodes of excessive sweating during sleep, often severe enough to soak clothing and bedding. They are a type of vasomotor symptom (VMS), which also includes hot flushes, and are primarily caused by hormonal fluctuations during menopause. These symptoms can significantly disrupt sleep have knock on effects to other aspects of day to day life and impact quality of life.[1]

Why do night sweats occur during menopause?

The decline in estrogen levels during menopause affects the hypothalamus, the brain's temperature regulation center. This can lead to an overreaction to slight changes in body temperature, triggering mechanisms like sweating to cool down, even when not necessary. This process results in night sweats.[2]

When do night sweats typically begin?

Night sweats often begin during perimenopause, the transitional phase leading up to menopause, and can continue into postmenopause. According to the Study of Women's Health Across the Nation (SWAN), the median duration of vasomotor symptoms is 7.4 years, with some women experiencing them for over a decade.[3]

Managing night sweats: evidence-based options

1. Hormone Replacement Therapy (HRT)

HRT is considered the most effective treatment for vasomotor symptoms, including night sweats. It involves supplementing estrogen levels to alleviate symptoms. The British Menopause Society and NICE recommend HRT as a first-line treatment for women without contraindications [4,5].

2. Non-Hormonal Medications

For women who cannot or choose not to use HRT, several non-hormonal options are available:

Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): Medications like paroxetine and venlafaxine have been shown to reduce the frequency and severity of night sweats.[6]
Gabapentin: Originally used for seizures, gabapentin can help reduce night sweats, especially in women who experience them at night.
Clonidine: This blood pressure medication has been found to provide some relief from night sweats, though side effects may limit its use.[6]
Fezolinetant: A newer, non-hormonal medication that targets the neurokinin B receptor pathway, showing promise in reducing vasomotor symptoms [7,6].

3. Lifestyle and behavioural adjustments

Implementing certain lifestyle changes can help manage night sweats:

Maintain a Cool Sleep Environment: Use breathable bedding and keep the bedroom temperature comfortable.
Avoid Triggers: Limit intake of caffeine, alcohol, and spicy foods, especially in the evening.
Stress Management: Practices like yoga, meditation, and deep-breathing exercises can help reduce stress, which may alleviate symptoms.[1]
Regular Exercise: Engaging in physical activity offers benefits on multiple levels to a woman’s quality of life. Including helping to regulate body temperature and improve sleep quality [8].

4. Complementary therapies

Some women find relief through alternative approaches:

Cognitive Behavioral Therapy (CBT): CBT has been shown to help manage the distress associated with night sweats and improve sleep quality [5].
Herbal Supplements: Phytoestrogens found in soy and red clover may offer mild relief, though evidence is mixed.[6]

When to seek medical advice

If night sweats are disrupting your sleep or daily life, it's important to consult a healthcare provider. Even mild symptoms warrant discussion, as effective treatments are available. Additionally, if night sweats are accompanied by other symptoms like unexplained weight loss or fever, seek medical attention to rule out other conditions.[1,2]

DisclaimerAt Voy, we ensure that everything you read in our blog is medically reviewed and approved. However, the information provided is not meant to replace professional medical advice, diagnosis, or treatment. It should not be relied upon for specific medical advice.

References

^¹

BMJ. Management of perimenopausal and menopausal symptoms. 2023. bmj.com https://www.bmj.com/content/382/bmj-2022-072612

^²

NICE. Menopause: diagnosis and management. 2024. https://www.nice.org.uk/guidance/ng23

^³

Avis NE, Crawford SL, Greendale G, et al. Duration of menopausal vasomotor symptoms over the menopause transition. JAMA Intern Med scribble-underline . 2015;175(4):531-539. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2110996