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Menopause hub

Night Sweats in Menopause

Night sweats are a widespread occurrence, affecting 41% of people day to day. They are more likely to affect women and are common in menopause, perimenopause, pregnancy and (in some cases) at certain points during your menstrual cycle. They are one of the most prominent menopause symptoms, with more than 80% of women impacted by a combination of them and hot flushes during the day.

An average hot flush or night sweat lasts 3-4 minutes but they can pass in as little as 30 seconds or go on for up to an hour. Although they can vary in frequency and intensity, it isn't unusual to wake up to find your body, clothing and bedding drenched in sweat. This can understandably be frustrating and debilitating, especially as this disrupts your sleep.

The first line treatment for menopause sweating is hormone replacement therapy (HRT) which can normally eliminate these symptoms pretty quickly. To get to grips with what's going on in your body with regard to menopause and excessive sweating and to better understand treatment for menopause night sweats, this guide explores this troublesome symptom in detail.

What are night sweats?

It’s normal to sweat sometimes during the night if your bedding or sleep environment is too warm. However, night sweats are hot flushes that occur at night, and they happen even if where you are sleeping is cool. They often disrupt your sleep as you wake up due to excessive sweating and other unpleasant physical sensations.

Symptoms of menopausal night sweats include:

  • A sudden wave of heat that spreads across your entire face and body
  • Drenching sweats that can soak through your clothes and bedding, meaning you need to towel yourself dry, bathe, and/or change your sheets
  • Reddened skin as if you’re blushing
  • Rapid heartbeat
  • A feeling of anxiety
  • Feeling chilly after the night sweats have subsided

Night sweats can be a telltale sign that you have reached perimenopause, especially if your periods are erratic and your menstrual bleed is heavier or lighter than usual.

Why do they happen during the menopause?

Hot sweats during menopause are caused by a reduction in the hormones oestrogen and progesterone. These hormones are produced by the ovaries and during a menstrual cycle, they help the lining of the womb repair itself after each menstrual period and then maintain the lining after ovulation in preparation for pregnancy.

During perimenopause and menopause, these hormones fluctuate and start to decline as you come to the end of your reproductive years. In response to the decrease in oestrogen and progesterone, your glands release higher amounts of other hormones, and these affect your hypothalamus (your brain’s thermostat) and thus, your body’s ability to regulate its temperature effectively.

Night sweats after the menopause

For some women, night sweats go away by themselves a few years after menopause starts. However, many women will deal with hot flushes and night sweats for far longer, between 7-11 years.

Information from the British Menopause Society states that some women can experience night sweats for up to 20 years. If you do continue to experience night sweats post-menopause, you’ll usually find that they become less frequent and severe over time.

How do you stop menopause sweats?

When it comes to treatment for menopause night sweats, hormone therapy consisting of oestrogen alone or combined with progestin (synthetic progesterone) is considered to be the most effective option. Up to 90% of all vasomotor symptoms of menopause disappear within three months of starting treatment, and many women see improvement within just a few weeks.

There are also other lifestyle changes and alternative remedies that can help with menopause night sweats.

Night sweats relief and remedies

Lifestyle changes

Simple ways to ease hot flushes and night sweats revolve around keeping your body temperature regulated as best as possible. Here are some things you can try:

  • Wear light clothing made from natural fibres such as cotton and linen
  • Keep your bedroom cool by opening a window or using a fan or air conditioning
  • Use a cool pack under your pillow
  • Switch to a lower tog duvet cover or use multiple layers of bedding that can be easily removed
  • Drink a small amount of cold water or have a cool shower before bed
  • Avoid potential triggers such as caffeine, alcohol, spicy food, smoking and hot drinks
  • Exercise regularly during the day
  • Maintain a healthy diet and body weight
  • Try to reduce your stress levels

Contraception

Symptoms of menopause and contraception use can be linked. For instance, the combined pill can mask or regulate symptoms, including hot flushes and night sweats. However, some birth control can also contribute to night sweats, making them worse. Therefore, contraception isn’t recommended as a remedy for night sweats, but it is worth discussing with a menopause specialist.

Medications

If you cannot take HRT because you have a history of breast cancer for instance, or don’t feel it is the right choice for you, there are non-hormone-based medications that can help reduce night sweats, including a blood pressure medication called clonidine and an epilepsy medication called gabapentin.

Cold water swimming

Cold water swimming is an activity which involves swimming in cold or icy water, typically outside in lakes, seas or other open bodies of water.

It is shown to be beneficial for navigating menopause and the sleep disturbances that it causes. One study asked women to report on the differences in their symptoms since cold water swimming. The finding revealed that:

  • 45% of women stated their anxiety was reduced by cold water swimming
  • Nearly 35% of women experienced less mood swings
  • 31% said their low mood was reduced
  • 28% said it reduced depression
  • 30% had fewer hot flushes
  • 20% reported night sweats to be considerably reduced

Turning your shower cold for a few minutes at the end of your cleanse may have similar effects and be a more convenient option for many women.

Alternative remedies

Natural supplements and holistic therapies can also help to manage night sweats and hot flushes. Herbal remedies that are sometimes used for menopause symptoms include:

  • Soy, red clover or flaxseed: these all contain plant compounds called phytoestrogens which have a similar chemical structure to oestrogen
  • Black cohosh
  • Vitamin E and Omega 3
  • Evening primrose oil: although results on its effectiveness on night sweats have been mixed
  • Milk thistle

Holistic approaches for managing menopausal night sweats include:

  • Yoga
  • Acupuncture
  • Breathing exercises
  • Meditation
  • CBT

Getting help with menopausal night sweats

If night sweats are disrupting your sleep and affecting your well-being, it might be a good time to speak to a doctor. Talking to a specialist who knows what you are going through will ensure you get practical guidance and treatment options to help you manage your symptoms.

When you speak to Menopause Care, you’ll discuss your medical history and lifestyle in depth with one of our trained specialists, who’ll help to develop a plan of action you are happy with and understand.

When appropriate, we will arrange blood tests to rule out other causes of your symptoms and to check your hormone levels. We will liaise with your GP and, when needed, other specialists involved in your care. If medication is prescribed, we can arrange for you to start taking it as soon as possible.

If you are starting HRT, we can optimise your HRT regime to eliminate symptoms as quickly as possible. We will then guide your care for as long as you need with regular follow-up appointments and can arrange further investigation where appropriate to optimise your health post-diagnosis.

We also offer in-house Cognitive Behavioural Therapy (CBT) to help you build strategies to reduce negative thoughts and develop positive behaviours. Further, we have an in-house dietitian to help address any concerns you may have surrounding your diet and symptoms.

To get started, book a consultation with a Menopause Care doctor.

References
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Night Sweats in Women: Causes, Remedies, and Tips. Jay Summer, John DeBanto (March 2024)

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Menopausal Hot Flashes: A Concise Review - PMC. Ramandeep Bansal, Neelam Aggarwal (March 2019)

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Night sweats - NHS. NHS (November 2023)

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International Menopause Society Hot flushes and night sweats -‐ backgrounder. IMS - International Menopause Society (October 2011)

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How do women feel cold water swimming affects their menstrual and perimenopausal symptoms?. Megan Pound, Heather Massey, Sasha Roseneil, Ruth Williamson, C Mark Harper, Mike Tipton, Jill Shawe, Malika Felton, Joyce C Harper (January 2024)

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Black cohosh extracts in women with menopausal symptoms: an updated pairwise meta-analysis. Ryoichi Sadahiro, Nohara Lilian Matsuoka et al. (July 2023)

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Evaluation of the effect of Silybum marianum extract on menopausal symptoms: A randomized, double-blind placebo-controlled trial. Zohreh Saberi, Narjes Gorji, Zahra Memariani, Reihaneh Moeini, Hoda Shirefkan, Mania Amiri (August 2020)

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