Night sweats are one of the most common symptoms of menopause, leaving women with disturbed sleep and resulting in exhaustion during the day as a consequence.
There is evidence that more than 70% of menopausal women experience this symptom. Often this can happen several times during the night causing broken sleep and inconvenience.
What are Night Sweats?
Night sweats are related to hot flushes (flashes) in that the symptoms are the same, only that they occur at night and in the midst of sleep and involve excessive sweating. An overwarm environment is not the root cause of menopausal night sweats, but this can contribute to the severity of a night sweat episode.
The Typical Night Sweat Experience
Night sweats affect women in different ways with some women suffering more than others. They can be unpredictable and resulting in you waking up with your pyjamas and bed sheets soaked in perspiration. This can cause problems with partners who cannot work out why suddenly the bed clothes have been thrown off waking them from a warm slumber to find their partner in a lather of sweat.
The disturbance to sleep patterns caused by night sweats in menopause and peri-menopause can lead to a number of other problems which can include irritability, difficulties in concentration, insomnia and other sleep disorders, exhaustion, increased stress as well as extreme tiredness.
Night sweats may cause problems with quality of sleep, affect the ability to fall asleep or interrupt your sleep. This can have an affect on your moods, energy levels and general feeling of wellbeing. If this is the case, then you should consider seeking treatment.
What Causes and Triggers Night Sweats?
Falling oestrogen levels during menopause play havoc with the part of the brain known as the hypothalamus. The hypothalamus controls the body’s temperature. It is thought that somehow the hypothalamus is confused by the low levels of oestrogen and that the body is overheating. The result is that the usual defences to overheating come into play culminating in excessive sweating and reddening of the skin in an effort to cool the body down.
It is important to know that night sweats are a result of hormonal imbalance brought about by the onset of menopause and while menopause is the most common cause of night sweats in women there are other possible causes which should be considered and ruled out. Sleep apnoea, thyroid dysfunction and diabetes can also cause night sweats.
Other Factors That Cause Night Sweats:
- Side effects from medication such as depression medication, cancer treatment or diabetes medication
- Sleep disorders
- Other medical conditions
What Can I do to Prevent Night Sweats?
Hormone deficiency is the recognised cause of hot flushes and so hormone replacement in the correct balance is the most effective way of treating these symptoms. Lifestyle changes can also make a difference in reducing hot flushes and sweats.
Lifestyle changes include:
- Avoid Alcohol and Caffeine
- Avoid Spicy Foods
- Stop Smoking
- Sleep in a light cool environment
- Daily Exercise
- Practice relaxation and breathing exercises
- Healthy diet and maintain normal body weight
- Maintain good water intake during the day
- No eating within 3 hours of bed time
- Avoid stressful situations before bed
Black cohosh is an herb native to Eastern North America. Various studies conducted on black cohosh have shown potential benefits for people with menopausal symptoms however evidence of effectiveness is inconclusive.
Black Cohosh may be beneficial for hot flushes, night sweats, mood swings, low libido and poor sleep. However, studies suggest positive benefits did not exceed 6 months to 1 year of use. Due to this and possible side effects on the liver and liver damage, use of Black Cohosh is not recommended long term.
Leach MJ, Moore V. Black cohosh (Cimicifuga spp.) for menopausal symptoms. Cochrane Database Syst Rev. 2012;9:12.
Red Clover is a plant native to Europe, Western Asia and Northwest Africa. The flower top is the section of the plant that is used to produce medicinal products.
There have been mixed findings on the effectiveness of Red Clover for the treatment of hot flushes, night sweats and breast tenderness. Some research has shown that taking red clover by mouth for up to one year does not reduce these symptoms although some evidence suggests that certain products containing red clover reduces the severity of symptoms but not the frequency.
Red Clover may increase Oestrogen and therefore some symptoms can become worse by exposure to increased Oestrogen. Therefore, Red Clover products should only be used under professional advice.
Nonhormonal management of menopause-associated vasomotor symptoms: 2015 position statement of The North American Menopause Society. Menopause.22(11):1155-72
- Wild Yam Cream: double blind placebo-controlled trials with wild yam cream have found little benefit for treatment with night sweats however in the short term it was showed to be free of side effects.
- Evening Primrose Oil: Studies have shown that evening primrose oil may decrease the intensity of hot flushes and sweats.
- Maca: Used in early menopause, Maca may have a substantial reduction in comfort felt by women experiencing symptoms.
Hormone Replacement Therapy
Hormone replacement therapy is the main treatment for menopause symptoms. It is highly effective and can be offered to most women experiencing hot flushes and sweats, however, like all treatments, risks and benefits should be discussed first.
HRT may be combined (oestrogen and progestin) or oestrogen only. The latter can only be offered to those women who don’t have a uterus. HRT is available in skin patches, gels or tablets.
There are a number of side effects from HRT and these may include breast tenderness, headaches and vaginal bleeding. There is an increase in the risk of blood clots and breast cancer in some women.
Bio-identical Hormone Replacement Therapy (BHRT)
Bio-Identical hormones also known as body identical hormones have the exact molecular structure as those made in the human body. Bio-identical hormones can be extracted from a number of natural sources such as Wild Yam.
Bio-Identical hormones are prescribed by a doctor and usually compounded by a compounding pharmacist meaning patients can receive a customised treatment at the lowest possible effective dose.
There have been numerous studies on BHRT including the French E3N study which have shown effectiveness of micronized progesterone treatment with a reduced side effect and risk profile. Sadly, because BHRT cannot be commercialised by the large pharmaceutical companies, no large scale double blind placebo studies have been conducted and therefore BHRT remains a largely misunderstood form of treatment by many doctors.
If you are experiencing night sweats please do not hesitate to contact us on 1300 883 405 to book a free consultation and discuss this with one of our doctors.
You can also view the video on our YouTube page with Dr Gary speaking about Hot Flushes.