Overview

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 menopause

Night sweats may cause problems with quality of sleep, affect the ability to fall asleep or interrupt your sleep.

Night sweats are related to menopause 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?

menopause night sweats treatment

Lifestyle changes can also make a difference in reducing hot flushes and sweats including the avoidance of alcohol and caffeine.

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
  • Anxiety
  • Other medical conditions

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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

Natural Remedies

Black Cohosh

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.

Reference: Leach MJ, Moore V. Black cohosh (Cimicifuga spp.) for menopausal symptoms. Cochrane Database Syst Rev. 2012;9:12.

Red Clover

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.

Reference: 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

In recent years, one of the most important shifts in menopause research and treatment is the recognition that body-identical hormone treatments have proven to be much safer than synthetic hormone treatments. This is something that the doctors at the Centre have supported since our inception in 2003. This has also meant that commercially produced TGA-registered body-identical hormones are available in specific doses.
‘Body identical’ hormone therapy refers to a hormone that is identical to those produced by the body. These are TGA approved treatments and have a documented profile of benefit as well as short term and long-term risk. Commercially available body-identical oestrogen is available in Australia as tablets, transdermal patches or gel in specific doses. Examples of these include Estraderm, Estradot, Climara, Estrogel and Sandrena gel. It is also available for topical vaginal treatment – Ovestin and Vagifem. Commercially available body-identical progesterone is now available in capsule form in Australia (as Prometrium). Prometrium is currently available as a 100mg capsule. Many of the studies/research available on commercial products do not extend to bioidentical hormones alone,as they predominately focus on synthetic hormone preparations. In studies that use bioidentical hormones, it does appear that the health outcome is more favourable compared to the synthetic alternative.
These products are compounded to an individual prescription from your doctor. Although the active constituents are pharmaceutical USP grade bioidentical hormones, the preparations are not individually TGA approved. Some large cohort studies have been conducted on patients using compounded bioidentical hormones and these studies have contributed to the development and controlled trials of set dose products that have been listed on the TGA register. However, because each prescription is compounded for an individual’s needs, there is no data available from controlled studies on these specific preparations regarding efficacy and safety.
Compounded bioidentical hormones may provide an option for patients where a commercial/pharmaceutical product does not achieve the desired therapeutic outcomes for patients and an alternate strength or mode of application, which is not commercially available, is indicated.
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Bio-identical Hormone Replacement Therapy (BHRT)
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These products are compounded to an individual prescription from your doctor. Although the active constituents are pharmaceutical USP grade bioidentical hormones, the preparations are not individually TGA approved. Some large cohort studies including theFrench E3N study, have been conducted on patients using compounded bioidentical hormones and these studies have contributed to the development and controlled trials of set dose products that have been listed on the TGA register. However, because each prescriptionis compounded for an individual’s needs, there is no data available from controlled studies on these specific preparations regarding efficacy and safety.
Compounded bioidentical hormones may provide an option for patients where a commercial/pharmaceutical product does not achieve the desired therapeutic outcomes for patients and an alternate strength or mode of application, which is not commercially available,is indicated.
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References:
  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3127562/pdf/mayoclinproc_86_7_010.pdf
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2211383/

 

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