7 Surprising Facts About Menopausal Night Sweats


You go to bed feeling fine, maybe even a little chilly, but soon you wake up red hot and sweating, kicking the sheets and ripping off your pyjamas. You can get so wet that you must change your clothes and bedding. The intense heat begins in the chest and extends to the neck and head. Beads of sweat grow until sweat runs down your face. It’s a menopausal hot flash and it takes five minutes to pass.

Multiply that by 20 or 30 and you can call it a day. Doctors believe that hot flashes and night sweats occur because of changes in estrogenic levels. Fortunately, there are many ways to combat the heat and excessive sweating of menopause

Hot flashes and sweating (vasomotor symptoms) are the most common symptoms of menopause and can affect three of them four menopausal women. Characterized by sudden sensations of warmth that seem to come out of nowhere and spread through the body, chest, neck, and face, hot flashes and sweats are likely caused by changes in hormone levels that affect body temperature control. The women talked about their experiences of hot flashes and sweats, the impact on their lives, and what they have done to relieve the symptoms.

Some women we spoke to have no hot flashes at all, only occasionally had a mild flush that lasted a few seconds or were simply unaffected. However, others had more intense hot flashes that occurred during the day and night, lasted several minutes or longer, and were accompanied by sweating, dizziness, light-headedness, and palpitations.

Women typically experience hot flashes at some point during menopause; in some, they lasted a year or more after the last period. However, hot flashes can continue for many years after menopause. There is no way to predict whether women will have hot flashes, and some women have hot flashes well into their 80s. Some women are still having hot flashes ten years after missing their period; another, who stopped hormone replacement therapy (HRT) four years ago, never thought that she would get hot flashes in her late 70s.

Women vividly described their hot flashes. A “tingling sensation” going from the feet through the whole body; a “bang” on the chest and neck that goes to the forehead; ‘a thermometer going up and down. One woman compared the heat she feels to be “under a lounge chair”, while another felt like someone had opened a “little trapdoor” in her stomach and placed a hot ember on it. While hot flashes can occur throughout the day without warning, women spoke of specific triggers that seemed to cause them. These included wearing woollen clothing and turtlenecks, changing temperatures, feeling stressed, drinking alcohol or coffee, and eating spicy foods. Even taking a hot shower, making love, and doing housework had influenced some women.

What Are Night Sweats?

Night sweats are soggy sweats strong enough to soak clothes and bedding and disrupt sleep. Sweating is usually a healthy cooling response that keeps your body temperature at a safe and comfortable level.

Night sweats, on the other hand, don’t necessarily feel comfortable. Instead, you may feel a sudden wave of heat spread through your body, followed by sweating, flushed skin, and a rapid heartbeat. You may wake up in a cold sweat and wonder what is causing your body to behave this way.

Night sweats often accompany menopause. When night sweats occur with other symptoms, it may indicate a condition that requires medical attention. Doctors often hear their patients complain about night sweats. Night sweats refer to excessive sweating at night.

But if your bedroom is unusually hot or you use too many beds, you may sweat while you sleep, and that’s normal. True night sweats are intense hot flashes that occur during the night and can penetrate clothing and bed sheets and have nothing to do with an overheated environment.

It is important to note that hot flashes do occur (a warmth and redness of the face or body) and can be difficult to distinguish from real night sweats. There are many different causes of night sweats. To find the cause, a doctor must obtain a detailed description. Taking a medical history and order tests to decide which medical condition is responsible for night sweats.

What Causes Night Sweats in Women?

Night sweats can affect anyone but are most associated with people who have been given a female gender at birth. Hormonal changes related to reproductive hormones like estrogenic and progesterone can cause uncomfortable changes in your body temperature that make you feel too hot. Your body may respond with a hot flash (flush) to cool itself off, or you may sweat profusely (night sweats).

Perimenopause and Menopause

Night sweats are common during perimenopause and menopause. Menopause officially begins when you haven’t had a period for 12 consecutive months. The average age at diagnosis is 51 years. Perimenopause is the time preceding menopause. During perimenopause, your ovaries produce less estrogen, progesterone, and testosterone, and your periods become irregular. Perimenopause usually occurs between the ages of 40 and 50.

Changes in hormone levels during perimenopause and menopause are likely causing the hypothalamus (the part of the brain that controls body heat) to have trouble regulating body temperature regulated. Think of a fault in your body’s internal thermostat. You may feel sudden warmth or redness in your face, neck, and chest. In response, your body tries to cool itself down by sweating too much.

People with primary ovarian insufficiency (POI) can experience night sweats for similar reasons to those in perimenopause menopause. With POI, your ovaries stop producing estrogen before the age of 40.

Premenstrual Syndrome (Pms) or Premenstrual Dysphoria (Pmdd)

Hormonal fluctuations during the menstrual cycle can also cause night sweats. Your estrogen levels drop before your period, at a time most associated with PMS and PMDD. While symptoms such as irritability and cramps are most associated with PMS and PMDD, night sweats can also occur.


Fluctuating hormone levels during pregnancy can also cause night sweats. Pregnancy-related night sweats are most common during the first trimester (weeks 1 to 14) and third trimester (weeks 27 to delivery). Sweating may continue for a few weeks after your baby is born as your hormones adjust to pre-pregnancy levels.

Are Menopause, Perimenopause, Pms/Pmdd, and Pregnancy the Only Causes of Night Sweats?

No. Night sweats are a symptom of several medical conditions and a side effect of several medications. Night sweats can occur for many reasons that affect people regardless of gender. Other causes include:

  • Infectious Diseases: Including tuberculosis and Human Immunodeficiency Virus (HIV).
  • Bacterial Infections: Including endocarditis (inflammation of the inner lining of the heart), osteomyelitis (inflammation of the bone/bone marrow), and suppurative abscess (pus from the liver).
  • Viral Infections: Including colds, flu, and COVID-19.
  • Hormonal Disorders: Including hyperthyroidism, endocrine tumours, and diabetes.
  • Substance Abuse: Including alcohol, heroin, and cocaine.
  • Neurological Disorders: Including autonomic dysreflexia, autonomic neuropathy (autonomic nerve damage), syringomyelia (spinal cyst), and stroke.
  • Cancer: Includes leukaemia (cancer of the blood and bone marrow) and lymphoma (cancer of the blood cells).
  • Behavioural Health Issues: Including Panic and Anxiety Disorders.
  • Sleep Disorders: Including Obstructive Sleep Apnea.
  • Digestive Disorders: Including Gastroesophageal Reflux Disease (GERD).
  • Side Effects of Cancer Treatments: Including aromatase inhibitors, tamoxifen, opioids, and steroids.
  • Side Effects of Other Medications: Including some antidepressants and diabetes medications, steroids, acetaminophen, aspirin, and medications for high blood pressure.

Night sweats can also be related to hyperhidrosis, a condition in which excessive sweating occurs for no apparent reason.

Surprising Facts

1) Some Women Can Suffer from Night Sweats for More Than 10 Years

It has been reported that about 75 percent of menopausal women experience hot flashes and night sweats; however, they can also start years before your last menstrual period. The average duration of hot flashes and night sweats is seven to nine years, and about a third of women will have hot flashes for a decade or more. There are eighty-year-old women who still have them.

2) Night Sweats and Hot Flashes May Not Be the Same

Recent research conducted by various health organizations and clinics around the world has shown that night sweats cause higher levels of stress compared to just that to hot flashes, either day or night. Also, women who had more hot flashes at night than during the day had a higher risk of depression. Night sweats also last much longer and produce a lot more sweat.

3) Some Women Are More Prone to Night Sweats

Several studies show that night sweats tend to occur earlier and more intensely in black women than in white women. May not be genetic. It can be socio-cultural and more difficult living conditions, such as financial burdens and racism. This has not been fully resolved.

Another study suggested that the same genetic variants that help predict reproductive aging are linked to the frequency and severity of hot flashes. On the other hand, women living in China according to one study, and Japan according to another study experience fewer and less intense hot flashes compared to women in the United States. This may be due to their increased soy consumption in their diet or other sociocultural factors, according to the study.

4) No One Knows the Exact Trigger of Menopausal Sweating

Night sweats are caused by declining estrogen levels, but the actual mechanism is not fully understood. Doctors think it’s like a faulty thermostat in the brain’s hypothalamus, which is the temperature control centre. The theory goes that when the ovaries stop producing estrogen, follicle-stimulating hormone (FSH) rises, activating neurons in the brain that control the body’s temperature set point. Whatever the trigger, the result is sleep deprivation during menopause.

5) Night Sweats Are Not Always Caused by Menopause

Many diseases can also cause night sweats: tuberculosis, HIV, diabetes, obstructive sleep apnea, lupus, some cancers, gastroesophageal reflux disease (GERD), and others,

Night sweats can also be a side effect of therapies such as aromatase inhibitors, tamoxifen, opioids, steroids, antidepressants, high blood pressure medications, diabetes medications, and more. If you have night sweats, consult a doctor to determine the exact cause.

6) Slow Breathing Can Help Reduce the Frequency and Intensity of Episodes

Try six to eight breaths per minute for 15 minutes twice a day and apply this at the beginning of episodes. This can be helpful for healthy pre-and post-menopausal women to reduce both the number and severity of those pesky menopausal symptoms.

7) Not All-Night Sweat Treatments Are Hormonal

The most effective way to treat annoying night sweats is hormone therapy (HT). However, not all women want or can. Brisdelle (paroxetine), a selective serotonin reuptake inhibitor (SSRI), is currently the only available non-hormonal drug approved by the U.S. Food and Drug Administration (FDA) for hot flashes, but other non-hormonal drugs, such as Antidepressants can help treat menopausal symptoms. There is more to come; stay tuned. Ask your doctor about new options.

Can Night Sweats Be Prevented?

Non-estrogenic drugs used to treat night sweats include:

  • Anticonvulsants (Gabapentin, Pregabalin): Also used to control/prevent seizures.
  • Antidepressants: A low-dose Brisdelle, a form of paroxetine, is FDA-approved to treat hot flashes.
  • Clonidine: Also used to treat high blood pressure, attention-deficit hyperactivity disorder, anxiety, and other conditions.
  • Megestrol: Also used to treat breast and uterine cancer, increase appetite, and reverse weight loss.
  • Oxybutynin: Also used to treat urinary tract disorders.

Lifestyle changes can help prevent some causes of night sweats. To reduce the risk of night sweats:

  • Limit your alcohol and caffeine consumption.
  • Avoid tobacco and drugs span.
  • Avoid tobacco and drugs.
  • Sleep in a cooler environment.
  • Consider buying a cooling mattress. Shop all Healthline-approved products for hot sleepers in our sleep shop.
  • Try to maintain a moderate weight.
  • Avoid do eat spicy foods during menopause, as these can make symptoms worse.

If you suspect your night sweats are related to an infection or other medical condition, do your research right away with a doctor. Ask your doctor for more information about your specific condition, treatment options, and night sweat prevention strategies.


Night sweats can be uncomfortable and disrupt sleep. In most cases, they are nothing to worry about. Sometimes they can be caused by an underlying condition that needs treatment.

Your doctor can help diagnose the cause of your night sweats. They may also recommend strategies to prevent or treat night sweats. Depending on the underlying cause, they may recommend lifestyle changes, medications, or other treatments.


Saravavan Nadarajan (Vanan)

Vanan, fitness expert and leader at EzFit Singapore, specializes in holistic training—home-based, boot camps, and corporate fitness—with over a decade of industry experience.

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