Menopause & Night Sweats: Causes & Remedies

Night sweats are among the most common menopause symptoms women experience during the menopausal transition. When night sweats occur multiple times throughout the night, they can cause sleep disturbances, potentially impacting overall quality of life. A variety of therapeutic options exist to manage these episodes effectively. Consulting a healthcare professional is the best way to determine the most effective treatment approach tailored to individual needs, including lifestyle adjustments, dietary changes, and medical interventions.

What are night sweats?

Night sweats, also known as vasomotor symptoms (VMS), (along with hot flashes), are triggered by fluctuations in estrogen and progesterone that influence the body's temperature regulation. These hormonal changes lead to the sudden expansion and subsequent contraction of blood vessels as the body attempts to cool itself down. During these episodes, individuals may experience intense heat, profuse sweating, skin redness, and a rapid heartbeat, often mirroring the sensations of a panic attack. Typically, these symptoms last from a few seconds to several minutes and conclude with a slightly chilled sensation.¹

While night sweats are thought to be associated with menopause, they can also be symptoms of other medical conditions. Diseases such as tuberculosis, HIV, diabetes, obstructive sleep apnea, lupus, certain cancers, and gastroesophageal reflux disease (GERD) are known to cause night sweats. Additionally, night sweats may occur as side effects of various therapies, including aromatase inhibitors, tamoxifen, opioids, steroids, antidepressants, and medications for diabetes and hypertension.²

Treatment and Prevention of Night Sweats During Menopause

Hormone Replacement Therapy (HRT)

HRT is recognized as one of the most effective treatments for managing night sweats. Research indicates systemic estrogen may reduce the incidence of VMS by up to 75%.³ For women with a uterus, progesterone is added to the regimen to prevent endometrial hyperplasia, a condition characterized by excessive thickening of the uterine lining.

A doctor will carefully tailor HRT to suit each individual's needs and consider any relevant risk factors. The goal is to prescribe the lowest effective dose of hormones to minimize potential side effects and ensure a balanced approach to symptom management.

Antidepressants

Paroxetine, an antidepressant, was the first non-hormonal medication approved by the FDA specifically for treating vasomotor symptoms like night sweats.³ Other antidepressants like venlafaxine and fluoxetine are also effective in managing night sweats. These antidepressants are typically prescribed to help alleviate hot flashes in menopause and can be discontinued once the symptoms subside.

Other Medications

Besides hormone therapy and antidepressants, medications such as fezolinetant and clonidine are also effective alternatives for easing night sweats. Fezolinetant works by blocking neurokinin B in the brain, which reduces the signals that trigger hot flashes and night sweats. Meanwhile, clonidine expands the thermoneutral zone, which is the range of temperature where the body can maintain its core temperature through passive heat loss, helping to alleviate night sweats.^4,5

Lifestyle Changes to Improve Menopause Night Sweats

These lifestyle changes can be a great starting point to alleviate night sweats naturally:

1. Avoiding Triggers

Environmental conditions and specific habits can often initiate night sweats. Common triggers include:^6,7

• Heated surroundings

• Heavy clothing

• Insulating bedding

• Warm beverages

• Spicy cuisine

• Alcohol and caffeine consumption

• Smoking

• Exposure to secondhand smoke

• Excess weight

• Emotional stress

Avoiding or minimizing these triggers can lessen the frequency, intensity, and length of night sweats.

2. Creating Certain Habits

Experts recommend the following strategies to manage night sweats:³

• Adopt a balanced, nutrient-rich diet that aids in weight management.

• Engage regularly in physical activities to enhance restful sleep, reduce stress, and maintain a healthy weight.

• Practice stress-relieving techniques, such as rhythmic breathing, meditation, or yoga.

• Opt for loose, breathable clothing, and dress in layers for easy adjustment to temperature changes.

• Use fans or air conditioning to maintain a cool home, workplace, or vehicle environment.

• Carry a handheld fan for immediate cooling relief when needed.

• Drink cool water or other chilled beverages regularly to help regulate body temperature.

3. Maintaining Good Sleep Hygiene

The following adjustments in bedroom environments and bedtime routines may help manage night sweats and promote restful sleep:

• Avoid caffeine and alcohol close to bedtime to prevent sleep disturbances.

• Use ceiling or bedside fans to maintain a cooler environment during the night.

• Establish a calming bedtime routine to minimize stress before sleep.

• Choose lightweight sheets, and wear loose, breathable clothing to bed to stay cool.

• Flip pillows throughout the night to keep the cooler side against the face.

• Try cooling gel pillows or using an ice pack under the pillow for additional coolness.

• Keep an insulated bottle of cold water by the bed to sip throughout the night.

• Have a cooling spray or a spray bottle filled with ice water to mist if needed.

4. Improving Diet 

Incorporating whole grains, fruits, and vegetables can help maintain overall health and hormonal balance. Soy products like tofu and tempeh contain phytoestrogens that may also assist in balancing hormones. Opting for smaller, more frequent meals will prevent metabolic spikes that lead to overheating.⁹ Staying hydrated by drinking plenty of water throughout the day is equally important, as it helps regulate body temperature. 

5. Taking Supplements

While many supplements, such as black cohosh, dong quai, and red clover, are known for their potential to alleviate night sweats, they may also have side effects or interact with other medications. Given these potential risks, it’s crucial to consult a physician before trying any new supplement.^10,11

6. Exploring Other Complementary Approaches

Some individuals experiencing menopausal symptoms find relief through alternative practices, which include the following:¹²

• Mindfulness meditation: Research suggests it can significantly lessen the discomfort associated with night sweats. This practice involves focusing on the present and accepting it without judgment, which can help manage the anxiety and stress that often accompany menopausal symptoms.

• Cognitive behavioral therapy (CBT): Studies indicate that CBT can effectively reduce the impact of hot flashes and night sweats. This therapeutic approach helps develop practical problem-solving skills and offers new coping strategies, enhancing their ability to manage the psychological aspects of these symptoms.

Experiencing menopausal night sweats? Discover if HRT is right for you.

If you’ve entered the menopause transition and are struggling with night sweats, you don’t have to suffer in silence. Take our brief menopause quiz to see if you’re an eligible candidate for HRT. Get started with Winona to take the first step toward feeling better.