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Riding the Heat Wave: What to Do About Night Sweats

Ally, a woman in her mid-20s, experiences hot flashes right before or during her period each month. “They are not enjoyable at all. I go to sleep fine and wake up with my shirt soaked. Sometimes they wake me up because I get cold due to my pajamas being wet,” she says.

Forty-four-year-old Dara has had regular night sweats since her mid-30s. “It's not related to menopause because I was pregnant [when] they started and still have a regular menstrual cycle.” She says she doesn’t usually feel them as they’re happening but wakes up to soaked sheets and pillows.

And Sharon, a 55-year-old postmenopausal woman says she stills experiences night sweats that feel like “heat fill[ing] up my stomach and burst[ing] out through my pores in the form of sweat and flushed skin.”

While these three women span three decades and three different life stages, they’re all dealing with the same thing: working up a sweat while sleeping. While night sweats are often associated with perimenopause and menopause, they can have an effect far beyond those periods.

Sweating Through the Night? First, Look at Your Estrogen

“Hormones can play a critical role in a woman’s mood, weight, and body temperature control while she sleeps,” says Dr. Jane Frederick, MD, FACOG, and specialist in reproductive endocrinology and infertility. “In fact, a leading cause of night sweats in women is fluctuating estrogen levels.”

Low estrogen can be caused by a range of factors: your period starting, being postpartum, going through menopause, or a handful of other everyday lifestyle factors that can cause an estrogen imbalance. When this key sex hormone drops, it can disrupt the hypothalamus, which is basically the body’s thermostat. A busted thermostat results in an inability to regulate body temperature, which can lead to—ta da!—night sweats.

Even if you’re pretty sure fluctuating estrogen levels are the cause of your damp nights, it’s a good idea to mention your symptoms to a doctor as there are a variety of other less common causes that could be at the root of your hormonal imbalance.  

Dr. Frederick says that other potential culprits include a condition known as hyperhidrosis (excessive sweating), infections in the body, or a side effect from certain antidepressants. If you get them once in a blue moon, it could be that you ate something spicy, are under stress, drank alcohol the night before, or even had a nightmare, all of which can cause changes in temperature. In rare cases, night sweats may also be caused by lymphoma.

“Everything from your medical history to your diet can play a role,” says Dr. James A. Gohar, ob-gyn, co-founder and CEO of Viva Eve.  “Your doctor will want to run tests to discover the root cause of your night sweats and provide a treatment plan from there.”

Operation: Staying Dry All Night Long

Night sweats can be tricky to manage. Sometimes, they go away once a particular period of hormonal upheaval ends, like postpartum or menopause.

Other times, they take a little more trial and error to figure out. Looking at your hormones is always a good place to start, so have your hormones tested to get some insight into what’s going on, particularly with your estrogen, and what you can do to rebalance anything that has gone rogue.

If your detective work determines you are going through menopause “then hormone replacement therapy may ease the symptoms,” Dr. Frederick says, adding that a progesterone cream before bed may help reduce hot flashes and other side effects of menopause. Gohar says that people experiencing menopause-related night sweats may opt to take medication that ease hot flashes including Selective estrogen receptor modulators (SERMs), or a blood pressure medication known as Clonidine.

While you’re figuring out what your hormones are up to, there are several things you can do to help make getting some rest a little more comfortable.

The main thing that’s helped Dara and Ally is sleeping in lightweight or no clothes. (If you do wear pajamas and your night sweats don’t wake you up, it’s a good idea to sleep commando to avoid getting yeast infections from sleeping in damp underwear.) Sharon says switching to bamboo sheets has been helpful (bamboo is cooling).

A few other things you can do are:

  • Turn down your home’s thermostat into the mid-60s or sleep with a fan on

  • Invest in a cooling pillow

  • Try cooling or wicking pajamas (Lunya and Soma both have good options)

  • Pass on that evening glass of wine as alcohol can increase your body temperature

  • Experiment with cutting out spicy foods at dinner

  • Drink a glass of cold water before bed

Regardless of their causes, night sweats can be disruptive, frustrating, and can leave you feeling tired the next day. While there’s nothing more frustrating than having to get out of bed in the middle of the night for an outfit change, keep in mind that you are not alone and once you pinpoint the cause, you can get your hormones back into a very temperate balance.

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