Night sweats post menopausal

Doctors often hear their patients complain of night sweats. Night sweats refer to excess sweating during the night. But if your bedroom is unusually hot or you are wearing too many bedclothes, you may sweat during sleep, and this is normal. True night sweats are severe hot flashes occurring at night that can drench your clothes and sheets and that are not related to an overheated environment.

It is important to note that flushing (a warmth and redness of the face or body) may be hard to distinguish from true night sweats.

There are many different causes of night sweats. To find the cause, a doctor must get a detailed medical history and order tests to decide what medical condition is responsible for the night sweats. Some of the known conditions that can cause night sweats are:

  1. Menopause. The hot flashes that accompany menopause can occur at night and cause sweating. This is a very common cause of night sweats in women.
  2. Idiopathic hyperhidrosis. Idiopathic hyperhidrosis is a condition in which the body chronically produces too much sweat without any identifiable medical cause.
  3. Infections. Tuberculosis is the infection most commonly associated with night sweats. But bacterial infections, such as endocarditis (inflammation of the heart valves), osteomyelitis (inflammation in the bones), and abscesses can cause night sweats. Night sweats are also a symptom of HIV infection.
  4. Cancers. Night sweats are an early symptom of some cancers. The most common type of cancer associated with night sweats is lymphoma. However, people who have an undiagnosed cancer frequently have other symptoms as well, such as unexplained weight loss and fevers.
  5. Medications . Taking certain medications can lead to night sweats. Antidepressant medications are a common type of drug that can lead to night sweats. From 8% to 22% of people taking antidepressant drugs have night sweats. Other psychiatric drugs have also been associated with night sweats. Medicines taken to lower fever, such as aspirin and acetaminophen, can sometimes lead to sweating. Many other drugs can cause night sweats or flushing.
  6. Hypoglycemia. Low blood sugar can cause sweating. People who are taking insulin or oral diabetes medications may have hypoglycemia at night that is accompanied by sweating.
  7. Hormone disorders. Sweating or flushing can be seen with several hormone disorders, including pheochromocytoma, carcinoid syndrome, and hyperthyroidism.
  8. Neurologic conditions. Uncommonly, neurologic conditions including autonomic dysreflexia, posttraumatic syringomyelia, stroke, and autonomic neuropathy may cause increased sweating and may lead to night sweats.

Night Sweats

If your night sweats occur on a regular basis, interrupt your sleep, or are accompanied by a fever or other symptoms, such as unexplained weight loss, then you should schedule an appointment with your physician.

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“Your doctor will take a look at your detailed medical history and may order tests, such as blood counts and virus and thyroid tests, to determine if you have any underlying medical conditions that could be responsible,” says Dr. Rosch.

Doctors of Osteopathic Medicine​, or DOs, focus on prevention by examining how your lifestyle and environment impact your health, rather than just treating your symptoms. They also complete extensive postgraduate and clinical training before becoming fully licensed physicians. Compare physician training requirements to those required for other types of clinicians.

What causes night sweats?

Practical reasons for why someone may experience night sweats include:

  • Spicy foods or hot drinks before bedtime
  • Hot weather or an over-heated bedroom
  • Excessive amounts of blankets or bedclothes
  • Exercising before bedtime

According to Dr. Rosch, the following medical conditions are common causes of night sweats.

  • Menopause—Known as “hot flashes” during the day, night sweats are very common for women going through menopause and are often the first sign.
  • Infections—Bacterial infections like endocarditis (inflammation of the heart valves) and osteomyelitis (inflammation within the bones) may result in night sweats, with tuberculosis being the most common infection associated with the condition.
  • Chronic sweating—Idiopathic hyperhidrosis is a medical condition in which the body chronically produces too much sweat without any identifiable environmental or medical cause.
  • Cancers—Night sweats can be early indicators of some cancers. However, a person with an undiagnosed cancer typically experiences additional symptoms, such as unexplained weight loss and fever.
  • Hypoglycemia—Since hypoglycemia, or low blood sugar, can cause sweating, people who are taking medications to lower blood sugar, like insulin and oral anti-diabetics, may experience sweating at night.
  • Hormone disorders—Night sweats can be a result of problems in the hormone-producing glands (endocrine system). If a person receives too much or too little of a hormone, such as serotonin, it can result in flushing and sweating. Night sweats may also be a side effect of hormone therapy medications that regulate the amount of hormones in your system.
  • Anxiety—Stress and emotional problems that cause sweating during the day can often have the same effect at night.

Before visiting your doctor, try to eliminate the practical causes of night sweats from your daily routine and sleeping environment. “Make sure your bedroom is at a comfortable temperature for sleeping, remove extra blankets from your bed, and refrain from exercising or eating spicy foods late in the evening,” advises Dr. Rosch. “If your night sweats persist, then make an appointment with your family physician.”

Night Sweats Well Past Menopause?

I am 69 years old and still have night sweats that leave my hair, neck, and chest soaked. I am not on hormones. My doctor says at my age taking them would increase my risk for breast cancer. What else can I do? What could be wrong?

— Irene, Texas

There are many possible causes of night sweats. One possible cause is an overactive thyroid, which can be responsible for generalized sweating. Your physician should check for thyroid disease. However, your symptoms do sound typical of a postmenopausal state — in spite of the many years that have passed since you went through menopause. In fact, postmenopausal symptoms of estrogen deficiency can reoccur after long periods of time. It may be worthwhile to speak with your doctor again about a trial of low-dose estrogen therapy to see if this helps. It is doubtful that a short course of estrogen, if helpful, will increase your risk of breast cancer.

Other things to consider include the temperature in your bedroom, whether you’re eating spicy foods, drinking alcohol just before going to bed, taking medications with this side effect, or are dealing with stress, sleep deprivation, or some diseases such as tuberculosis or certain cancers that are known to increase sweating.

Taking a cool shower before getting into bed can sometimes be helpful as well.

Regardless, it is important that you speak with your physician about the problem. You should be evaluated to rule out any serious conditions and then work with your doctor to find ways to minimize the sweats if they are in fact due to your postmenopausal status. Good luck!

Medically reviewed by Clare Sullivan, BSN, MPH, CRRN

What are night sweats?

Night sweats are episodes of perspiration that occur at night while you are sleeping. People who experience this condition typically report waking with wet bedclothes or sheets, having an increased heart rate, and chills for 1-4 minutes. Menopause or a fever are leading causes of night sweats, but they can also be related to some cancers or be a side effect of certain cancer treatments.

Which cancers can cause night sweats?

Lymphoma and leukemia are commonly associated with night sweats, but excessive sweating is also linked with carcinoid tumors and adrenal tumors. Night sweats can also be a side effect of some cancer treatments, particularly certain types of hormone therapy commonly used to treat breast, gynecologic, and prostate cancers. Other medications, such as opioids, steroids, and antidepressants, can also cause night sweats.

Night sweats can be related to some cancer or cancer treatments.

Why do night sweats happen?

Sweating is the body’s normal method for regulating the body’s temperature. When night sweats occur, the body’s thermostat gets confusing messages.

How can I avoid night sweats?

Fortunately, there are steps you can take that may help better control body temperature and ease the symptoms of night sweats:

  • Use sheets and bedclothes made from natural fibers, like cotton. You might also want to try wick-away fabrics that absorb moisture from the skin and dry quickly.
  • Sleep with one foot or leg out from under the covers. This can help cool your body temperature.
  • Use air conditioning or fans to keep air moving and the room temperature cool.
  • Take a cool shower before bed.
  • Try to maintain a healthy weight.
  • Exercise.
  • Consider using a cool gel pillow.
  • Practice relaxation and stress-reduction techniques, such as yoga, acupuncture, meditation, or breathing exercises. Some studies suggest that the slow and steady rhythm of breathing may reduce night sweats and help you get back to sleep.

Talk with your doctor to learn what might be causing your issues and what steps might best help correct the problem.

Hot flashes, night sweats may linger well into a woman’s sixties

(Reuters Health) – A significant proportion of women aged 60 to 65 were still having menopausal hot flashes and night sweats in a new Australian study, suggesting that bothersome symptoms last longer than is usually assumed and are mostly going untreated .

The use of hormone replacement therapy to relieve menopause symptoms has dropped dramatically in all age groups, the study authors note, but current guidelines advise against it for any women over 60, leaving this group with few options.

“Most of the recommendations regarding management of postmenopausal women apply to women less than 60 years old,” said Susan Davis, the study’s senior author. “So we specifically wanted to determine the prevalence of symptoms in women aged 60 to 65 years.”

Davis is a professor of women’s health and director of the Women’s Health Research Program at Monash University in Melbourne.

Hot flashes and night sweats, also known as vasomotor symptoms, occur when the ovaries reduce their production of estrogen at menopause. While not all women experience these symptoms, for those who do, it can significantly affect quality of life.

“Some women simply cannot complete a day’s activities without considerable stress,” said Wulf Utian, an emeritus professor at Case Western Reserve University in Cleveland, Ohio, who was not involved in the study.

Although women typically go through menopause between the ages of 45 and 55, and vasomotor symptoms can start at any point during that transition, conventional wisdom holds that they only last a few years.

But one recent study found that for half of all women with bothersome hot flashes or night sweats, these symptoms typically last seven full years.

Davis and her colleagues analyzed data from a questionnaire-based study of women across Australia and focused on 2,020 participants between the ages of 40 and 65.

The researchers found that 42 percent of women 60 to 65 years old reported having hot flashes and night sweats, while 74 percent of women under 55 reported experiencing these symptoms.

For 6.5 percent of women between 60 and 65, the vasomotor symptoms were moderate to severe. The same was true for 28.5 percent of postmenopausal women under 55 and 15 percent of all women 55 to 60 years old.

Smoking and being overweight increased the likelihood of symptoms, while having an education beyond high school was linked to a lowered risk, Davis and her colleagues report in the journal Menopause.

Less than 12 percent of the postmenopausal women in any age group used hormonal therapy of any kind. Women aged 60 to 65 years were the greatest users of vaginal estrogen, a topical version of the treatment, with nearly 8 percent using this therapy.

Davis said in an email that hormone therapy is the most effective treatment for menopausal symptoms. She added that low dose antidepressant therapy can also give some relief.

Symptoms like hot flashes and night sweats may also be caused by other conditions, Utian noted. “Especially in older women other causes include hypertension (most frequent), diabetes, anxiety,” he told Reuters Health in an email.

The researchers write that current clinical guidelines recommend that hormone therapy should be limited to three to five years of use and should not be used by women over 60. They note that their results show there is some discrepancy between the recommendations and what doctors are prescribing. But they point out that overall hormone use was “strikingly low.”

Such low rates of medication may show that postmenopausal symptoms are not receiving sufficient attention, the study team writes. Utian agreed that the symptoms of this age group are undertreated.

Davis recommended that anyone who experiences severe symptoms “should seek out treatment from a reliable source.”

“This is a real symptom, not to be ignored, for which numerous options are available that will provide significant relief,” Utian said. “Don’t try and just live with it, see your health provider.”

SOURCE: Menopause, online February 20, 2015.

Our Standards:The Thomson Reuters Trust Principles.

Night Sweats and Women’s Health: Possible Causes

Night sweats are common is women who are going through perimenopause and menopause. Perimenopause is a normal, natural phase of a woman’s life. During this time, a woman’s ovaries produce less estrogen, progesterone, and testosterone, and menstrual periods become irregular. The low or changing levels of estrogen in particular are the cause of night sweats.

Perimenopause usually happens between ages 40 and 50. It is the transition step before menopause. A woman has reached menopause when she hasn’t had a period for 12 months in a row. The average age of menopause is 51.

Are perimenopause and menopause the only causes of night sweats?

No. Night sweats can occur for a variety of reasons and can occur in both women and men. Other health conditions in which night sweats are seen include:

  • Infectious diseases, including tuberculosis, human immunodeficiency virus (HIV)
  • Colds, flu, fever
  • Bacterial infections, including endocarditis (inflammation of the inner lining of the heart), osteomyelitis (inflammation of bone/bone marrow), pyogenic abscess (pus in the liver)
  • Hormonal diseases, including overactive thyroid, diabetes, endocrine tumors
  • Substance abuse, including alcohol, heroin, cocaine
  • Hyperhidrosis (the body produces too much sweat without any known medical cause)
  • Neurologic disorders, including autonomic dysreflexia, autonomic neuropathy (damage to autonomic nerves), syringomyelia (cyst in the spinal cord), stroke
  • Panic disorder, anxiety
  • Gastroesophageal reflux disease (GERD, a digestive disease)
  • Obstructive sleep apnea (a sleep disorder)
  • Cancer, including leukemia (blood and bone marrow cancer) and lymphoma (blood cell cancer)
  • Side effects of cancer treatments, including aromatase inhibitors, tamoxifen, opioids, steroids
  • Side effects of other medications, including some antidepressants and diabetes medications, steroids, acetaminophen, aspirin, and high blood pressure drugs

Women who experience other than menopause-related night sweats typically have other symptoms, as well. Only your doctor can determine the cause of your night sweats. Almost all causes are treatable. If you have ongoing night sweats, see your doctor.

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Night Sweats in Postmenopausal Women Linked to Reduced 20-Year Mortality Rate

September 16, 2009 — Night sweats in relatively healthy postmenopausal women are linked to a reduced risk for death during the following 20 years, independent of use of hormone therapy, according to the results of a prospective, population-based cohort study reported in the September issue of Menopause.

“Night sweats, reported by approximately half of postmenopausal women, are thought to reflect more severe hot flashes, although there is some evidence that they have a different etiology and may have more severe consequences related to impaired sleep,” write Johan Svartberg, MD, PhD, from the Department of Medicine, University Hospital of North Norway in Tromsø, Norway, and colleagues. “The purpose of this study was to examine the associations of vasomotor symptoms with risk of all cause, cardiovascular disease (CVD), and coronary heart disease (CHD) mortality in community-dwelling older women, with a mean age of 69 years.”

The study cohort consisted of 867 postmenopausal women who gave lifestyle and menopause-related history at the 1984 to 1987 visit of the Rancho Bernardo Study and who responded to a questionnaire, mailed in 1989, on menopause and vasomotor symptoms. Follow-up for survival continued through July 2004 in 98% of the cohort. Average duration of follow-up was 11.5 years.

Hot flashes were reported by 73% of women, and 39% of these also reported night sweats. Of 405 deaths during follow-up, 194 were attributed to CVD and 71 to CHD. There was no apparent association between hot flashes alone and all-cause mortality. However, women who had night sweats as well as hot flashes had an almost 30% lower all-cause mortality risk vs women who did not have night sweats (hazard ratio , 0.72; 95% confidence interval , 0.55 – 0.94). This association was independent of body mass index (BMI), past or current use of estrogen or progestin, physical exercise, and smoking status.

After adjustment for past or current use of estrogen or progestin, there was a similar lower risk for CVD and CHD mortality in women with night sweats (HR, 0.62; 95% CI, 0.42 – 0.92 and HR, 0.51; 95% CI, 0.26 – 0.99, respectively). Although these associations were independent of hormone use, adjustment for BMI, physical exercise, and smoking abolished their significance.

“Reported night sweats at menopause are associated with reduced risk of death over the following 20 years, independent of multiple risk factors including past or current use of postmenopausal estrogen therapy,” the study authors write. “A similar association was observed for CVD mortality that was not independent of heart disease risk factors. Although these results are intriguing, they need to be confirmed in other large population-based studies.”

Limitations of this study include history of vasomotor symptoms obtained many years after menopause for some women; possible recall bias; and inability to evaluate the effect of more recent, frequent symptoms or duration of symptoms. Because women in the study cohort are white and upper middle class, the results may not be generalizable to other populations.

The study authors have disclosed no relevant financial relationships.

Menopause. 2009;16:888-891. Abstract

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