Night sweats are typically one of the most annoying symptoms of perimenopause. My patients confirm this to me nearly every day. Night sweats are not only uncomfortable, they can also interfere with your sleep. You already know sleep is important for many obvious reasons, but you may not know it is the time when you make your brain chemicals that power you up for the day. You also know how you feel when you either get interrupted sleep or not enough sleep: foggy, moody, forgetful, and irritable (like overreacting to your kid spilling milk or forgetting to finish a chore).
A 44-year-old woman in perimenopause recently came to see me after hearing about our menopause clinic from a coworker — she had waited a month to get in and was anxious to talk. She walked in with a list of symptoms and questions in her hand — night sweats was at the top. She said to me, “Why is this happening and can you make it stop?” She falls asleep without a problem, but the four nights before her period, she wakes up drenched in sweat — pajamas, bedsheets, even the hair on the back of her neck. Every night she changes her night shirt and top sheet, falls back to sleep, and continues to have minor sweats over the next four hours until the alarm sounds. She wakes up exhausted and feeling foggy, and she feels like she’s a step behind everyone else all day. The same thing happens all four nights until her period is in full force, and she was looking for relief before she was due for her next “sleepless” cycle.
Her other symptoms included slightly irregular and heavier periods than before and occasional hot flashes during the day (but not interfering with work or making her too uncomfortable). These same symptoms are very common in women who still have almost-regular periods.
For this patient, we started looking at lifestyle habits — wine or sugar before bed, not drinking enough water during the day — that can trigger night sweats. In addition, conditions like being overweight and having high blood pressure can also be triggers for many patients. Solutions to these issues are quite simple: no wine or sugar before bed, drink more water, lose weight, and manage your blood pressure. But, there are other options to consider as well. Adding a very low dose hormone patch just the three days before her period could be a lifesaver for this patient. She could also try going back on the birth control pill, or looking for relief by using a medicine in the class SSRI (Selective Serotonin Reuptake Inhibitors) just the week before her period.
The point is that there are many treatment options and at least one of them may be right for this patient (and for you). You may also be relieved to know that having these symptoms does not mean you are crazy or that something is terribly, irreversibly wrong with you. Your next step is to see your doctor or nurse practitioner to rule out medical problems (like thyroid) and to be as healthy as possible every day.