You go to bed feeling fine, maybe even a little chilly, but pretty soon you are waking up burning hot, drenched in sweat, kicking the covers off and tearing off your pajamas. You may be so soaked you have to change clothes and your sheets.

What Are Menopausal Night Sweats?

Hello, night sweats, one of the more unpleasant side effects of menopause. Night sweats are vasomotor symptoms (VMS): sudden, intense feelings of heat that happen when blood vessels expand, which increases blood flow, and then the vessels then contract. You sweat, your skin turns red, and your heartbeat may speed up. They can often feel similar to a panic attack, and can last a few moments or longer. Afterwards, you might feel a little chilled.

Did You Know?

1. Some Women Can Experience Night Sweats for More Than 10 Years

It has been reported that around 75 percent of menopausal women go through hot flashes and night sweats; however, they can also start years before your last menstrual period. “The mean duration of hot flashes and night sweats is seven to nine years, and about one-third of women will flash for a decade or more. I have had women in their eighties in my office who still have them,” says Stephanie Faubion, MD, North American Menopause Society (NAMS) medical director, and a NAMS Certified Menopause Practitioner.

2. Night Sweats and Hot Flashes May Not Be the Same Things

New research presented at the 2022 Annual meeting of the North American Menopause Society (NAMS) showed that night sweats caused a higher level of stress compared with hot flashes alone, whether during the day or night. Also, women who had more hot flashes at night rather than the day were at greater risk for depression. Night sweats also last much longer and produce much more sweating.

3. Some Women Are More Predisposed to Night Sweats

A study published in Women’s Midlife Health found that night sweats tend to happen earlier and more intensely for Black women compared with white women. “It may not be genetic. It may be sociocultural, and more difficult life circumstances such as financial stress and racism. That hasn't been sorted out completely,” says Dr. Faubion. Another study, published in 2021 in Menopause, suggested that “same genetic variants that help to predict reproductive aging are associated with frequency and severity of hot flashes.” On the other hand, women living in China, per one study, and in Japan, per other research, experience fewer and less intense hot flashes compared with women in the United States. This is possibly due to their larger intake of soy in their diets or other sociocultural factors, per research (PDF).

4. No One Knows the Exact Trigger for Menopausal Sweating

Night sweats are caused by declining estrogen levels but the actual mechanism isn’t fully known, says Faubion. “We think it's like a faulty thermostat in the brain’s hypothalamus, which is your temperature control center.” The theory is when your ovaries stop producing estrogen, your follicle-stimulating hormone (FSH) increases, setting off brain neurons that control the body’s temperature setpoint. Whatever the trigger, the consequence is menopausal sleep deprivation.

5. Night Sweats Aren’t Always Caused by Menopause

There are many diseases that can also cause night sweats: Tuberculosis, HIV, diabetes, obstructive sleep apnea, lupus, some cancers, gastroesophageal reflux disease (GERD), and others, notes Cleveland Clinic. Night sweats can also be side effects of therapies such as aromatase inhibitors, tamoxifen, opioids, steroids, antidepressants, high blood pressure drugs, diabetes medications and more. If you are experiencing night sweats, see a healthcare provider to establish the exact cause.

6. Slow Breathing Can Help Ease the Frequency and Intensity of Episodes

Try six to eight breaths per minute for 15 minutes twice per day and applied at the onset of hot flashes. NAMS (PDF) reports that “this can be helpful for healthy peri- and postmenopausal women in decreasing both the number and severity of this bothersome menopausal symptom.”

7. Not All Treatments for Night Sweats Are Hormonal

The most effective way to deal with disruptive night sweats is hormone therapy (HT). However, not every woman wants to or can take it. Brisdelle (paroxetine), a selective serotonin reuptake inhibitor (SSRI), is currently the only nonhormonal medication available that is approved by the U.S. Food and Drug Administration (FDA) for use for hot flashes, but other nonhormonal drugs, such as antidepressants, can help treat menopausal symptoms. More are under development; stay tuned. Ask your doctor about any new options.

You Don’t Have to Sweat It Out!

Faubion urges women to look for solutions to night sweats and menopausal sleep problems. “There are safe and effective treatments out there that are underutilized. I think women and their providers need to be better educated on when and how to use them. There is no need to suffer.”

If you need help finding a physician who can help you, NAMS has a list of NAMS Certified Menopause Practitioners around the country.

7 Surprising Facts About Menopausal Night Sweats