Waking up drenched in sweat during the night is miserable.
Your sheets are soaked. You’re chilled. And you’re exhausted from disrupted sleep.
If you’re a woman in perimenopause or early menopause, you may assume night sweats are just part par for the course.
But here’s what many people don’t realize:
Night sweats are not an exclusively female problem limited to those in perimenopause and early menopause. Men get them too. Women can continue to have them long after they’ve reached menopause. And even for women in perimenopause or early menopause, declining estrogen isn’t always the culprit.
All of the above is important, because correctly identifying the cause of a person’s night sweats is essential for finding the right solution.
Beyond Estrogen: Other Hormonal Causes
While it’s true that declining estrogen is notorious for causing hot flashes and night sweats among women who are in perimenopause and menopause, there are other culprits:
Thyroid Disorders
Both hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid) can cause night sweats.
Hyperthyroidism revs up the metabolism, which can cause excessive sweating, rapid heartbeat, and generally feeling overheated.
Hypothyroidism can also cause sweating, though less commonly.
If you’re experiencing night sweats in conjunction with unexplained weight changes, fatigue, or temperature sensitivity, thyroid testing is warranted.
Low Testosterone
Many men don’t realize that declining testosterone can cause night sweats that are similar to what women experience during perimenopause and menopause.
Andropause (which is the gradual decline in testosterone production in men after the age of 30) can trigger nighttime sweating.
Men often assume their night sweats are caused by stress, when low testosterone is the real issue.
Progesterone Deficiency
Women commonly experience night sweats during perimenopause and menopause due to low progesterone.
Progesterone has a calming, cooling effect on the body, and its absence often triggers nighttime temperature dysregulation.
As a consequence, women will often experience night sweats even when estrogen levels are adequate.
Blood Sugar Imbalances
Nocturnal hypoglycemia (low blood sugar during sleep) can trigger a stress response that causes sweating.
However, it isn’t the low blood sugar itself that causes sweating.
Rather, this type of nocturnal sweating occurs because the body releases adrenaline and cortisol in response to the low blood sugar. And it’s the stress hormones that actually cause the sweating.
This phenomenon is particularly common in people with diabetes or prediabetes, but it can also affect people with insulin resistance or irregular eating patterns.
Cortisol Dysregulation
Cortisol levels are meant to be at their highest in the morning (when you need to wake up) and at their lowest during the night (when it’s time to sleep).
When these rhythms are disrupted—often as a consequence of chronic stress—elevated nighttime cortisol can cause night sweats.
Non-Hormonal Causes to Consider
Not all night sweats have a hormonal etiology. Other potential causes include:
- Infections
- Immune system disorders
- Certain medications (like antidepressants and blood pressure medications)
- Sleep apnea
- Anxiety
- Alcohol consumption
- A sleeping environment that isn’t cool enough
A knowledgeable provider can help to identify hormonal causes versus non- hormonal causes.
Getting the Right Diagnosis
If you’re experiencing persistent night sweats, a comprehensive evaluation should include:
Hormone Testing
- Thyroid hormones, including T3 Free and TSH (at a minimum)
- Sex hormones (estrogen, progesterone, and testosterone)
- Cortisol (ideally tested by saliva at four points during the day)
- Fasting glucose and fasting insulin
Symptom Pattern Analysis
- When do the night sweats occur?
- Are they associated with hot flashes that happen during the day?
- What other symptoms are present?
- Are there other symptoms that occur simultaneous to the night sweats?
This kind of data can often provide important diagnostic clues.
Medical History Review
- What medications are being taken (if any)?
- Are there any other health conditions present?
- What lifestyle factors may be relevant?
All of the above can provide context for understanding a person’s night sweats.
Treatment Approaches Based on Cause
For Estrogen and Progesterone Deficiency (Women)—Bioidentical estrogen and/or progesterone replacement effectively eliminates night sweats for most women when estrogen and/or progesterone deficiency is the cause. Many women report dramatic improvement within weeks.
For Low Testosterone (Men)—Testosterone replacement can resolve night sweats for men with low testosterone, with most men reporting relief within weeks.
For Thyroid Issues—Optimizing thyroid hormone levels (whether by treating hyper-
or hypothyroidism) typically resolves issues with sweating if the sweating is rooted in a thyroid imbalance.
For Blood Sugar Problems—Stabilizing blood sugar through dietary changes and medication (if needed) can eliminate nocturnal hypoglycemia and its associated sweating. Eating a small high-protein snack before bed can also be helpful.
For Cortisol Dysregulation—Stress management, sleep optimization, and adaptogenic supplements can help to restore cortisol production to its appropriate rhythms.
Lifestyle Strategies That Can Help
Regardless of the underlying cause(s), the following lifestyle strategies can help to reduce night sweats:
- Keep the temperature in your bedroom on the cool side
- Use moisture-wicking sheets and sleepwear
- Avoid alcohol, spicy foods, and caffeine in the evening
- Implement stress reduction strategies before bed
While lifestyle changes alone rarely resolve hormone-related night sweats completely, they can go a long way toward augmenting other strategies.
Don’t Suffer Unnecessarily
Night sweats can rob you of quality sleep, leaving you exhausted and unable to function at your best during the day. Even worse, chronic sleep disruption cam worsen other hormone imbalances, resulting in a downward spiral.
The good news is that once underlying hormone imbalances are identified and addressed, most people experience a complete resolution of their night sweats.
Are you ready to identify and treat the cause of your night sweats? Renew Youth provides comprehensive hormone evaluation and personalized treatment. Call us at (800) 859-7511 or use our easy contact form to schedule your complimentary 30-minute consultation.