Night sweats are common in women of all ages—here’s what could be causing them.
Does waking up in the middle of the night drenched in sweat with damp sheets and pjs sound all too familiar? Night sweats are actually a common complaint for women (and sometimes men) of all ages. Even though many people only expect them during menopause, there are many other causes of night sweats, meaning they can happen to plenty of younger women who are far from entering menopause.
“Typically when people think of night sweats, they’re thinking of the fluctuating estrogen in menopause. So people who are experiencing it outside of menopause (including men who can get night sweats too) are usually really confused about what’s going on,” said Danielle DeSimone, a health coach at Parsley Health in New York City.
If you’re wondering what could be causing your night sweats, keep reading to find out the most common causes and what you can do to help.
Top night sweats causes
Normal hormonal fluctuations
Every menstruating woman experiences a normal pattern of hormones each month, which can be one of the causes behind annoying night sweats. “In younger women who have hormonal related night sweats, it can be caused by fluctuating levels of estrogen, especially when estrogen tends to drop,” DeSimone said.
For most women, your estrogen levels are lowest right before you get your period, or during the luteal phase of the menstrual cycle. If you notice that you get night sweats before your period—in the week or two ahead of it—, that could be a sign it’s related to your estrogen levels. The same can be said for during your period, since all of your hormones, including estrogen drop during this time.
Even though it’s normal to have fluctuations in your hormones every month, if the symptoms are affecting your sleep and quality of life, you may want to consider getting a hormone test.
“Night sweats can be a result of estrogen already being really low, and then dropping even lower. So that could be a hormone imbalance, like maybe not enough progesterone to keep estrogen in check,” DeSimone said.
The fix: Getting hormones tested is a great first step to see which hormones, if any, are out of balance. You can then work with a doctor and health coach at Parsley to come up with a custom plan to help you get things balanced and manage night sweats.
Fatigue, weight gain, insomnia, PMS, or PCOS? We treat the root cause of hormonal imbalance so you can get back to feeling like yourself again.
Hormonal birth control
Since hormones are a common reason behind night sweats, hormonal birth control can also play a role since oral contraceptives and other forms of hormonal birth control affect the menstrual cycle and hormone levels in the body.
“Oral contraceptives cause fluctuating levels of estrogen. And with oral contraceptives people tend to think you’re constantly keeping estrogen stable and high,” explains DeSimone. In fact, if you were to look at estrogen and progesterone on a line chart, you’d see that your estrogen spikes every time you take the pill, then falls, then spikes again when you take the next dose. “So every day you’re having that peak and valley, and depending on what time of day you take the pill it can definitely cause that low estrogen overnight, which can cause night sweats for some women,” says DeSimone.
The fix: If you suspect the birth control pill could be behind your night sweats, you can consider coming off the pill and switching to another form of birth control. The hormonal IUD is one option, since hormonal IUDs (like Mirena) tend to have lower doses of hormones than the pill, and the hormones are not meant to circulate in the bloodstream. The copper IUD is another option to talk to your doctor about (it is a non-hormonal IUD.) If you don’t want to come off your birth control pill, you can also try adjusting the time that you take your pill to see if it affects your night sweats.
Regardless of if you are on birth control or not, it won’t hurt to work on your hormone health, which DeSimone says often starts with nutrition. The first steps are reducing or eliminating refined carbs, added sugar, and overly processed foods, and replacing them with healthy, whole foods and fats.
Fats in particular are great to focus on since they are so important for hormone health. “Our hormones are also produced from healthy fats, especially cholesterol, so don’t be afraid to add some well sourced animal products into your diet, as well as coconut oil which is a great source of plant cholesterol. Add healthy fats to every meal and every snack to try to balance blood sugar,” DeSimone suggests. You can also incorporate plenty of dark, leafy greens and cruciferous vegetables to help the liver detox excess hormones. Consider also reducing your intake of caffeine, alcohol, and sugar as much as possible to help the liver do its job even better.
Thyroid problems are pretty common, with an estimated 20 million Americans dealing with some form of thyroid disease. According to DeSimone, thyroid issues could cause night sweats since one (of the many) important functions that the thyroid regulates is body temperature.
“With thyroid issues, it’s usually hyperthyroid or overactive thyroid that could cause night sweats and this is because your thyroid controls your metabolism,” DeSimone says. “Hyperthyroidism tends to put the metabolism into overdrive, so body temperature tends to rise. Night sweats are one of the main signs that someone with an overactive thyroid might notice.”
And underactive thyroid, or hypothyroidism could also cause night sweats in certain situations. Mainly, if someone with hypothyroid begins taking thyroid medication and has trouble adjusting to the dose of higher thyroid hormone. Sometimes, the dose can be a little too high, pushing someone into a subclinical hyperthyroid state. DeSimone mentioned it can take some time to get the right amount of thyroid hormone dosing in this situation.
The fix: “Most hypo and hyperthyroidism is caused by autoimmunity,” DeSimone says.
“And we know that autoimmunity starts in the gut, so we want to focus on a gut healing diet.”
“Diet staples that are very inflammatory for the gut are gluten, dairy, and added sugar. So you can consider reducing or maybe eliminating those,” DeSimone says. Once you remove inflammatory foods, she suggests adding more healthy fats (especially omega 3’s,) non-starchy veggies, leafy greens, and to choose starchy root veggies like sweet potatoes over grains and beans since they are easier on digestion.
DeSimone also recommends adding a collagen or glutamine supplement to your routine, which both help heal the gut. Collagen contains glutamine, which is one of the only known substances that can close tiny tears in the gut lining. “This helps prevent a root cause of autoimmunity and leaky gut syndrome,” she explains.
Blood sugar imbalance
Keeping blood sugar stable not only supports your energy levels, mood, and a healthy weight but it can also help prevent night sweats. Feeling “hangry” actually triggers a biological response in your body that can cause night sweats.
Low blood sugar triggers a stress response in the body, which produces hormones that raise body temperature. “The body will start producing adrenaline and cortisol and this causes the body to go into fight or flight mode, which increases basal body temperature,” DeSimone explains.
The Fix: You may have poorly regulated blood sugar if you’re eating a lot of processed foods, refined sugars, or processed carbs or eating frequently throughout the day, says DeSimone.
Eating a more balanced diet throughout the day is the best way to ensure that your blood sugar stays balanced at night. You can start by looking at what you eat at night and later in the day since that can also affect you while you sleep.
“Avoid high carb, high sugar, processed foods before bed—especially on its own,” she suggests. That means the bowl of cereal or high carb/sugar food many people reach for to relieve stress. Instead, pair that with a healthy fat or ideally replace it with something higher in fiber and lower GI carbs, DeSimone says. This will keep your blood sugar from spiking and then falling a few hours later, making it a great night sweats treatment.
Sleep apnea is another common issue that can trigger excessive sweating at night. It’s a dangerous condition that should be managed with the help of a doctor. And while snoring is one tell-tale sign of sleep apnea, night sweats can be another. “Sleep apnea causes the same kind of stress response that happens with low blood sugar, except it’s caused by a lack of oxygen,” DeSimone says.
The Fix: Get tested for sleep apnea to rule out the cause or seek further treatment. According to DeSimone, being overweight is one factor but losing 5-10 percent of body weight can often relieve a lot of pressure that causes it.
Stress and anxiety
It’s not surprising that stress and anxiety can make you lose sleep, but it can also cause night sweats. This can be trickier to pinpoint since you may not be having trouble falling asleep, but the stress is catching up to you later in the night (in the form of waking up with damp clothes and sheets!).
This is a sign that the sympathetic nervous system is overreacting, explains DeSimone. When you’re at rest, your body should be in the parasympathetic nervous system, but sometimes your stress hormones peak and fall overnight because it’s the only time you’re at rest all day.
“While we’re sleeping our brain is going to try and work through the stressors that we didn’t necessarily get to deal with during the day. That will cause the fight or flight response that activates the sympathetic nervous system and raises your body temperature,” DeSimone says.
The Fix: “At Parsley we recommend a healthy wind-down routine at night. It’s really hard for most people to go from the fight or flight mode of the workday to asking the body to get into that restful sleep,” DeSimone said. Her suggestions for unwinding at night? Find 30-60 minutes before bed to do anything that takes your mind off of work or other obligations. Some examples are reading, taking a bath, journaling, meditating, or doing some deep breathing.
“All of these things are meant to get the body into the parasympathetic nervous system, priming the body for better quality sleep.”
Too much alcohol
Finally, if you’re having wine with dinner each night or perhaps a night-cap even later, it may be a reason for your night sweats, impacting your quality of sleep and hormones more than you’d expect.
“Alcohol impairs our ability to regulate our body temperature and also disrupts our circadian rhythm,” DeSimone says.
It can also affect hormones, especially estrogen. “Alcohol will inhibit our body’s ability to metabolize hormones, especially estrogen. So we can get a backup of estrogen. For women who are on oral contraceptives or some form of hormonal birth control that can be problematic if the body is making its own estrogens, and we are getting a lot of synthetic estrogens. That can lead to imbalances in our sex hormones and other hormones.”
The fix: DeSimone suggests trying out a few nights without alcohol to see how that helps your night sweats and sleep quality. “For the vast majority of people, they are going to get better quality sleep, and that can be a good starting point for evaluating nightly habits.”
If you suspect hormone imbalances are at play, DeSimone also suggests considering removing or reducing alcohol from your diet since it can help the liver detox any excess hormones, especially estrogen.