Wet sheets, clothes too… Hot flashes at night are a frequent symptom in women, especially during (pre)menopause or in the event of an unsuitable contraceptive. But sometimes it can be a more serious cause.
Night sweats, also known as nighttime hot flashes, manifest as excessive and sudden sweating, that can wake And wetting sheets and clothes overnight. It is a common symptom in the womanAbove all at menopause. What can cause night sweats? When to worry? How to mitigate them?
What are the causes of a night sweat in women?
“Night sweats are mainly caused by a hormonal variationmore precisely by a drop in estrogen, explains Dr. Elisabeth Paganelli, medical gynecologist and general secretary of the National Union of Obstetrician Gynecologists of France (SYNGOF). This phenomenon can occur in different contexts:
► During pre-menopause Or there menopause. At this stage of life, the level of estrogen hormones decreases irregularly, then drops, which disrupts the normal functioning of the hypothalamus, the main thermoregulatory center.
► In some women under IUD (hormonal IUD) or on progestin-only pills for which the level of estradiol (an estrogen) in the ovaries may be reduced.
► Also“when we want stop severe endometriosis (for example before an operation), the patient is administered analogues which block the function of the ovary, which means that she has practically no more estradiol produced by her ovaries and this low level can cause flushing nocturnal heat“, continues our interlocutor.
► In the case of hormone-dependent breast cancer, cancer cells have positive estrogen receptors. “To limit the risk of recurrence, the patient can be prescribed drugs that aim to block the production of estrogens (anti-aromatases for example), which can cause nocturnal hot flashes. explains the gynecologist.
► There’s also a whole bunch of environmental causes which can cause excessive nocturnal sweating such as:
- An overheated room
- Unsuitable bed linen (duvet too warm, synthetic sheets, etc.)
- Wearing clothes that are too hot for sleeping
- Playing a sport just before bedtime (which increases body temperature)
- Eating very spicy/hot at dinner
- Excessive alcohol consumption before going to sleep
- A strong stress
- Taking certain medications (such as certain antidepressants, diabetes medications, Viagra, etc.)
What are the causes of night sweats in men?
In addition to the environmental factors mentioned above, in men, night sweats are often linked to a drop in testosterone levels (testosterone gradually decreases with age, but particularly at andropausebetween 45 and 65). Sleep apnea or hyperthyroidism can also promote night sweats.
Is this a sign of infection? Cancer?
In the case of’an infection such as tuberculosis or Covid-19 for example, sweats appear suddenly and are not exclusively nocturnal but also occur during the day. Above all, they are associated with a very poor general condition with the presence of other symptoms such as severe fatigue, cough, fever, body aches, chest pain or weight loss. Same thing with cancer. “Cancers like Hodgkin’s lymphoma can cause night sweats, but this symptom is not isolated and is accompanied by other signs that impact day and night (loss of appetite, weight loss, fever, fatiguee…)“, insists Dr. Paganelli.
When to worry and when to consult?
Whether they persist and become bothersome on a daily basis, night sweats are not to be neglected and should lead to consulting a doctor. “The doctor will do questioning of the patient to know if his sweats are exclusively nocturnal or also occur during the day. The patient’s general state of health (presence of other symptoms, intense fatigue, high blood pressure, heart problems, etc.) must also be taken into account.“, specifies our interlocutor. The doctor generally prescribes a blood test and may, in the presence of signs suggestive of a thyroid disorder such as hyperthyroidism, prescribe a TSH test (thyroid hormone).
What are the solutions to calm night sweats?
The treatment depends of course on the cause:
► In the case of night sweats related to menopause when they are bothersome to the point of impairing the quality of life of women, hormone replacement therapy can be prescribed in the absence of contraindications such as a history of breast cancer, even cured. Care must be taken to comply with the latest recommendations from the Haute Autorité de Santé who insists “son the need for a minimum dose prescription and for the shortest possible duration“, due to an increased risk of breast cancer, endometrial cancer, ovarian cancer, venous thromboembolic risk and stroke (especially during the first year of treatment).
► In the case of night sweats related to contraception“the gynecologist can suggest another contraceptive such as an estrogen-progestogen pill in the absence of contraindications, a copper IUD or consider permanent contraception for her or her partner“, mentions Dr. Paganelli.
► In the case of night sweats related for the treatment of hormone-dependent breast cancer“the patient must continue her treatment, but we can give her advice on lifestyle and sleep to reduce their hot flashes (lower the temperature of their room, adapt their bed linen or their mattress, ventilate regularly… )“, concludes the expert.
Thanks to Dr Elisabeth Paganelli, medical gynecologist, general secretary of the National Union of Obstetrician Gynecologists of France (SYNGOF)