Dealing With Hot Flashes and Night Sweats

Hot flashes and night sweats strike whenever they feel like it in menopausal women. They don’t care if you’re trying to sleep. And they can just as easily ignore the fact that you’re dressed up for a special occasion or in front of an audience delivering your most important presentation to date.

Hot flashes and night sweats can be wicked enough to soak your hair and melt your makeup, and powerful enough to keep you from getting the sleep you so desperately need.

If you’ve experienced severe hot flashes or night sweats, you know already they’re nothing to shrug off. What you really want to know is how to deal with these menopause symptoms.

Hot Flashes and Night Sweats: What’s It All About?

If there’s a surefire sign of the approach of menopause, you can bet on one (well, really two): Hot flashes and night sweats. Dealing with them can be tough, but hey, don’t sweat it. We’re going to let you in on many great solutions to relieve these menopause symptoms.

First thing to know: AM/PM sweating is created equal. Though there’s no real difference in the way you sweat, there’s just a different name for sweating after hours. When hot flashes strike at the stroke of bedtime, they’re known as night sweats.

Their mission: to make you miserable. And yours? To learn to deal with these sudden crazy-making heat surges so you can stay even-keeled, sane and get some rest.

The First Sign of Menopause

Ask just about any woman in her 40s or 50s about the first sign of menopause and the probability is high that she’ll tell you it was hot flashes and/or night sweats. Why? Because they’re the most common of the menopausal symptoms, occurring in about 85 percent of women.

Hot flashes and night sweats usually begin way before menopause is official, meaning you’ve been without your period for 12 consecutive months. They start when hormone levels  begin to shift, usually in your 40s, during the period known as perimenopause.

Hot flashes usually start suddenly in your face. (It can look like you’re blushing, but you know it’s something different.) From there they spread, traveling downward, enveloping your neck and chest in lovely droplets (or waves) of sweat. Menopausal hot flashes are usually felt in your upper torso; however, they can also reach clear down to your toes. As if the heat surges weren’t enough, some menopausal women will also experience a rapid heartbeat, or feelings of anxiety or stress at the same time.

How Long? How Fierce? How Come?

For most women, hot flashes last for two years or less, but for some of us, they can hang around for a long time (by some estimates as long as 14 years!). That means that even once you’re finally post-menopausal, you may still be battling hot flashes and night sweats. (To be safe, don’t throw away your portable fans quite yet.)

Just as the length of time you’re saddled with hot flashes can’t be predicted, you often can’t anticipate when a hot flash will strike or how many you’ll get each day. Some women will have predictable hot flashes they can practically set a clock by, while others will experience hot flashes that occur where and when they please, settling in for as long as they like.

(Imagine your least-favorite relative arriving at your door at all hours or when you’re not in the mood for company. Maddening? Yeah, that.)

What’s normal? We hate to break it to you, but there is no normal when it comes to hot flashes and night sweats. You may average one a day. But then again, it’s possible to have one every hour all through the day and night.

The Truth Behind the Sweat

So, why do hot flashes and night sweats happen? The most common and accepted theory is that the dip in hormone levels, mainly estrogen levels, causes your hypothalamus (your body’s thermostat of sorts) to misfire and misread your body temperature. It somehow senses that your body is too warm and sets off a series of events to attempt to cool it off.

Blood vessels near your skin’s surface widen to release heat; your sweat glands launch into action, setting off a hot flash. It’s only once the hot flash subsides that your body returns to feeling normal, although many women experience chills and may even begin to shiver, before they regain their equilibrium.

What are Vasomotor Symptoms?

Around 80% of women going through perimenopause and menopause experience Vasomotor Symptoms (VMS). The decrease in estrogen levels that occur during menopause affects the regulation of the body's temperature. Because of this, even small changes in temperature can cause a woman’s body to react, leading to symptoms such as hot flashes and night sweats. 

Additionally, vasomotor symptoms can cause chills, flushing, and a rapid heartbeat. These symptoms can be uncomfortable and distracting and can interfere with a woman’s sleeping habits. When this occurs, VMS can contribute to various health issues such as weight gain, fatigue, anxiety and depression. VMS is also associated with an increased risk of cardiovascular disease, high blood pressure, diabetes, high cholesterol, and atherosclerosis.

Treatment options include lifestyle changes or medications like HRT or low-dose Paxil, which can help alleviate these symptoms and improve a woman’s quality of life during menopause.

Coping With Hot Flashes and Night Sweats

Try your best to incorporate these lifestyle changes and  stay away from — or at least cut back on/try to avoid too much of — these things, which have all been shown to trigger hot flashes and night sweats, or make them occur more frequently:

·  Stress

·  Obesity

·  Caffeine

·  Alcohol

·  Spicy foods

·  Heat

·  Tight or constricting clothing

·  Smoking

Swipe right on these solutions to tame your inner furnace:

·  Tuck an ice pack under your pillow.

·  Sleep in a cool room (best temp for sleep is about 65 degrees Fahrenheit, according to experts).

·  Wear light fabrics.

·  Use a fan at night, carry a portable one with you during the day.

·  Dress in layers so you can peel them off as needed when a flash strikes.

The jury is still out on some of these solutions, which may work for some women but not for others (a good and legit reason to speak with a qualified healthcare provider first):

·  Hormone replacement therapy (FDA approved for menopausal symptoms)

·  Non-hormonal therapy (including some antidepressant SSRIs and SNRIs)

·  Some drugs used to control blood pressure, seizures or nerve pain

·  Evening primrose oil

·  Black cohosh

·  Various herbal products

And though these are not overwhelmingly proven to help, they can’t hurt (anything other than your pocketbook) and may make your menopausal hot flashes, night sweats and life in general more pleasant to deal with and manageable:

·  Hypnosis

·  Cognitive behavioral therapy (CBT)

·  Relaxation training and biofeedback

·  Mindfulness-based stress reduction

·  Yoga

·  Aromatherapy

·  Reflexology Exercise

·  Plant-based foods (like soybeans, chickpeas, lentils, flaxseed, grains)

·  Acupuncture

Does a hot flash mean you’ll never wear anything but your lightest fabrics ever again? That you’ll never sleep soundly again? No. Indeed, not every woman experiences excessive sweating. In fact, some don’t sweat at all, some experience only a teensy-weensy bit of perspiration on their upper lip — and a lucky few never feel one at all.

But let’s get real. When hot flashes and night sweats arrive repeatedly and refuse to leave, they can interfere with daily life and similarly, inhibit sleep. Don’t suffer alone. If it’s time to talk to a health care provider about new treatment options, we can help.

 Sources:

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3. Nancy Ferrari. "Menopause-related hot flashes and night sweats can last for years". Harvard Health. Aug 14, 2020. https://www.health.harvard.edu/blog/menopause-related-hot-flashes-night-sweats-can-last-years-201502237745

4. "Perimenopause: Rocky road to menopause". Harvard Health. https://www.health.harvard.edu/womens-health/perimenopause-rocky-road-to-menopause

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9. Avis, Nancy E et al. “Vasomotor Symptoms Across the Menopause Transition: Differences Among Women.” Obstetrics and gynecology clinics of North America vol. 45,4 (2018): 629-640. doi:10.1016/j.ogc.2018.07.005