perimenopause-night-sweats are bullshit too hot, too cold, chills, sweating

“It’s Gettin’ Hot In Herre”

“It’s gettin’ hot in herre.” I used to love that song. Unfortunately, that song has become my nightly mantra. But it’s not ‘herre’ on the dance floor, it’s here in my bedroom. I’m getting hot and uncomfortable. And I can’t sleep!

It's gettin' hot in herre

I wake up in the middle of the night absolutely drenched in sweat.

The sweat has soaked through the thin layers of clothing I’m wearing, into my second-favorite pair of sheets. My favorite are in the wash after last night’s episode. These pajamas are supposed to wick away moisture. But they can only handle so much.

I’m practically panting. My heart is racing, but not just from the odd sensations or the rude awakening. As soon as I realize why I’m awake, every part of my body and mind feel upset. 

And then the chill sets in. I’m freezing cold and shivering uncontrollably because there isn’t an inch of me that isn’t sopping wet. 

And I have to get up – again – and change my pajamas, as well as my bed sheets. Time to contemplate running another 2:00 am load of laundry.

night sweats ruining pajamas too much sweating hot flashes

They’re heeeeeere. The night sweats – spookier than a poltergeist in some ways! 

Essentially a hot flash, but they happen when you’re supposed to be sleeping. There are a lot of thoughts that pop into my head when I think about night sweats…


This is bogus.

In other words: nope.

Waking up in the middle of the night feeling inexplicably sticky, sweaty, hot, cold, or all of the above? It’s far from the ideal sleep I should be getting. But, like many women, no matter how many tricks or supplements I try, the night sweats ruin all hope of a good night’s sleep. 

And sure, we’ve all heard about hot flashes. But night sweats are rarely talked about in mainstream health conversations. 

So when I finally got to the root of my own night sweat issues and discovered it was a symptom of perimenopause, I realized how little awareness there is out there on this topic.

Night sweats are an inconvenience

But they’re also so much more than that. 

nights-sweats-in-perimenopause interrupt sleep patterns poor womens health

Night sweats are one of the many symptoms associated with perimenopause and postmenopause. Why they happen is complex and not fully understood. But what is understood is that the changes in estrogen associated with the menopause experience makes temperature regulation unstable. 

The concept is:

  1. Hot flashes or night sweats are triggered by your brain becoming too sensitive to temperature changes.
  2. Your hypothalamus (the part of your brain that helps regulate body temperature) overreacts. Oops.
  3. Thinking you’re way warmer than you are, your brain tells your body to chill. Literally.
  4. The signals your brain sends to your body cause your blood vessels to dilate and your skin to release heat. 
  5. As your body is trying to cool down you might also experience red skin, heart palpitations, or excessive sweating.

lack of estrogen perimenopause impacts brain and hypothalamus causes hot flashes night sweats

This whole process can cause some pretty extreme sensations. But the worst of it is that night sweats have a serious impact on sleep quality. And over time, they can cause long-term sleep disruptions and damage your overall well-being. 

The night sweats anxiety factor

I sometimes dread going to sleep because I don’t want to wake up in the middle of the night dripping with sweat. I fret that this might be another night that I don’t sleep well. And guess what all of that stress can do? Trigger night sweats.

It’s a brutal, self-perpetuating cycle. Night sweats = anxiety = lack of sleep = anxiety = night sweats = lack of sleep. 

You might not even recognize the toll night sweats are having on your well-being – until you are able to address them and get them under control.

Night sweats – you don’t know, until you know

Night sweats feel embarrassing to talk about. And, unless you’ve had them, I don’t believe you can understand their true impact. 

stress anxiety night sweats become worse perimenopause

Night sweats can be a symptom of many things – medical conditions, infections, hormonal imbalances, or perimenopause and postmenopause. So, night sweats are definitely a symptom that needs to be taken seriously. If they’re happening to you – don’t ignore them! 

But I’m not just tired of experiencing night sweats – I’m also tired of women’s health needs not being taken seriously. We still don’t understand why night sweats happen and many healthcare providers are still dismissive. Perhaps we don’t properly explain how awful the experience can be to our doctors. Or perhaps our doctors aren’t up to date on treatment options. Regardless, too many of us are struggling. 

Night sweats are a symptom of something bigger

night sweats anxiety perimenopause stress and womens health

Night sweats are always a sign something is up with our bodies. This is sometimes an underlying medical condition, such as infection, cancer, or sleep disorders. Certain medications can also cause night sweats.

Typically for women, experiencing night sweats is a sign of perimenopause or postmenopause. According to The North American Menopause Society, up to 80% of women will experience hot flashes. This includes night sweats. (They’re just hot flashes while you sleep.) 

But just because it’s common, it doesn’t mean we should treat it like a normal experience. Or downplay its impact on our life. 

It does no good to ignore this symptom. Ignoring night sweats can delay the diagnosis and treatment of potentially serious conditions. And it can cause you to suffer needlessly. Sometimes for years. 

Night sweat triggers

While night sweats in perimenopause and postmenopause are caused by changes in estrogen, there are other things that can make night sweats worse, both in duration and number of episodes.

Anxiety and stress are contributing factors. See the night sweat stress spiral described above. 

Alcohol disrupts sleep and can trigger hot flashes and night sweats. I’ve noticed that red wine consumption pretty much guarantees a night of hot and sweaty, disrupted sleep. And not the good kind.

Smoking. As with everything else, smoking makes hot flashes and nights sweats worse.

Exercise. It helps with everything. And it is shown to reduce the severity and duration of hot flashes and night sweats.

I am still in denial about this one, but caffeine can also be a hot flash/night sweat trigger. I suspect it’s also negatively impacting my sleep whether I am sweating or not, even thought it didn’t used to be a problem for me.

And I think I may need to turn down the spice level. I love Mexican and Indian food, but the spice can also trigger flashes and sweats. Sugar is also said to be a trigger.

alcohol and nights sweats good or bad for womens health perimenopause

Managing night sweats

Night sweats might be a typical symptom of perimenopause and postmenopause, but you do not have to live with them. 

perimenopause night sweats cause poor sleep quality bad for womens health

What can you do about night sweats?

  1. Know that your experience with night sweats is valid and real. Ask for help. 
  2. Be prepared to advocate for yourself. Unfortunately, the reality is that women and female-presenting people generally need to advocate for themselves in health settings. Women’s health still isn’t always taken seriously, including the impact of night sweats.
  3. Feel free to fire a doctor that doesn’t get it and won’t take the time to listen to your lived experience.  Find the right medical practitioner. One who understands, listens, and provides you with solutions to address your symptoms. 
  4. Know that hormone therapy (previously called hormone replacement therapy) is considered the most effective treatment for night sweats and hot flashes according to the North American Menopause Society. There are risks which should be discussed with your doctor. For most, the benefits outweigh the risks.
  5. There are other medications that can help with night sweats if you aren’t a candidate for hormone therapy. And while some supplements are said to help with night sweats there isn’t research to support these claims. I have had no luck with supplements.
  6. Pay attention to common night sweat triggers. There are common lifestyle changes you can make when combatting hot flashes and night sweats. Journaling your day and recording your habits, particularly around common triggers (alcohol, smoking, sugar, lack of exercise) will help you see if there are any patterns occurring. 
  7. Try to do things throughout the day to reduce your stress levels. Talk a walk or meditate. Even just setting daily reminders to stop and breathe deeply for a few minutes can be very helpful.

We don’t need to suffer. There are solutions.

My next move is to try hormone therapy. And find a new mantra. “It’s gettin’ hot in herre” belongs on the dance floor.

It's gettin' hot in herre


Source 1: Harvard Health Publishing. (2019). Night sweats in men: Causes, diagnosis, and treatment. 

Source 2: Mayo Clinic. (2021). Night sweats. 

Source 3: Verywell Health. (2020). Night sweats and alcohol. 

Source 4: