Nightsweats? Options for reducing nightsweats during menopause

Waking up between 1-3 AM with a wet pillow, wet blankets, and wet hair due to sweating and hot flushes? 60-80% of women who are perimenopausal and menopausal will experience hot flushes and nightsweats.

Why do some women get nightsweats?

Nightsweats due to peri-menopause and menopause are related to decreasing estrogen levels, namely estradiol, (there are 3 types of estrogen: estradiol, estriol, and estrone). Estradiol is the estrogen that helps with secondary sex characteristics, uterine lining thickness, follicle maturation, cognitive function, bone density, and temperature regulation at the hypothalamus.

How can you diminish nightsweats?

What can you do to alleviate nightsweats? There are 3 main avenues to take when it comes to perimenopause and menopause support.

1. Do nothing. Some women prefer to leave nature to do it's thing and trust that their bodies will figure it out.

2. Hormone replacement - either traditional Hormone Replacement Therapy (usually Premarin - pregnant mare's urine, or another estrogen, and possibly progestin), or Bio-Identical Hormone Replacement (BHRT). I will note here, that we are not pregnant horses, and Premarin contains many horse estrogen conjugates of whose effects we are unaware of, (not to mention the Women's Health Initiative study that came to an early halt due to increased cardiovascular disease risk). BHRT in contrast, uses hormones that are as similar to our own as possible. The hormones are compounded and prescribed based on symptoms, history, and lab testing for hormone levels (urine hormones and their metabolites), leading to a much safer and more accurate prescription method. BHRT is still out of favour with many traditional allopathic standards of care, as the long-term studies are not yet available. Use of either HRT or BHRT for treatment of peri-menopausal and menopausal hot flashes and nightsweats can be effective, since both involve replacement of diminishing estrogen.

3. Naturopathic Medical Treatment: This can involve use of diet and lifestyle changes, acupuncture, BHRT (in some provinces), orthomolecular treatment (vitamins, minerals, and other nutrients), and botanical medicines to manage night-sweats.

Nutritional changes involve clean eating, less wine, more cruciferous vegetables, eliminating food sensitivities and refined carbohydrates, and adding soy isoflavones (particularly genistein).
Botanical medicine to decrease nightsweats include black cohosh, sage, valerian root, red clover, and licorice root.
1mg of folate, 400IU of vitamin E, and up to 800mg of magnesium are all helpful in reducing nightsweats during menopause.

Although the actual mechanism-of-action of the nightsweats in relation to estrogen is still poorly understood, it is known that many women improve with estrogen therapy, and that low estradiol in the serum, combined with elevated FSH levels are correlated with more hot flashes and night sweats. Consult with your naturopathic doctor to start alleviating nightsweats.

References:

Vasomotor Symptoms and Menopause: Findings from the Study of Women's Health Across the Nation 2011

The Effectiveness of Sublingual and Topical Compounded Bioidentical Hormone Replacement Therapy in Postmenopausal Women 2014

A Randomized Trial of Acupuncture for Vasomotor Symptoms in Post-Menopausal Women 2010

Understanding the Pathophysiology of Vasomotor Symptoms 2007

What Causes Hot Flushes? The Neuroendocrine Origin of Vasomotor Symptoms in Menopause 2009