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Sleeping Hot: How to Sleep Well During Menopause

A hot flash can come on quick and be overwhelming. You get the feeling that your temperature is rising, your face gets red and flushed, and you break out in a sweat. If you’re going through menopause or will soon be approaching it, chances are these symptoms are familiar to you. In fact, up to 75 percent of all women experience hot flashes related to menopause.

If it happens during the day, a hot flash is uncomfortable. But when it happens at night, it can be disruptive to sleep. Too many nights spent tossing and turning can be a drain on your quality of life. Unfortunately, those hot flashes may not be the only thing keeping you up.

“Hot flashes at night are called night sweats because they can cause bedclothes to become wet – and they often wake up the sufferer,” said John J. Fitzgerald III, DO, a gynecologist on staff at Abington-Jefferson Health with an office in Blue Bell. “Many women also experience sleep disturbances not caused by hot flashes. Menopause can lead to anxiety and depression and may worsen existing sleep disorders, such as sleep apnea and restless leg syndrome.”

What is Menopause and Perimenopause?

Menopause is defined as the time in a woman's life, usually between the ages of 45 and 55, when the ovaries stop producing eggs and menstrual periods end. After menopause, a woman can no longer get pregnant. Perimenopause, which means “around menopause,” is the time leading up to menopause. Some of the symptoms of menopause may start during this time, including hot flashes and night sweats.

“During menopause, the complete depletion of ovarian follicles – the cells in the ovaries that produce the hormones related to the menstrual cycle – results in low levels of estrogen,” said Dr. Fitzgerald. “It’s characterized by irregular menstrual cycles, endocrine changes and symptoms such as hot flashes.”

On average, menopause occurs when a woman is in her early 50s, but individuals can experience it later or earlier depending on genetics and other factors.

What Causes Hot Flashes and Night Sweats

In short, estrogen withdrawal is the culprit.

Women who have not yet reached menopause, a stage called premenopause, get rid of their body heat when their core temperature rises by a certain set point. A control center in the brain—called the hypothalamus—regulates this function and is closely tied to how much estrogen is circulating in a woman’s body.

However, during menopause, when estrogen levels dip and other hormone levels rise in response, the hypothalamus doesn’t get the same message about when to regulate body temperature. Instead, temperature regulation happens at a much lower point—which means that while everyone else may be cool, someone going through menopause will be sweating.

“The feeling of warmth results from inappropriate dilation of the vascular system, causing an increase in blood flow to the skin in the upper chest and face,” said Dr. Fitzgerald. “Perspiration results in rapid heat loss and a decrease in core body temperature. As a result, shivering may occur as a normal mechanism to restore the core temperature to normal.”

If you’re going through menopause, it can feel like a temperature rollercoaster ride. No wonder it’s so hard to get a good night’s sleep.

How to Treat the Problem

Managing the discomfort associated with hot flashes depends on their severity and frequency, as well as your medical history, personal choice and other menopausal symptoms you may have.

  • If they’re mild: Hot flashes and night sweats that don’t interfere with lifestyle usually do not need medical therapy. Instead, simple changes in behavior, such as lowering room temperature, using fans and air conditioners, dressing in layers of clothing, and avoiding triggers (such as spicy foods, alcohol and stressful situations) can help reduce the number of hot flashes.
  • If they’re moderate to severe: These types of hot flashes and night sweats can be treated with hormonal or non-hormonal therapies. Estrogen replacement therapy or a combination of estrogen and progesterone therapy may help. For patients who cannot use hormone replacement therapy, other medications such as antidepressants and antiepileptics may be a better option.

“If you’re experiencing night sweats and other uncomfortable symptoms related to menopause, talk to your doctor,” said Dr. Fitzgerald. “Together, we can determine how to give you relief in a way that works with your history and lifestyle.”

To find a physician to help manage menopause, please call 215-481-MEDI (6334).

Page last reviewed: November 14, 2017
Page last updated: November 14, 2017

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