Night Sweats in Menopause: Causes, Other Explanations and What Helps

Menopausal night sweats are hot flashes that happen during sleep. They cause sudden heat and sweating that can soak your nightclothes or bedding and wake you up. They’re common in perimenopause and the early years after menopause and can disrupt sleep for years. Night sweats with fever, weight loss or swollen glands need a medical check.

What do menopausal night sweats feel like?

You may wake up feeling intensely hot, flushed and sweaty, sometimes with a racing heart. Afterward you often feel chilled, especially if your nightclothes or sheets are damp. Some people wake several times a night; others have occasional episodes.

Many people also notice they wake frequently, or in the early hours, even without obvious sweating. Night sweats and sleep problems are closely linked. See sleep problems.

Why does menopause cause night sweats?

Night sweats are a vasomotor symptom, just like hot flashes. Falling and fluctuating estrogen affects the brain’s temperature-control center, narrowing the range of temperatures the body tolerates comfortably. A small rise in core temperature can trigger flushing and sweating to cool you down, whether you’re awake or asleep.

How common are night sweats, and how long do they last?

Up to 80% of women experience hot flashes or night sweats during the menopause transition. In the SWAN study, women with frequent hot flashes or night sweats had them for a median of 7.4 years, including a median of 4.5 years after the final period. The NHS notes that women from a Black ethnic background are more likely to have severe symptoms that last longer. See how long menopause symptoms last.

What else can cause night sweats?

Menopause is a very common cause of night sweats in midlife, but not the only one. Other causes include:

• Infections, particularly if you also have a fever
• Medicines, such as some antidepressants, hormone treatments and medicines that lower blood sugar
• An overactive thyroid, which can cause sweating, palpitations and weight loss
• Anxiety
• Alcohol, especially in the evening
• Low blood sugar at night, in people with diabetes who use certain medicines
• Sleep apnea, which can cause sweating along with snoring and gasping
• Rarely, some cancers, such as lymphoma, usually with other symptoms such as weight loss, fever or swollen glands

A useful clue: menopausal night sweats usually come with daytime hot flashes, changes in your periods, or other menopause symptoms. See perimenopause or something else.

What makes night sweats worse?

• A warm bedroom or heavy duvet
• Synthetic nightwear or bedding that traps heat
• Alcohol, caffeine or spicy food in the evening
• A hot bath or shower just before bed
• Stress, and lying awake worrying about sleep

Tracking episodes alongside evening habits can show your personal triggers. Our private Symptom Explorer can help.

What will a clinician assess?

A clinician will usually ask:

• How often you have night sweats and how much they affect your sleep
• Whether you also have daytime hot flashes or changes to your periods
• About your medicines and alcohol intake
• Whether you have fever, weight loss, cough, swollen glands or other symptoms
• Whether you snore or stop breathing at night

If your symptoms fit menopause and you’re over 45, NICE advises no blood tests are needed to identify perimenopause or menopause. Other tests, such as a blood count, thyroid function or a chest X-ray, may be needed if another cause is suspected.

What treatments help night sweats?

Treatments for night sweats are the same as for hot flashes.

• Hormone therapy. The Menopause Society describes hormone therapy as the most effective treatment for hot flashes and night sweats. NICE recommends offering it after discussing benefits and risks.
• Menopause-specific CBT. NICE recommends considering it for hot flashes and night sweats, and separately for sleep problems such as waking at night linked to vasomotor symptoms.
• Non-hormonal medicines. Fezolinetant, which NICE recommends when HRT is unsuitable, and elinzanetant, approved by the FDA in 2025, target the brain’s temperature-control pathway. Some antidepressants, gabapentin and clonidine are alternatives, although NICE doesn’t recommend SSRIs, SNRIs or clonidine as routine first-line treatment for vasomotor symptoms alone.
• Supplements. NICE notes some evidence for isoflavones and black cohosh, but safety and quality are uncertain.

Gabapentin can cause drowsiness, which some people find helpful at night and others find troublesome. Discuss side effects with your clinician.

Practical steps that may help

Your bedroom

• Keep it cool and well ventilated, and use a fan.
• Choose light, breathable bedding in layers you can throw off, such as cotton, linen or moisture-wicking fabrics.
• Keep a spare set of nightwear and a towel within reach.
• Keep a glass of cold water by the bed.

Your evening

• Cut back on alcohol, especially close to bedtime.
• Avoid spicy food and caffeine in the evening.
• Take a lukewarm rather than hot shower before bed.
• Wind down with a calming routine.

If you wake up

• Cool down quickly: remove a layer, turn your pillow and sip water.
• Try slow, relaxed breathing instead of checking the time.
• If you can’t get back to sleep after around 20 minutes, get up and do something calm in dim light until you feel sleepy.

Keeping a night sweat diary

For two weeks, note:

Bring the diary to your appointment. It makes treatment decisions much easier.

Sharing a bed

Night sweats can disturb a partner too. Some couples find it helps to:

• Use separate duvets or blankets of different weights
• Put a fan on your side of the bed
• Choose cooling or moisture-wicking bedding and mattress protectors
• Agree that it’s fine for one person to move to another room occasionally to catch up on sleep, without it meaning anything more

Talking openly about it reduces worry and resentment on both sides.

When should you see a doctor?

Book an appointment if:

• Night sweats are regularly disrupting your sleep or daily life
• You’re under 45 and think menopause could be the cause
• You’d like to discuss treatment

Seek prompt medical advice if night sweats come with:

• Fever, or night sweats that started after travel or an infection
• Unexplained weight loss
• Swollen glands, a persistent cough, or coughing up blood
• Diarrhea, tremor or palpitations
• Night sweats that are new and you have no other menopause symptoms

Questions to ask at your appointment

1. Do my night sweats fit with menopause, or should anything else be ruled out?
2. Could any of my medicines be contributing?
3. Would hormone therapy or a non-hormonal medicine suit me?
4. Can I access menopause-specific CBT for night sweats and sleep?
5. Could I have sleep apnea?

See your first menopause appointment.

Related symptoms

Hot flashes · Sleep problems · Fatigue · Brain fog · Anxiety

Frequently asked questions

Why do I get night sweats but not hot flashes during the day?

Some people notice symptoms mainly at night, when the body’s temperature changes during sleep and bedding traps heat. The cause and treatments are usually the same as for daytime hot flashes.

Can night sweats happen before periods stop?

Yes. Night sweats often begin in perimenopause while periods are still happening, and sometimes worsen just before a period.

Are night sweats a sign of something serious?

Usually not, when they come with other menopause symptoms. But night sweats with fever, weight loss or swollen glands should always be checked.

Does HRT stop night sweats?

Hormone therapy is the most effective treatment for night sweats for most people, although it isn’t suitable for everyone. Non-hormonal medicines and CBT are alternatives.

References

1. NICE guideline NG23: Menopause, identification and management (2024 update, via NCBI Bookshelf)
2. NICE NG23 recommendations (fezolinetant)
3. Avis NE et al. Duration of menopausal vasomotor symptoms. JAMA Internal Medicine, 2015
4. ScienceDaily: Hot flashes, night sweats last seven or more years (SWAN)
5. NHS: Symptoms of menopause and perimenopause
6. Mayo Clinic Press: Menopause symptoms? It could be a copycat
7. The 2022 hormone therapy position statement of The North American Menopause Society
8. Contemporary OB/GYN: FDA approves elinzanetant (Lynkuet)

Editorial status: evidence-based educational article. Last evidence check: September 10, 2026.