Night Sweats

Night sweats or night time “hot flashes” can be a very frustrating problem for women in menopause or peri-menopause.

Typically a hot flash is an experience of intense heat with sweating and increased heartbeat. The hot flash can last for a few minutes or up to 30 minutes.

Usually the sensation of heat begins on the face or chest, or back of the neck and then spreads throughout the entire body. The skin will feel hot to the touch.

Recently I received this reader question:

Q: “I’m a 44 year old female, and several nights a month I get “night sweats.” About 10 years ago, my doctor suggested using Evening Primrose Oil, which helped for a while, but doesn’t any longer. Any suggestions? What else can I try for night sweats?”

A: Specifically I am wondering if your body has shifted in to full menopause, defined by the cessation of menstrual periods for 12 consistent months. If this has occurred you should check in with your doctor and have your FSH levels tested to determine you are in fact “post menopausal.”

Much more can be done for night sweats in addition to a good source of oils in the diet, such as evening primrose oil. If EPO is no longer working, I would try adding or switching to flaxseed oil as it is also a good source of lignans which are shown to be beneficial in menopause.

Freshly grind whole flaxseeds with a coffee grinder and consume about 1-2 tablespoons daily. You can mix them in with yogurt, applesauce, or juice and consume one hour before expected bedtime. Several of my patients have found immediate relief and “sleep like babies” just from this tip, however, not everyone has the same biochemistry so lets talk about why these night sweats are happening and what other treatments are shown to be clinically beneficial.

First of all, as women age, the ovaries are making less and less estrogen. Estrogen naturally keeps us “cool” in both the temperature and attitude aspects as it not only affects our thermostat, but our neurotransmitter production, and thus mood swings occur along with other symptoms of menopause such as night sweats.

Men have less estrogen in their systems, but don’t get hot flashes typically because they are not having hormonal fluctuations. Therefore, the main treatment goal is to keep estrogen levels consistent so that estrogen levels don’t suddenly drop and cause hot flashes and night sweats.

Treatments for Night Sweats & Hot Flashes in Menopause:

• First, please see your doctor to insure you are entering menopause and are not suffering from a different problem before implementing any self help or natural protocols. FSH levels should be drawn, as well as testing of your thyroid, Basic Metabolic Panel, and CBC- Complete Blood Count (to rule out cancer and other causes of night sweats.) Also this transition period can be EXTREMELY stressful for some women so having the support of your physician, friends, and maybe an online support group should ease the transition.
• HRT: Hormone Replacement Therapy is the most common treatment for menopause, however not all women need this aggressive of a treatment. If needed, I recommend estradiol and generic progesterone over premarin or prempro as premarin is made from “Pregnant Mare Urine” and is thus collected in a manor abusive to animals….and is also expensive! Not everyone will find relief from the same treatments so ultimately start with natural treatments and work your way up to HRT if need be. If you opt for HRT the “bioidentical hormones” are now available in a generic form at Walmart for about $4 for estradiol and generic progesterone each.  
• Isoflavones: Molecules that weekly mimic estrogen found in nature such as soy, red clover (pictured above) and so forth can be helpful in establishing a more consistent estrogen level. Be sure to take these supplements regularly for optimal effect. As stability is key.
• Flaxseed: 1-3 tablespoons freshly ground as mentioned above. Read: “How to Unleash you Inner Fabulosity.”
• Ginseng: and other adrenal adaptogens are helpful as the liver and adrenal glands take over the sole production of hormones as the ovaries cease estrogen production. The ”Siberian” form of Ginseng is best for women. I also like Ashwaganda and Schisandra for women with stress accompanied by low sex drive.
• Liver Support:  The liver is metabolizing estrogen, so ensuring it’s proper functioning is prudent. Try increasing “Liver Support Foods,” to avoid the ups and downs of estrogen levels causing night sweats. Read: “Spring Cleaning Diet.”
• Avoid the Hot Flash Trifecta: Caffeine, Spicy Foods, and Alcohol. This is one of the main problems women endure with natural treatments. If you aren’t willing to give these foods/beverages up….try having them earlier in the day. At the very least do an elimination period for a week so you can experience what life is like without them, then have them all at once and see if they induce a hot flash. Knowledge is powerful motivation. Read: “How I Gave Myself a Hotflash.”
• Avoid sugar and heavy carbs before bedtime. A light dinner of veggies, brown rice or other complex carbs, and light protein is best for dinner. Skip the dessert before bed.
• Consider an herbal sedative in the evening as the main issue with night sweats is losing sleep and resulting sanity! If you aren’t sleeping well you likely aren’t coping well with the menopause transition. Proper sleep is imperative to good health.
• Keep a fan by your bed, workstation, etc.
• Try a cooling mist spritz of water & essential oils Clary Sage and Lavender (add a few drops of each per ounce of H2O) and spritz on your face, neck, chest. Old rinsed out perfume bottles work great for this. Always test on your inner arm before first applying to your face, chest or neck. You can keep the bottle in the fridge by day, or on ice near your bed at night for added cooling benefit.
• Osteoporosis and menopause go hand in hand, as estrogen drives calcium in to our bones.  Keep in mind that you should be taking 1 capsule of 500mg of calcium with food twice daily, combined with 250mg of magnesium and 1000 IU of vitamin D, along with weight bearing exercise to prevent your bones from becoming brittle and susceptible to fractures.  Read: “Osteoporosis Diet.”
• Proper Colon Elimination: If you are not having 1-2 bowel movements daily, you should increase water and fiber in your diet. Along with the liver, the colon plays a role in estrogen elimination, and consistency is key.
  Wicking Fabrics: Try sleeping in pajamas and bedding that are designed to wick sweat away. Work out clothes designed to “breathe” can make for great pajamas for those with night sweats. I have heard of specific menopausal pillows and bedding designed for night sweats, try an internet search for these products, or check Amazon.com.
• Black Cohosh: Although a recent study found black cohosh to be ineffective, I think it was the specific chemical form of the extract studied, as many women have received relief from the product “Remifemin,” which I highly recommend. Give any menopause treatment 3 solid months before abandoning it.
• Exercise in the morning. By exercising in the AM you should sleep better and exercise is also beneficial for menopause.

 How do I know if my Night Sweat Treatment is working?

• I know this problem is frustrating, because most women want an IMMEDIATE and quick fix….for good reason. Although HRT is great for a quick fix, it can be difficult to wean off in the long run. Remember menopause is a natural transition of life, and a healthy body should go through it relatively smoothly.
• Be gentle with yourself and ask those around you to be nice to you while you are getting things figured out.
• To monitor treatment efficacy, keep account of the duration and frequency of your night sweats and hot flashes. The goal is to head in diminishing direction. If after 3 months you are finding no effect with your treatment, then try something else. If you are receiving some relief then keep the current treatment on board and add something new in to the mix. A diet diary may also be helpful. Rate your hot flashes on a scale of 1-10 with 10 being the most severe each day along with what you ate and drank. Note the duration in minutes as well. This may help sort out dietary causes such as alcohol, caffeine, and spicy foods and encourage you to decrease consumption.

Hope that helps! 

 There are many great herbal natural products compounded specifically for hot flashes be sure your brand is high quality and independently laboratory tested and/or prescription grade. The aforementioned tips are some of my favorites, but there are also many options available.

~Dr. Nicole
Related Reading:
“Nutrition Care During Menopause”
“The Natural Approach to Menopause”
“Rosemary Salmon Recipe”
“Rosemary for Rememberance”