“I’m waking up between 1 and 4am – I’m dripping with sweat!” This was the cry I received this week from a lady living in an area of the United States, which is experiencing a heat-wave. Some of you in the United Kingdom and Europe are having a hotter than usual summer as well. For months she had been sleeping all night, with minimal hot flushes and enjoying renewed energy levels and weight management, but the other night, she woke up with night sweats. Then the next night. Then the next night. She is exhausted.
So what changed? Well, w
hen it’s hot outside, it’s going to be hot inside your body too. When the environment is hot, then we sweat more. We lose vital minerals such as magnesium and sodium which regulate our blood pressure, so when the climate warms up, our blood pressure increases too. We feel hot. But for women in their menopause transition, there’s something else as well. Our sweat glands and the tiny blood vessels that take blood to the skin are sensitive to oestrogen. So when oestrogen is low, then our heart rate is working harder to move blood to the surface of the skin and dissipate, or remove the heat. It’s a double whammy and it’s no wonder, we feel ‘hot’! Add to this, the fact that for women who are already overweight either before or during their menopause transition, then night sweats and hot flushes become more intense as well. If this is you, then you have become oestrogen dominant,
so your fat cells are expanding and storing more oestrogen that a thinner women does. Combine this with not sleeping all night, and your inflammation levels inside you, increase as well. [This is what my ‘Transform Me’ weight loss programme helps you to turn around]
As I often say to women who come onto the MyMT programmes
– hot flushes are a sign that your internal or ‘core’ temperature is higher than it should be. Sweating is your survival mechanism to help your body cope with heat that is building up internally, such as when we have a fever or we have inflammation inside us, or we are exercising in hot environments.
But we also sweat and experience hot flushes when we reach peri-menopause (the start of our reproductive ageing, when oestrogen and progesterone production decline).
But the cause of these sweats is different.
Night sweats in our menopause transition are caused by lowering oestrogen having an effect on other areas in the body which regulate your temperature.
And when we are accumulating even more heat in our body from an extreme heat-wave as has been happening in the Northern Hemisphere (and many parts of Australia over summer), then on top of the climate challenges, if our diet doesn’t suit menopause, or if we have inflammation that has been sitting in joints and muscles, or if we are doing lots of vigorous exercise, the body’s heat production can go into over-drive. What happens then, is that because our body is always trying to adjust and ‘right’ itself, we end up sweating more to get rid of all this excess heat production. So, with our body trying to adjust to environmental changes as well, the sweating can seem excessive at night when your body is trying to restore harmony again – hence, you can wake up with the sheets of your bed soaked.
When I was really trying to understand why I was experiencing night sweats and lots of hot flushes, I was guided by the great work of Deecher and Dories (2007)*. Their studies explain that when we have night sweats, there is a problem with the neural (nerve) and hormonal ‘communication’ between three areas. These are:
1. The pituitary gland in the brain.
2. Our thyroid gland (which requires iodine and selenium to regulate it).
3. Our skin – which we often forget is the largest organ in the body containing millions of tiny blood vessels that go to our sweat glands. The function of sweat glands are affected by low oestrogen too. They don’t dilate as much.
This means that to sort out your night sweats, you need to focus on these three key areas, not just the changing levels of oestrogen and progesterone, which has been the hallmark of menopause treatment for decades. When we focus on these three areas, then we can usually un-pack why we are getting night sweats, when we never used to.
One of the first things to understand is that our core body temperature is regulated by our brain (pituitary gland) and it works to our 24 hour circadian rhythm. This is why if you are frustrated and weary from your night sweats and lack of sleep, then the management of this begins by turning around your circadian rhythm (I have the step-by-step plan for this in the SLEEP MODULE).
When we overheat and sweat at night, something is up with the nervous system and our temperature regulation. The normal response to over-heating is that when core body temperature goes high, this is communicated to the brain by hot and cold temperature receptors around the body. They are located in your skin (the largest organ), your gut, your thyroid, your blood vessels and your spinal cord. Messages about your temperature regulation occur at many different sites in your body. Normally, when our core body temperature goes higher than it should, then peripheral vaso-dilation (dilation of our blood vessels) is triggered, resulting in increased blood flow to the blood vessels in our skin where our sweat glands are located. This sequence of events is regulated by our thyroid and our nervous system, which controls blood pressure and blood vessel dilation. But here’s the kicker, – these sites are also where you have oestrogen receptors too. And during menopause, these oestrogen receptors cannot do their job. Add to that a heat-wave and excess sweating during the day and loss of magnesium and other essential minerals that are in sweat, then the thyroid can get out of balance too.
So, how do we manage this temperature chaos during menopause?
Well, firstly, think about the night sweats in terms of the three areas – pituitary, thyroid and skin. All are controlled by our circadian rhythm, the way we adapt to our environment, our stress levels and the nutrients that control our thyroid health – iodine and selenium. Get these areas sorted first – (which is some of what women learn on the MyMT programmes).
Secondly, when it’s hot outside or inside, then you need to let your skin breathe – it’s your largest organ. So wear loose clothing, go barefoot if possible and cool your hands down by running cold water over the wrist and palms. Same with your feet. The feet and hands have numerous blood vessels which help to dissipate or reduce heat. They are an important component of our evolutionary cooling mechanism. When our feet are cool, we feel cooler inside our body.
I have other strategies that I have researched in my programmes, and this also includes lists of foods which help to keep us cool. We also need to eat lightly at night too and the timing of foods is critical to turning off night sweats. When we eat lightly at night, the gut (which has all the temperature sensors too) doesn’t have to process and digest all the evening food. This is particularly important for some proteins, which increase metabolism and are known as being ‘thermo-genic’ or heat generating.
A word of caution though – the official term for night sweats is ‘hyper-hidrosis’ and it is well known in medicine, that an under-lying virus or inflammation can also disrupt temperature regulation, so if you aren’t getting on top of your night sweats then please also see your Doctor because it could also be something more serious.
If you are having problems getting on top of your sleep, especially those of you in the Northern Hemisphere who are in your summer months, then I would love you to have a look at my 12 week menopause symptom reduction programmes.
For leaner women, I have ‘Circuit-Breaker’
and for over-weight women, I have ‘Transform Me’ . Paula
came on board at the start of July on my special promotion. Thank goodness she did. With all she has got going on in her life and a busy full time job doing shift work, her night sweats and hot flushes were sapping her energy levels. With her weight going up to an all-time high, she was at her wits end. If this is you too, then I would love to guide you through menopause without relying on medications, so that you thrive too.
Wendy Sweet, RN/PhD [Women’s Healthy Ageing Researcher & MyMT Creator & Coach].
* [Deecher, D. & Dorries, K. (2007). Understanding the pathophysiology of vasomotor symptoms (hot flushes and night sweats) that occur in peri-menopause, menopause and post-menopause life stages. Archives of Women’s Mental Health, 10: 247-257]