Night Sweats In Women : Causes, Symptoms, Diagnosis & Treatment

Last Updated: 26/08/2022

Night sweats in women (nocturnal hyperhidrosis) is an increase in sweating that worries women at night. The symptom may be accompanied by weakness, fever, a feeling of heat and redness of the face. The main causes of hyperhidrosis are menopause and other hormonal disruptions in the female body, night sweats also occur with infectious diseases, rheumatic diseases. To determine the etiological factor, laboratory tests, ultrasound, and a neurological examination are performed. To reduce or completely eliminate unpleasant manifestations, it is necessary to act on the cause of increased sweating.

Causes of night sweats in women

Climax

Increased sweating is one of the symptoms of "hot flashes", which are observed in 85% of women after 45-5 years. Night sweats are caused by changes in the brain center of thermoregulation due to inhibition of ovarian function and a decrease in the concentration of sex hormones in the blood. Patients may wake up due to profuse sweating, wetting of bed and underwear. After waking up, there is an agonizing feeling of heat that rises from the chest to the neck and face. With severe hyperhidrosis, drops of sweat flow down the face, the scalp sweats heavily.

In severe menopause, the number of attacks of sweating and fever reaches 5-7 times during the night. In the morning, one feels tired and weak, with chronic lack of sleep, concentration and working capacity decrease. Some patients report having hot flashes associated with spicy food or alcohol the night before. If such manifestations are disturbing several times a night, combined with severe headaches or clouding of consciousness, you should consult a doctor to rule out other causes of the painful condition.

Physiological fluctuations of sex hormones

The appearance of sweating during sleep in women is noted a couple of days before menstruation, since during this period the concentration of progesterone rapidly decreases, and the level of estrogen is still low. With severe hyperhidrosis, patients are forced to change clothes or bedding in the middle of the night, in case of moderate sweating, the woman continues to sleep, but in the morning she notices stains on the pillowcase or sheet. Increased sweating, as a rule, is accompanied by a change in the smell of sweat - it becomes stronger and sharper due to the increased work of the apocrine sweat glands.

Hormonal changes in pregnant women cause disruption of the thermoregulation center in the hypothalamus, which is manifested by increased sweat formation. The symptom is especially pronounced in the first trimester. Profuse sweating forces women to wake up at night to ventilate the room and change clothes. Normally, unpleasant manifestations decrease as we approach childbirth, and then completely disappear. If the disorder persists even after the provoking cause has been eliminated (after childbirth, with the onset of menstruation), a specialist consultation is necessary.

Endocrine disorders

Common causes of nocturnal hyperhidrosis in middle-aged and older women are disorders of the peripheral endocrine glands, which are accompanied by general autonomic disorders and increased sweating. Night sweats are more often expressed moderately, sleep disorders are usually absent. Sometimes profuse sweating at night is the cause of awakening and is combined with a deterioration in well-being, palpitations, and weakness. Sweating at night in women is caused by such endocrine diseases as:

  • thyrotoxicosis . The disease is characterized by profuse night sweats that cause bed linen and clothing to get wet. Patients often wake up from a feeling of heat and stuffiness, there may be an increased heartbeat, tremor of the fingers.
  • Diabetes mellitus . Severe night sweats are the first sign of a decrease in blood glucose concentration, which often occurs at night with an inadequate insulin regimen. A combination of a symptom with restless sleep, throwing in bed is typical.
  • Syndrome Itsenko-Cushing . An increase in the level of hormones of the adrenal cortex causes moderate sweating at night. The disorder is accompanied by a change in metabolic reactions, cardiac and vascular pathology, and accumulation of fat on the abdomen.

 

Connective tissue diseases

Systemic inflammatory processes are more common in women, due to the peculiarities of the immunological response of the female body and increased production of autoantibodies. Chronic inflammation in the joints, soft tissues and skin causes various autonomic reactions, one of which is increased night sweats. Collagenosis is characterized by complaints of restless sleep and frequent awakenings. In the morning sweat stains on bed linen are clearly visible, hair looks greasy and stuck together due to increased sweat separation.

Neuropsychiatric diseases

Psychogenic reasons for the development of increased sweating at night in women are psychosis, depression, somatoform disorder. With these pathologies, nocturnal hyperhidrosis is accompanied by depression of mood, loss of interest in life and habitual activities. There is severe drowsiness, weakness and fatigue. Often night sweats are associated with disturbing dreams, nightmares. In addition to hyperhidrosis, patients present with many other complaints - abdominal pain, dyspepsia, feelings of "fading" of the heart, shortness of breath and a feeling of lack of air.

infections

When a pathogen enters the body, fever appears, various toxins accumulate in the blood, which is associated with night sweats. By evening, body temperature may rise, and at night, when it decreases, sweat is plentiful. Hyperhidrosis occurs against the background of other nonspecific symptoms: arthralgia and myalgia, headaches, loss of appetite. The most common infectious causes of night sweats in women are:

  • Acute viral processes : influenza, SARS, infectious mononucleosis.
  • Bacterial and protozoal invasions : malaria, brucellosis, purulent tonsillitis.
  • Slow infections : tuberculosis, herpes simplex, HIV.

Complications of pharmacotherapy

Most often, profuse night sweats develop after excessive intake of antipyretic drugs, which is why there is a sharp decrease in body temperature to normal or subnormal. This is accompanied by great weakness and drowsiness, so that the patient does not wake up at night, even if the bed linen gets wet. Other medications can also cause hyperhidrosis:

  • Psychotropic drugs : tranquilizers, neuroleptics, sedatives.
  • Antihypertensive drugs : beta-blockers, calcium antagonists.
  • Hormones : corticosteroids, levothyroxine.

Rare Causes

  • Idiopathic hyperhidrosis .
  • Diseases of the cardiovascular system : endocarditis, rheumatic heart disease, myocardial dystrophy.
  • Oncological diseases : lymphogranulomatosis, non-Hodgkin's lymphoma, chronic leukemia.
  • Sleep apnea .

Diagnostics

To identify the causes of severe sweating at night, women most often turn to a general practitioner. The specialist organizes an initial examination, which includes laboratory tests and instrumental imaging methods in the presence of specific complaints. Diagnostic search is aimed at detecting the underlying pathology that causes night sweats. The most informative are:

  • Laboratory tests . Determine the levels of estrogen and progesterone on different days of the cycle. In case of deviations from the norm, an additional assessment of the tropic hormones of the pituitary gland is prescribed - FSH and LH. To exclude another endocrine cause of sweating, the level of thyroid-stimulating hormones, glucocorticoids, and blood glucose is studied.
  • bacteriological research . With nocturnal hyperhidrosis occurring against the background of elevated body temperature, it is necessary to carry out a bacterioscopy of a smear from the throat, collect sputum for bakposev. Sometimes they examine the blood for hemoculture. Serological tests (RIF, ELISA, PCR) are performed for express diagnostics of infectious diseases.
  • Sonography . Ultrasound of the thyroid gland and adrenal glands, a study of the reproductive system is shown. During an ultrasound examination, the structural features of organs, the presence of cysts, and volumetric formations are studied. With complaints of palpitations and shortness of breath, ultrasound of the heart and main vessels is informative.
  • Neurological examination. To assess the autonomic nervous system, standard tests are used (orthostatic, Danini-Ashner), dermographism is assessed. Reflexes, muscle tone and coordination of movements are checked. Additionally, a psychiatric evaluation is recommended.

If signs of organic lesions of internal organs are detected on ultrasound, a CT scan of the abdominal cavity and cervical region is prescribed. To assess the state of the thyroid gland, radioisotope scintigraphy is performed. If suspicious enlarged lymph nodes are found, a puncture is made under ultrasound guidance, then a cytomorphological analysis of biopsy samples is performed. Usually, a consultation with a gynecologist is required with an examination of the genital organs in the mirrors.

Treatment

Help before diagnosis

To find out the cause of profuse sweating at night, a woman needs to visit a doctor. To reduce discomfort before the diagnosis is verified, several rules should be followed: air the room before going to bed so that the temperature does not exceed 22 ° C, choose bed linen and pajamas made from natural fabrics, refuse strong coffee and tea in the evening. Impressive patients are advised to avoid watching horror films in the evening, heavy psychological dramas. Before going to bed, it is advisable to drink a cup of herbal tea (with chamomile, lemon balm, thyme).

Treatment of excessive sweating in women is carried out using medication and non-pharmacological methods.

 

Conservative therapy

Hyperhidrosis caused by physiological fluctuations in hormones or emotional reactions is successfully treated with the use of psychotherapy, physiotherapy methods aimed at strengthening the body, stimulating the nervous system. In other situations, the appointment of medications is required, which are selected according to an individual scheme, based on the cause of night sweats. Typically, treatment includes the following groups of drugs:

  • Hormonal agents . Tableted estrogens are recommended for severe manifestations of menopause to reduce the frequency of hot flashes. In insulin-dependent diabetes mellitus, insulin replacement therapy is performed.
  • NSAIDs . They are used for infectious pathologies to eliminate fever. They also have a pronounced anti-inflammatory effect, therefore they are used as part of pathogenetic therapy.
  • Tranquilizers . The drugs are indicated for depression, psychosis to normalize the mental state, eliminate anxiety and psychomotor agitation. Means are combined with sedative drugs.
  • Antibiotics . With bacterial infections, etiotropic therapy is effective, aimed at destroying the pathogen. With ARVI, interferons and antiviral drugs may be prescribed.
  • Cytostatics . Medicines in combination with radiotherapy are used in lymphoproliferative processes to destroy tumor cells. They are also recommended for severe connective tissue diseases.

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