Do you suffer from pre-period night sweats? When my patients tell me about their night sweats, often their first question is “does this mean I am starting menopause”? . Often times these women are in their 20’s or 30’s, and certainly are not yet ready for this transition. Rest assured that there ARE other reasons you may have to strip down your clothing in the middle of the night (not for the reasons you’re thinking!) . Sweating and hot flashes that occur before your period are some of the many presentations of PMS or pre menstrual syndrome (1). These symptoms are associated with fluctuations in the levels of progesterone and estrogen during the cycle, meaning that any woman (at any age) can suffer from hot flashes or night sweats (and it’s more common than you think!) (1). The average age for menopause is 51, but up to 40% of women report experiencing hot flashes in a given year (3). Even if you aren’t close to menopause, and your periods are regular, you can still experience night sweats before your period.
So why does it happen?
Hormone FluctuationsWell if we think about post menopausal women, the main reason why they are said to experience hot flashes is due to the very low levels of estrogen. Right after you ovulate (mid way through your cycle ), your progesterone rises paired with a rise in your basal body temperature. At this time estrogen levels begin to decline. Estrogen is at its lowest point right before and at the very beginning of your period. This hormonal shift affects your hypothalamus (the temperature regulation part of your brain)(2). The lowered levels of estrogen causes a release of norepinephrine, making you a lot more sensitive to changes in temperature. PMS night sweats can occur due to this hormonal shift. Similarly, estrogen has the ability to improve hot flashes by raising your core body temperature sweating threshold, which means that it takes more to make you sweat (2). If you have a pre existing imbalance in your hormones, this natural shift can be a whole lot more pronounced, causing you to experience uncomfortable night sweats before each period.
Imbalanced blood sugarWhen you consume refined carbohydrates and high sugar foods, this causes an imbalance in your blood sugar levels throughout the day (3). Our body deals with blood sugar by releasing a hormone known as insulin (3). Overtime, your body becomes less sensitive to the actions of insulin, and can no longer store blood sugar which leads to the overproduction of insulin, and consistently high blood sugar levels. Too much insulin, can also cause the ovaries to make testosterone (the main male hormone), leading to an imbalance of your other sex hormones (3). On top of just causing night sweats, this imbalance can also lead to acne and excess hair growth.
AnxietyAnxiety activates your sympathetic nervous system or the “fight or flight” response. This leads to the constriction of your peripheral blood vessels, causes your temperature to increase (3). As a reaction to this increased temperature, your body will trigger sweating in order to cool off (3).
Alcohol & certain medsAlcohol disrupts the body’s natural ability to regulate its own temperature which can cause both sweating and shivering (3). Some women find that they are particularly sensitive to alcohol, and women suffering from hot flashes often mention wine as a main culprit.
When to see your healthcare provider
So how do you know if you should see someone about your night sweats?(4). It is a good idea to see your healthcare provider if your night sweats are accompanied by one or more of the following:
- trouble getting a good night’s sleep
- more or less of an appetite than usual
- unexplained weight loss
- unexplained rash
- swollen lymph nodes
- Irregular periods
- Heavy Periods Painful periods
- Spotting between periods
- Irritability & mood swings