Saturday, March 26, 2011

How to Cope with Menopausal Night Sweats?

Night Sweats Symptoms

Doctors in primary care fields of medicine often hear their patients complain of night sweats as they are common. Night sweats refer to any excess sweating occurring during the night. However, if your bedroom is unusually hot or you are using too many bedclothes, you may begin to sweat during sleep - and this is normal. In order to distinguish night sweats that arise from medical causes from those that occur because one's surroundings are too warm, doctors generally refer to true night sweats as severe hot flashes occurring at night that can drench sleepwear and sheets, which are not related to an overheated environment. However, night sweats and hot flashes during menopause for many women is a sad reality, which cannot be resolved by proper night gowns or bedding.

Hot flashes are probably the most well-known symptom of the menopause. In addition to hot flashes, many menopausal women experience the symptom's nocturnal accomplice known as night sweats. You wake up in the middle of the night cold and clammy, your heart pounding, and the sheets drenched in sweat. It's hard to calm down and get comfortable again, and it's impossible not to be irritated by the interruption to a good night's sleep.

While there are a wide range of signs, symptoms and effects of a woman’s menopausal transition (including mood swings, hypoglycemia and irritability), the symptoms that are related to the menopause night sweats phenomenon are the following
  • Heart palpitations or rapid heartbeat
  • Headaches and Migraines
  • Increased atherosclerosis risk
  • Flushing, hot flashes, and of course, night sweats.

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What Causes Night Sweats?

Hot flashes and night sweats are caused by a complex interaction that involves fluctuating estrogen levels; the hypothalamus (a region of the brain that regulates body temperature); norepinephrine, a key brain chemical, and specialized receptors in the brain; and the body's blood vessels and sweat glands.

During menopause, estrogen levels fluctuate. The hypothalamus, a region of the brain that regulates body temperature and is affected by hormones, can become confused by these changes in estrogen levels. Like a faulty thermostat, the hypothalamus may respond to the changes in estrogen as if it senses an increase in your body's temperature. In an attempt to cool you down, the hypothalamus sets off a cascade of events, including dilating blood vessels to release heat (which you feel as a hot flash) and triggering sweat glands (which you feel as sudden, intense perspiration). The result is you wake up drenched and chilly, with a speeding heart and a sensation of anxiety.

According to JoAnn Manson, MD, MPH, PhD, an endocrinologist and professor of women's health at Harvard Medical School, about 80 percent of women in menopause experience some hot flashes and night sweats. She adds, "Of those women, 15 to 20 percent will have symptoms severe enough to warrant medication if they want it."

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Not-Menopausal Causes

There are many different causes of night sweats, other than menopause. To determine what is causing night sweats in a particular patient, a doctor must obtain a detailed medical history and order tests to decide if an underlying medical condition is responsible for the night sweats. Some of them:

  1. Infections
Classically, tuberculosis is the infection most commonly associated with night sweats. However, bacterial infections, such as the following conditions can also be associated with night sweats:
  • endocarditis (inflammation of the heart valves),
  • osteomyelitis (inflammation within the bones due to infection),
  • abscesses (for example, boils, appendix, tonsils, perianal, peritonsillar, diverticulitis), and
  • AIDS virus (HIV) infection.

  1. Cancer
Night sweats are an early symptom of some cancers. The most common type of cancer associated with night sweats is lymphoma. However, people who have an undiagnosed cancer frequently have other symptoms as well, such as unexplained weight loss and fever.

  1. Medication
Taking certain medications can lead to night sweats. In cases without other physical symptoms or signs of tumor or infection, medications are often determined to be the cause of night sweats.
Antidepressant medications are a common type of medication that can lead to night sweats. All types of antidepressants including tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), and the newer agents, venlafaxine (Effexor) and bupropion (Wellbutrin) can cause night sweats as a side effect, with a range in incidence from 8% to 22% of persons taking antidepressant drugs. Other psychiatric drugs have also been associated with night sweats.

Medicine taken to lower fever (antipyretics) such as aspirin and acetaminophen can sometimes lead to sweating.

Other types of drugs can cause flushing (redness of the skin, typically over the cheeks and neck), which, as mentioned above, may be confused with night sweats. Some of the many drugs that can cause flushing include:
  • niacin [(Niacor, Niaspan, Slo-Niacin) (taken in the higher doses used for lipid disorders)],
  • tamoxifen (Nolvadex),
  • hydralazine,
  • nitroglycerine, and
  • sildenafil (Viagra).

Many other drugs not mentioned above, including cortisone, prednisone, and prednisolone, may also be associated with flushing or night sweats.

  1. Hypoglycemia
Sometimes low blood glucose (hypoglycemia) can cause sweating. People who are taking insulin or oral anti-diabetic medications may experience hypoglycemia at night that is accompanied by sweating.

  1. Hormone disorders
Sweating or flushing can be seen with several hormone disorders, including pheochromocytoma, carcinoid syndrome, and hyperthyroidism.

  1. Neurologic conditions
Uncommonly, neurologic conditions may cause increased sweating and possibly lead to night sweats including:
  • autonomic dysreflexia,
  • post-traumatic syringomyelia,
  • stroke, and
  • autonomic neuropathy.

How to Deal with Night Sweats?

Breathe deeply

According to the National Institutes of Health (NIH), studies suggest that slow, rhythmic deep breathing, known as paced or relaxation breathing, may help reduce hot flashes and night sweats. Relaxation breathing may also help you get back to sleep after a night-sweat episode.

Look for patterns

Either right when you wake up from a night sweat or the next morning, take a minute to write down anything you might have done differently before the incident. Did you eat anything spicy? Drink some alcohol? Smoke tobacco? (All three are thought to worsen symptoms.) By keeping track of such potential triggers, you'll be able to glean a pattern and avoid those things in the future.

Stay comfortable

Put a fan in your bedroom to keep air cool and circulating. And consider wearing "wicking" pajamas. There are a number of pajamas on the market made specifically for night sweats, and ironically some of them use man-made fabrics. Some leverage developments originally made while developing better diapers. That may sound strange, but if you think about it, it starts to make sense. This night sweats sleepwear leverages the same capability to draw moisture away from the skin that diaper manufacturers developed to keep babies dry and comfortable until their diapers could be changed. These wicking pajamas are often referred to as wicking sleepwear, or because of how often they’re marketed towards women entering menopause, hot flashes sleepwear.

When it comes to sheets and bedding, natural fibers are your friend. One of the things that make sweating at night so uncomfortable is the feeling of sticky wetness. Man-made materials such as polyester will trap moisture and heat and thus simply exacerbate the issue. Natural fibers like cotton, bamboo and linen breathe and allow moisture to pass through the material. Linen in particular is a great fiber to help control heat and moisture. You may even find specific night sweats sheets designed to wick away the moisture.

A glass of cold water by your bedside can help you cool down if you wake up with night sweats.

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Try hormone replacement therapy

Though HRT has come under scrutiny for its potential risks, it continues to be a popular and effective way to negate some of the more trying symptoms of menopause (like night sweats). Talk to your doctor about the pros and cons of hormone replacement therapy; depending on the severity of your symptoms and your overall health, it could be an appropriate strategy for you.

Consider a natural course

Currently the National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health is funding a rigorous scientific study to determine whether taking a black cohosh supplement, extracted from the root of a native North American plant (Cimicifuga racemosa), can help reduce menopausal symptoms, including night sweats. Preliminary evidence is encouraging. Dr. Manson also recommends soy products for menopause symptoms, with a caveat: "They can be helpful for mild hot flashes and night sweats but won't do much for the moderate to severe cases." Similarly, a recent study found that women dealing with mild night sweats found relief from dang gui bu xue tang, a Chinese herbal remedy that includes dong quai, a popular herb from the celery family that is commonly used in traditional Chinese medicine to treat gynecological symptoms.

Avoid Alcohol and Stimulants

Alcohol and stimulants like caffeine can make it hard to get a good night’s sleep. Avoid using alcohol and stimulants for four to six hours before you go to bed. You’ll also want to avoid tobacco, refined sugar, saturated and hydrogenated fats, and acidic foods like pickles or citrus fruits.

Avoid Spicy Foods

Many people find that eating spicy foods raises their body temperature and can contribute to night sweats. You may want to avoid spicy foods until the symptoms of menopause pass.

Exercise

A recent study done at Penn State indicates that increasing cardio-respiratory fitness, including walking and yoga, could be a way to reduce menopausal symptoms. Other research from the University of Pittsburgh suggests that during menopause, overweight women have significantly more hot flashes and night sweats. Getting active and losing weight, of course, may not only reduce night sweats but can also positively affect your overall health and well-being.

However, any strenuous activities, like exercise, can exacerbate night sweats if performed at night. Limit strenuous physical activity to the daylight hours and devote the hour or two before bed to relaxing in preparation for sleep.

Sources and Additional Information:


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