Hot flashes

Night sweats in menopause

Night sweats mean you soak your nightclothes and bedding even when the room is cool. In midlife they are a common menopause symptom, though medicines, a thyroid problem or an infection can cause them too, and NICE names HRT as the most effective treatment for hormonal sweats when it suits you.

By Ines Kovac. Published 22 October 2026. 7 minute read.

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Rumpled white pillows and a white duvet against a dark wooden headboard.

What night sweats are

The NHS describes night sweats as sweating so much that your nightclothes and bedding are soaking wet, even though the room is cool. On that page, common causes include menopause symptoms, which it calls hot flushes, plus anxiety, some medicines, low blood sugar, alcohol or drug use, and hyperhidrosis. Hyperhidrosis means you sweat more than your body needs in order to cool down. Sometimes no cause is found.

Perimenopause night sweats

Hot flushes can happen in the day or at night. The NHS menopause symptoms page uses night sweats for the night-time episodes, and it says sleep may be worse when those sweats are part of the picture. Waking from the heat is one kind of broken night. Insomnia in menopause sets that waking apart from other broken nights. The sleep topic links the rest of those guides.

Perimenopause night sweats can start while you are still having periods. The National Institute on Aging lists night sweats among common symptoms of that transition. It describes them as hot flashes at night that can break your sleep, and says they are likely related to changing hormone levels. The perimenopause topic is the longer account of that stage. If your periods are irregular and you are under 45, early menopause is the guide for that pattern.

When hot flashes happen at night, the institute's hot-flash page calls them night sweats. It says they are common in the menopausal transition and can last for many years. The years after your last period have their own guide, how long menopause lasts.

NICE Clinical Knowledge Summaries group hot flushes and night sweats as vasomotor symptoms, and say they can come with profuse sweating, palpitations or anxiety. A pounding or racing heartbeat with the heat is covered in heart palpitations in menopause. Anxiety and low mood in these years are covered in HRT, anxiety and low mood.

Other causes of night sweats in women

Medicines are one cause the NHS names for the public. It gives some antidepressants, steroids and painkillers as examples, and says a GP may prescribe a different medicine if a drug is thought to be the cause. Anxiety, low blood sugar, and alcohol or drug use sit on that same list, with menopause symptoms and hyperhidrosis.

Infection and an overactive thyroid are not named on that public page. Doctors still consider both when the sweating is heavy.

For the thyroid, NICE CKS lists hyperthyroidism among endocrine causes to weigh when hot flushes come with flushing and profuse sweating. In Scotland, NHS Borders guidance on Right Decisions is written for clinicians. It lists infection and hyperthyroidism among medical causes of sweating that soaks bedclothes or bedding, and it places thyroid function tests among the checks primary care may arrange. The page patients read remains the public NHS night sweats page.

For infection, NICE CKS on tuberculosis says active tuberculosis should be suspected when risk factors are present together with weight loss, fever, night sweats, loss of appetite or a general feeling of being unwell. The NHS tuberculosis page asks you to see a GP when night sweats come with a persistent cough and weight loss. Diarrhoea sits on the general night sweats list as its own reason to book that visit.

The CKS assessment of hyperhidrosis says sweating during sleep may be due to an infection such as tuberculosis, or to cancer. Fever, weight loss, loss of appetite or palpitations may point to an illness beyond the sweating itself. That page is for the clinician doing the assessment.

Night sweats: when to see a doctor

The NHS night sweats page sets out when to see a GP. Book a visit if the sweats regularly wake you or worry you, if you also have a very high temperature or feel hot, cold or shivery, or if you have a cough or diarrhoea. Book one too if you are losing weight with no clear reason, or if you regularly wake with sheets that are soaking wet.

A persistent cough with weight loss is the pattern the tuberculosis page asks you to take to a GP.

In the United States, the National Institute on Aging says to talk with a doctor if menopausal symptoms concern you, and to ask about lifestyle changes or medicines.

Getting through a wet night

For the night you are in, the NHS suggests lightweight clothing, a cool bedroom, a cool shower, a fan or a cold drink, and cutting down on spicy food, caffeine, hot drinks, smoking and alcohol. It also says cognitive behavioural therapy can help you manage hot flushes. The same cooling steps for daytime heat are on the hot flashes topic.

NICE CKS says the steps may still help some people. The evidence behind them is limited and conflicting. The summary cites the Menopause Society: there is no strong evidence that cooling techniques and avoiding triggers improve vasomotor symptoms. A cooler room can make the episode you are in easier to get through. These steps have not been shown to make the sweats come less often.

Readers describe waking in bedding and nightclothes that are drenched. Some keep a spare layer, a towel and a fan by the bed so they can get dry and try to sleep again.

Write down the time, whether you were drenched or only damp, and what you ate or drank. The hot flush and night sweat diary is the sheet for that week, ready for the GP.

How to stop menopause night sweats

NICE NG23 says to offer hormone replacement therapy to people with vasomotor symptoms associated with menopause. A NICE discussion aid calls HRT the most effective treatment for hot flushes and night sweats. Hormone replacement therapy for menopause explains the treatment and the forms it comes in. How long HRT takes to work is the guide for a new prescription.

The same NICE chapter asks clinicians to consider menopause-specific cognitive behavioural therapy as well as HRT, or in place of HRT when hormones are ruled out or you would rather not take them. Night-time awakening that comes with the sweats is included, on the same terms. If you are still waking after the sweats ease, insomnia in menopause explains how that therapy differs from CBT for chronic insomnia.

NICE says not to routinely offer SSRIs, SNRIs or clonidine as first-line treatment for vasomotor symptoms on their own. For someone who is not taking HRT, the NHS treatment page says you may be offered CBT, and if that does not help, clonidine or an antidepressant. The NHS says clonidine can help reduce the daytime flushes and the sweating at night caused by menopause. The hot flash relief finder sets out the evidence for the other options.

What to take to your appointment

Bring a short record of how many nights were affected, whether you were drenched or only damp, the medicines you take, how your periods have been, and whether you also had weight loss, fever or a cough. The diary above covers the night pattern. The menopause symptom checklist and the Greene symptom score are optional if you also want other symptoms on paper.

This page is general information from the sources below.

My take

I would start with the room and the sheets. Soaked sheets in a cool room are what the NHS calls night sweats, and a warm room with light sweating is worth writing down on its own. Take any medicine, alcohol, fever or cough from that week to the GP before treating the nights as menopause. If those are absent and HRT suits you, I would ask for HRT before menopause-specific CBT.