I woke-up suddenly.
What the hell happened?
Was there thunder? A loud noise from an intruder? No. Everything was calm and peaceful. Was I having the recurring nightmare about my crazy ex-boyfriend from graduate school chasing me? No. I’m breathing normally, and my heart is beating in a steady rhythm.
Why have I woken up so completely?
Then I felt it: My sheets were soaked through. Changing position allowed me to feel just how wet everything was around me. Sheet, pillowcase, pajamas, underwear, hair -- it was all at least damp, and throwing back the covers created an immediate chill that took me from warm and sleepy to clammy and alert in an instant.
Am I dying?
Perimenopause: A Rude Awakening
There was no way to get comfortable again in my bed without stripping the sheets and remaking it, and there was no way I was going to deal with that at 4 a.m. Instead, I changed my PJs and popped a thermometer in my mouth. Was I dying of Yellow Fever? No. Temperature was normal, though my feet were still sweaty. I put on some gym socks and padded downstairs to find some answers on the internet. A quick Google of "night sweats" brought up a whole list of perimenopause symptoms and articles about menopause.
I'm only 42, so that didn't really occur to me until I saw the M-word in blue script over and over on my laptop screen. I mean, I'm definitely cool with not having any more babies, but I had never really given menopause much thought -- other than that it might be kind of nice to stop investing in tampons some day. I had heard about hot flashes, of course, but night sweats had never really crossed my radar. Waking-up soaking wet in the middle of the night; is this the future of bedtime?
Welcome to perimenopause.
What Causes Night Sweats During Perimenopause?
The first thing I learned was that there's a whole era leading up to menopause known as perimenopause. That's when you get to have the yucky physical symptoms of menopause while still having your period -- and even the possibility of a surprise "change of life baby" when you thought you were done ovulating for good.
In general, night sweats are related to hot flashes, one of the most notoriously uncomfortable aspects of menopause. A hot flash is caused by a precipitous drop in estrogen levels, which doctors think messes with your body's thermal neutral zone. This is your body's normal temperature, which it keeps steady even when the temperatures outside get very hot or cold. Scientists think the thermal neutral zone narrows when estrogen drops, which means you can heat up a lot more quickly -- in a flash, as it were.
When your core temperature regulation system goes haywire, your brain tells your body to flood all of your blood vessels, which makes your skin feel suddenly very hot. This is like blushing on steroids: your skin will flush red, and the sudden heat wave from your own blood rushing to your skin will make you start to sweat.
When a hot flash happens in your sleep, you end up with night sweats. Odds are pretty good that you'll soak through several layers of fabric since you can't adjust your layers while you're sleeping.
When to Worry about Night Sweats as a Woman
Waking up utterly drenched in my own sweat wasn't just gross -- it was seriously unnerving. I couldn't help but be worried. Was I actually dying of a rare disease? Would I ever sleep through the night again?
Fortunately, night sweats aren't much to worry about for most women of a certain age. That is to say, if you're even five years out from when you think you could be menopausal, that's probably all it is. Hot flashes and night sweats won't hurt you, though they're super-uncomfortable when they're happening.
There are a few cases in which night sweats could be a symptom of another issue, however. Some changes in your menstrual cycle should be checked out by a doctor to make sure they aren't part of a larger problem like fibroids, polyps or uterine cancer. Get checked out if your night sweats are accompanied by a period that:
lasts longer than a week
is extremely heavy
has an unusual amount of clotting
happens more frequently than 21 days apart
Night sweats and hot flashes may also be a symptom of a thyroid problem or an abnormal hormonal imbalance. If they happen frequently and you're concerned - especially if you think you might be too young for menopause, or you thought you were done with the process entirely -- see your doctor.
Bad Night Sweats = Sleep Deprivation
You should also see your doctor if you're literally losing sleep over night sweats. I was sucked into the rabbit hole of internet research, but that's not quite the same as having night sweats so often that the quality of your rest takes a nosedive and you become sleep deprived. There are treatments available to alleviate symptoms of perimenopause, menopause, and postmenopause, so don't be afraid to share your misery and ask about your options. You don't have to tough it out alone.
As for me, my first encounter with night sweats was shocking, but I'm not so worried now that I know they're so common. It's pretty likely they'll be back for me at some point since 80 percent of women experience hot flashes, and they can persist for a decade.
Time for moisture-wicking sheets & PJs.
Elizabeth is a professional writer and editor living in Newburyport, Massachusetts. She earned her M.A. in Creative Writing at the University of Massachusetts, Boston, and her poetry has previously been published in The Worcester Journal. When not busy writing, she also sings in a band, grows almost all her own food, and occasionally even cooks it. You can catch up on all of her adventures in extreme gardening at PortPotager.blogspot.com or read more of her work at TheBlogwright.com. Check out Elizabeth's short story collection Both Sides of My Skin.