Night sweats in menopause: causes and what actually helps

Name: Night sweats in menopause: causes and what actually helps
Creator: MenoWoman

Night sweats are hot flashes that happen during sleep, and they are a common reason for broken sleep in menopause. Hormone therapy works best, and newer non-hormonal medicines, CBT and a cool bedroom also help.

Researched by the MenoWoman team. Edited by Marcela Sat. Updated 7 November 2026. We may earn from links.

Woman sitting calmly on her bed by an open window

See a doctor if night sweats come with fever, weight loss, cough, pain or diarrhea. Also get checked if they start long after other menopause symptoms ended.³

What it is and how common it is

Night sweats are hot flashes that happen while you sleep. You may wake up hot and drenched, then feel cold once the sweat dries.¹

Most women have hot flashes or night sweats around menopause. Studies put the share at roughly 36% to 87%.² Night sweats tend to become more frequent near the last period and can stay frequent for years after it.¹

Night sweats can range from feeling warm and clammy to soaking your nightwear and sheets. Some women have hot flashes mainly by day, others mainly at night.

Why it happens in menopause

Lower estrogen makes the brain's temperature control more sensitive. Your body starts to sweat at a lower temperature than before.¹ The same process causes hot flashes during the day.

Night sweats often wake you up, and it can be hard to get back to sleep. Being awake more also makes you notice hot flashes you might have slept through.¹ Over time this can lead to ongoing sleep problems and daytime fatigue.

What else can cause it

Sweating because the room is warm or the covers are heavy is not true night sweats.³ Real night sweats have many possible causes besides menopause:³

Medicines, including some antidepressants, hormone treatments and diabetes drugs.
An overactive thyroid.
Sleep disorders such as obstructive sleep apnea.
Anxiety, and alcohol or drug use.
Infections such as tuberculosis, HIV or a heart valve infection.
Some cancers, including lymphoma and leukemia.

Most of these are uncommon. A doctor can decide whether tests are needed.

Treatment options

Hormone therapy is the most effective treatment for night sweats and hot flashes.⁴ Your doctor will weigh your personal risks before prescribing it.⁴

Fezolinetant and elinzanetant are newer non-hormonal prescription medicines for moderate to severe hot flashes and night sweats.^7,6 Fezolinetant needs liver blood tests.⁷ Availability and cost vary by country.

Older non-hormonal options include certain antidepressants, gabapentin and oxybutynin.⁹ Each has its own side effects, so a doctor or pharmacist can help you compare them.

CBT is another option. NICE recommends considering menopause-specific CBT for hot flashes and night sweats.⁵

Everyday measures

Small changes to your bedroom and evening routine can help:^2,1

Keep the bedroom cool and use a fan.
Use light cotton sheets and layered covers you can push off.
Keep cold water by the bed.
Cut back on alcohol, caffeine and tobacco, especially in the evening.
Try a calming routine, such as mindfulness, before bed.

Cooling bedding, breathable pajamas or a cooling mattress cover may add comfort.¹⁰ There is little trial evidence for these products, though.

What helps: options rated

Option	Evidence	What the research shows
Hormone therapy (HRT)	Strong evidence	The most effective treatment for hot flashes and night sweats, according to The Menopause Society.⁴
Fezolinetant and elinzanetant	Strong evidence	Prescription medicines approved for moderate to severe hot flashes and night sweats in many countries.^6,7 Fezolinetant requires liver blood tests.⁷
Other non-hormonal prescriptions	Strong evidence	The Menopause Society recommends certain antidepressants, gabapentin and oxybutynin for hot flashes and night sweats.⁹
CBT	Strong evidence	NICE recommends considering CBT for night sweats and for sleep problems linked to menopause.⁵
Cool bedroom and layered bedding	Some evidence	Advised by sleep and menopause bodies and low risk.^2,1 Rated some because there are few trials.
Evening primrose oil	Weak evidence	Very few studies. One found fewer night sweats but no change in hot flashes. Ask a doctor or pharmacist before using it if you take regular medicines.⁸
Black cohosh and soy isoflavones	Weak evidence	Results are mixed or small. The Menopause Society does not recommend supplements for hot flashes or night sweats.^9,8
Cooling products (pillows, mattress covers)	Weak evidence	May help comfort, but there is little published research on these products.¹⁰

Ratings explained: how we rate. Always talk to a doctor or pharmacist before starting a medicine or supplement.