By Mr Silas Gimba, FRCOG, Consultant Gynaecologist and Menopause Society Certified Practitioner (MSCP), certificate valid to 31 December 2028
Night sweats are episodes of heavy sweating during sleep, even when the room is cool. They can occur during perimenopause, but they can also have other causes. Age or night sweats alone cannot establish the cause.
Night sweats and perimenopause
Hot flushes and sweats are recognised symptoms of the menopause transition. In otherwise healthy people aged 45 or over, recently started hot flushes or sweats together with changes in periods may support identification of perimenopause without routine blood tests.
Night sweats can also be unrelated to menopause. Anxiety, some medicines, low blood sugar, alcohol or drug use and excessive sweating can contribute, and sometimes the cause is not known. Regular or worrying symptoms should be assessed rather than automatically assumed to be hormonal.
When should you speak to a GP?
See a GP if night sweats regularly wake you or worry you. You should also seek assessment if they occur with a very high temperature or feeling hot, cold or shivery; a cough or diarrhoea; or unexplained weight loss.
A clinician may ask about other symptoms, medicines and general health before discussing the most appropriate next steps.
What may help?
If the bedroom or bedding is making you too hot, practical changes to the sleep environment may help. Alcohol can also contribute to night sweats for some people.
Where night sweats are associated with menopause, treatment should be tailored to the individual. Hormone replacement therapy (HRT) may be offered for hot flushes and sweats after discussion of suitability, benefits, risks and alternatives. Menopause-specific cognitive behavioural therapy (CBT), a type of talking therapy, may also be considered, including for sleep problems linked to hot flushes or sweats.
NICE advises that certain antidepressants, called SSRIs and SNRIs, and the medicine clonidine should not routinely be offered as the first treatment for hot flushes and sweats alone. Other treatment may be appropriate when there is a different underlying cause.
A consultation does not guarantee that a prescription will be issued.
Key point
Night sweats can occur during perimenopause, but persistent or concerning symptoms need an individual assessment because other causes are possible.
This article provides general information and is not a diagnosis or a substitute for individual medical advice.
Sources
- NICE, Menopause: identification and management (NG23), recommendations, updated 15 April 2026: https://www.nice.org.uk/guidance/ng23/chapter/Recommendations
- NHS, Night sweats: https://www.nhs.uk/symptoms/night-sweats/
- NHS, Treatment for menopause and perimenopause: https://www.nhs.uk/conditions/menopause-and-perimenopause/treatment/
- MHRA, Blue Guide, Appendix 6: Guidance for providers offering medicinal treatment services: https://assets.publishing.service.gov.uk/media/6012d8c9d3bf7f05c2040b4e/Appendix_6.pdf
Sources accessed 17 August 2026.