Night Sweats in Older Women

Common Causes and Diagnostic Approach

• The American College of Rheumatology suggests that menopause is the most frequent hormonal cause of night sweats in older women, characterized by recurrent episodes of flushing, perspiration, and sensations ranging from warmth to intense heat on the upper body and face, sometimes followed by chills 1
• Autoimmune diseases, such as various rheumatic and musculoskeletal diseases, can present with night sweats, according to the American College of Rheumatology 2

Initial Assessment and Management

• A comprehensive symptom evaluation, including determining frequency, severity, and impact on quality of life, is recommended by the European Society for Medical Oncology, to assess night sweats in older women 3
• The Infectious Diseases Society of America recommends assessing for associated symptoms like weight loss, fever, or fatigue, and evaluating the medical history for malignancy, autoimmune disease, or infection, when investigating night sweats 4
• The American College of Rheumatology suggests considering hormone replacement therapy for menopausal symptoms, if no contraindications exist, and evaluating for contraindications to hormone replacement therapy, including history of breast cancer, coronary heart disease, previous venous thromboembolism, stroke, or active liver disease 1
• The European Society for Medical Oncology recommends considering non-hormonal approaches first, especially in women with contraindications to hormone replacement therapy, for managing menopausal night sweats 5

Non-Pharmacological Approaches

• The American Geriatrics Society recommends improving sleep hygiene, avoiding triggers, and considering relaxation techniques, such as progressive muscle relaxation, guided imagery, or meditation, to manage night sweats in older women 6, 7