Sweats are annoying and do not always have anything to do with hormonal changes, even in middle age. The most important causes and what should definitely be clarified by a doctor.
It’s the menopause! An obvious thought when you’re over 40 and your nightgown is clinging to your body with sweat or the drops are running down your back while you rip your jacket off.
But the thing is: there can be completely different reasons behind sweating. You should be alert if night sweats occur regularly and intensively over a longer period of time without any recognizable cause, i.e. if your clothes, pillow and blanket are really soaked, says Professor Dr. Petra-Maria Schumm-Draeger, specialist in internal medicine from Munich.
Causes of sweating
Rarely are there connections with neurological diseases (e.g. Parkinson’s disease) or cancer diseases. “Especially if the sweating occurs together with unclear weight loss or is accompanied by neurological deficits, a thorough medical check-up is important,” says Schumm-Draeger. In most cases, however, the triggers are less dramatic – and yet it is important to have them on the slip of paper.
Messenger substances in action: Thyroid diseases
Small organ, big effect: Our thyroid gland is involved in many bodily processes. “If there is hyperthyroidism, the thyroid produces too many thyroid hormone messengers. This can trigger increased sweating during the day and at night,” explains the internist. “Especially in younger women, an autoimmune disease of the thyroid gland, Basedow’s disease, is conceivable, but the most common cause of hyperthyroidism in Germany is overactive (‘hot’) thyroid nodules.”
What is examined: The blood values show an increased production of thyroid hormones, in the ultrasound one recognizes abnormalities of the organ.
What to do about it: Medication can usually slow down the overproduction of thyroid hormones. In some cases, surgery or radioiodine therapy is necessary.
Defense at full speed: infectious diseases
As soon as the organism ramps up the defense system and body temperature to fight an infection, nocturnal fevers and sweating are even desirable. “Even a bacterial disease such as purulent tonsillitis puts a strain on the body and is often accompanied by night sweats,” says Petra-Maria Schumm-Draeger. And even if the infection is already over, the body still does its best work in the recovery and stabilization phase – sweating can also occur in the days and weeks afterwards.
What is examined: Acutely increased inflammation levels are shown in the blood count, for example, viruses and bacteria can be detected by throat or nose swabs.
What to do about it: Drink plenty to compensate for lost fluids and rest. Antibiotics are sometimes prescribed against bacterial inflammation, while painkillers such as paracetamol or ibuprofen help with headaches and body aches.
Sleep saboteurs: snoring & breathing pauses
Both mean stress for the body, to which it often reacts by waking up bathed in sweat. “If the night sweats are accompanied by exhaustion and daytime tiredness and if snoring is known, you should consult a sleep doctor,” advises Petra-Maria Schumm-Draeger.
What is examined: In the sleep laboratory, among other things, sleep depth and duration as well as oxygen supply are measured, in the ENT practice it can be determined whether the airways are narrowed.
What to do about it: Losing weight and not drinking alcohol often bring about an improvement. Avoiding lying on your back at night also reduces snoring. In the case of pronounced sleep apnea, hyperbaric treatment with a sleep mask is necessary.
Stress-related sweating: Mental illnesses
“Pathologically excessive feelings of anxiety in the context of an anxiety or panic disorder often trigger sweating attacks in combination with other stress symptoms,” says the internist. Then not only does the sweat flow, but also the heart races. A temporary high level of family or professional stress can also trigger excessive sweating because the sympathetic nervous system is then in constant excitement.
What is examined: In a thorough medical interview, stress factors are clarified, blood tests and electrocardiograms (ECG) provide information about possible cardiovascular problems.
What to do about it: Stress reduction, for example through specific relaxation techniques, regular endurance sports and targeted rest periods. If an anxiety disorder is diagnosed, it can be treated with psychotherapy and possibly also with medication.
Excessive sweat production: hyperhidrosis
Some people just sweat a lot more than others. This can be very distressing and excruciating and is considered a disease if it restricts daily life. Then one speaks of hyperhidrosis, excessive sweating without a recognizable reason. Hyperhidrosis can affect the hands, feet or armpits (“primary axillary hyperhidrosis”), for example.
What is examined: Specialized dermatologists – in practices or in the sweat clinics of university clinics – test where excessive sweat is flowing and how much it is. And of course all other possible causes of sweating must be ruled out for the diagnosis “hyperhidrosis”.
What to do about it: So-called tap water iontophoresis is a promising method for sweaty hands and feet. The affected body part is immersed in a bath through which weak direct current flows, which can then shut down the sweat glands. A cream with a (prescription) drug has recently been used on the armpits. It blocks certain receptors that activate sweat glands. A hope for those affected, because the previous treatment options are painful: The nerve toxin botulinum toxin is injected with about 25 pricks per armpit and session. It can not only paralyze wrinkles, but also sweat glands – and for many it is still more pleasant than having them removed by surgery.