Excessive sweating (which can occur both at night and/or during the day) is a very common part of chronic fatigue syndrome, fibromyalgia, and menopause. But it can also occur in people with none of those problems.

It reflects poor functioning of the autonomic nervous system (which controls blood pressure, pulse and sweating), which is controlled by the hypothalamus in the brain. Other common causes of sweats and/or hot flashes, in addition to CFS and fibromyalgia, include:

• Estrogen and progesterone deficiency with menopause and peri-menopause. This can begin as much as 12 years before periods stop and your blood tests for menopause become abnormal. The tipoff is that the sweats/flashes are worse around and in the week before your period. The treatment is to use bioidentical estrogen and progesterone.

• Testosterone deficiency in men (including drops in levels when testosterone treatments wear off). In men, consider this if you have CFS/FMS, fatigue, low libido, difficulty with erections, high cholesterol, or depression.

• Infections of many types. Sinusitis or spastic colon suggests yeast. Many other antibiotic sensitive or viral infections can also cause sweats.

• Drops in blood sugar caused by a low adrenal.

• Acid reflux being inhaled (especially at night while sleeping). Taking Pepcid or tagamet at bedtime for a few nights to see if night sweats lessen will tell you if this is the cause.  

Evaluating for and treating the above problems will often help the sweats to lessen or go away. In addition, the herbal black cohosh has been shown to help stabilize autonomic nervous function and decrease the sweats and flashes in menopausal women in a number of studies. Give it two months to see the full effect.