Waking drenched at 3am is one of the most common perimenopause complaints, and it is easy to assume hormones are the whole story. Often they are part of it. They are not always all of it.
Thyroid problems, anxiety, sleep apnoea, some antidepressants and other medicines, and even alcohol in the evening can cause night sweats or fragmented sleep. Several of these are easy to check and change the advice if found.
A consultation usually starts with your cycle pattern, how often and when the sweats happen, your medicines and your medical history. Tests are added only when they would alter the plan, since a hormone level on its own rarely settles the question in perimenopause.
Options range from practical measures such as cooler bedding, timing of caffeine and alcohol, and treating the sleep problem itself, through to hormone treatment, which suits some women and not others depending on history and risk. A first visit is for the discussion; nothing is started without weighing benefits and risks.
If sweats are drenching, come with weight loss, fever or a racing heart, or begin before your mid-forties, say so, because those patterns deserve a wider look.