Why do I sweat so much?

“Don’t sweat it.” People often use that idiom to encourage others to stress less. But that may be hard to do if you’re indeed wondering, “Why do I sweat so much?”

Everyone sweats, but some men feel like they’re constantly drenched, even when others seem comfortable in the same conditions. Excessive sweating is common, embarrassing — and often misunderstood.

Rather than assuming it’s due to heat or exercise (the most common culprits), it’s important to understand that sweating exists on a spectrum and that certain circumstances make it worth bringing up with a doctor. While heavy sweating is often harmless, it can sometimes signal an underlying health condition or medication side effect, says Dr. Rachel Reynolds, interim chair of dermatology at Harvard-affiliated Beth Israel Deaconess Medical Center.

Many of Dr. Reynolds’ patients are distressed by their excessive sweating. “They’re embarrassed by it or find it contributes to difficult social interactions,” she says. “It’s common, and they’re not alone.”

Factors that influence sweating

Our bodies have two main types of sweat glands — eccrine and apocrine — that release sweat onto the skin’s surface when we’re hot. Simply put, sweating is the body’s natural cooling system in action. “If you’re overheating, it’s a way for the body to cool itself,” Dr. Reynolds explains.

Sweat production varies widely from person to person. A plethora of factors influence it, from genetics, body size, and fitness level to stress, food and alcohol choices, and hormones.

Being male is also a big part of the picture, and the rise of testosterone levels at puberty fuels a higher “sweat rate” for men that persists throughout adulthood. Men’s generally larger body size and higher muscle mass also generate more heat.

“The male sweat rate is more than double that of women,” Dr. Reynolds says.

Symptoms that may point to hyperhidrosis

Hyperhidrosis is a condition that essentially means your body is sweating more than it needs to just to regulate temperature. Overactive sweat glands are usually located in the armpits, palms, soles of the feet, face, scalp, and groin.

Figuring out you might have hyperhidrosis could be an “aha” moment or a dawning realization that the amount you’ve always sweated is causing anguish, Dr. Reynolds says.

“If someone is sweating through their clothing and feels embarrassed, has very sweaty hands that make them reluctant to shake hands with others, perspires very visibly on their face, or has very sweaty feet that make them uncomfortable in shoes, those are all examples of hyperhidrosis,” she says.

Common causes of excessive sweating

Hyperhidrosis causes can also include a variety of secondary medical conditions that provoke excessive sweating, either by triggering overheating or stimulating nerves that regulate sweat. Common possibilities include

• obesity
• diabetes
• hyperthyroidism (overactive thyroid gland)
• sleep apnea
• infections
• anxiety disorders.

Some medications can also make people feel they’re sweating for no reason, Dr. Reynolds says. These include certain antidepressants, opioids, calcium-channel blockers, amphetamines, and so-called anti-androgen therapies such as finasteride (Proscar, Propecia) that treat enlarged prostate and hair loss.

When to see a doctor about sweating too much

If you’re on the fence about whether to seek medical advice, Dr. Reynolds suggests making an appointment if your excessive sweating

• starts suddenly
• occurs without an obvious trigger
• wakes you at night
• is accompanied by weight loss, fever, chest pain, or shortness of breath
• significantly interferes with work, exercise, or socializing.

An important distinction must also be made between daytime sweating and sweating a lot at night, she notes. While alcohol use or harmless factors such as a warm bedroom can provoke night sweats, consistently waking up drenched can signal a serious condition, such as infection or some blood cancers like lymphoma.

“See a doctor if you’re developing night sweats, especially with unexplained fevers or weight loss, or if you experience any change in your baseline sweat pattern,” she says.

Image: © Westend61/Getty Images