Lyme Disease and Early Menopause: When Symptoms Are Misdiagnosed
Lyme disease can mimic early menopause, causing fatigue, night sweats, and mood changes that are often misattributed to hormones.
Lyme disease can mimic menopause symptoms in women—fatigue, night sweats, and mood swings aren’t always hormonal.
One of my patients came to me in her late 30s, convinced she was going through early menopause. She had all the classic symptoms—intense fatigue, night sweats, brain fog, anxiety, irregular periods, and mood swings. Several doctors told her it was hormonal. Some ran labs. Others offered reassurance or stress reduction tips. None looked further.
She was told to wait it out. But while she waited, her symptoms grew worse.
When Lyme Disease Mimics Menopause Symptoms in Women
Lyme disease and early menopause can look nearly identical. In women, Lyme disease may present with profound fatigue, dysregulated temperature, emotional shifts, and disrupted menstrual cycles—all of which can be confused with perimenopause.
These overlapping symptoms are part of a broader pattern seen in Lyme disease symptoms, where multisystem involvement can mimic other conditions.
These symptoms are often mistakenly chalked up to hormonal fluctuations. But when standard hormone treatments fail, it’s time to look deeper.
Babesia, Night Sweats, and the Hormone Trap
One of the most common symptoms I see in women with Babesia—a malaria-like parasite transmitted by ticks—is night sweats. These aren’t mild flushes; patients describe drenching, disruptive, soaking sweats that wake them up at night.
Night sweats and fatigue are also common in Babesia co-infection, which is frequently missed when symptoms are attributed to hormones.
Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
I am 70. I have late-stage Lyme disease and use bioidentical hormone cream since 2000 when I went into menopause. My doctor for 20 years was Christopher Foley of St. Paul, MN, who died in 2021 from Covid. This past year my fear level increased. I ran out of my HRT cream for several months. I gained a lot of weight. I need to be re-tested for Lyme disease (which tests?) and recently I have developed heavy sweating (before bed usually) around my face and neck. I have Long Covid, and many Lyme symptoms came back with it. I live in South Central SD, 3 hours from Sioux Falls. Can you recommend anyone closest to me who uses BHRT and also knows about chronic late-stage Lyme disease?
I am sorry to say i don’t have a name. You should reach out to doctors or association to be checked for a tick illness ie Babesia or to rule out other causes
O recently entered menopause.. and since then things have gone down hill dramatically. I am trying HRT with extreme sensitivities to progesterone as well as the shifts. I stopped progesterone and had a mental breakdown for two weeks. Now I’m severely foggy can’t work. I am not functioning with this extreme brain fog
( interferes with movement and tasks- like cement ), and mental health concerns)
I had Lyme 20 years ago. I treated with herbs. I did not treat coinfections. Am in heavy tick area..
Also was in some mold in past had the urine tests done and have low positive for a couple – I don’t know how valid they are)
I am so confused as the fog and issues are so extreme . I thought I’d try hrt snd if that resolved the brain fog and mental/ mood then I would not be looking at Lyme again.
Pre menopause I had brain fog and si issues. The si has resolved possibly with the estrogen.
I am very worried. I don’t know how to determine what’s the cause and I don’t have a lot of money to spare. Plus two young kids depending on me. Any advice would be appreciated.
That kind of “cement-like” brain fog is something patients can describe during menopause, especially with a history of Lyme or prior neurologic symptoms. It’s often not just one cause, but overlapping factors.
You’re not alone in feeling this confused by it.
I’m 46.5 and have been “menopausal “ per labs for 2 years. I was dx with Alpha gal syndrome in Dec 2025 after complaints of panic attacks, severe joint inflammation and pain and an ER visit with pancolitis diagnosis. W/in a week of Alphagal dx I was started on HRT. My symptoms of early morning panic waking’s and night sweats improved after initiating estradiol and progesterone, I also removed all mammal at that time as well. In the last 3 months I’ve started having eczema and transient spots on the skin that feel sunburnt, hot but not to touch and my skin is overly sensitive and hurts. I struggle to keep the patch on and have the progesterone compounded because of AGS. I wonder if the patch not consistently providing adequate release could cause these skin symptoms? I have to use Vanicream twice daily to help, and cannot use body washes or take hot showers. I’m worried about Lyme. Doc ordered (against her wishes) a Lyme total antibody CIA which was negative, but refuses to order any further testing. What’s next?
Alpha-gal syndrome can clearly contribute to significant symptoms, but in my practice I also look for an underlying illness when symptoms remain unresolved despite strict dietary changes. Symptoms such as joint pain, skin sensitivity, burning sensations, panic episodes, and autonomic-type complaints may warrant a broader clinical evaluation rather than focusing on alpha-gal syndrome alone. A negative Lyme screening test does not always end the discussion if the clinical history remains concerning.