What are the next steps to manage my ongoing night sweats, spinal gel-filled cyst, and recent vaginal infection recovery?

Management of Night Sweats in a 61-Year-Old Woman

Your ongoing night sweats require systematic evaluation for underlying medical causes, particularly sleep disorders, cardiovascular conditions, endocrine dysfunction (especially menopause-related), and neurological issues, following the SCREeN framework (Sleep, Cardiovascular, Renal, Endocrine, Neurology). 1

Initial Diagnostic Evaluation

Your night sweats warrant a comprehensive workup to identify treatable causes:

Medical History Review

• Menopause status is critical - at 61, you are likely postmenopausal, and night sweats may represent vasomotor symptoms, though persistent symptoms at this age require evaluation for other causes 1
• Sleep disorders must be assessed: Do you have difficulty falling or staying asleep? Do you snore or gasp at night? Do you wake feeling unrefreshed or fall asleep during the day? 1
• Cardiovascular symptoms: Do you experience ankle swelling, shortness of breath with walking, or lightheadedness when standing? 1
• Endocrine symptoms: Have you noticed excessive thirst, changes in weight, or heat/cold intolerance? 1
• Neurological symptoms: Any tremor, movement problems, or gait abnormalities? 1

Required Baseline Testing

• Blood work: Complete metabolic panel (electrolytes/renal function), thyroid function tests (TSH, free T4), calcium, HbA1c 1
• Urine testing: Dipstick for albumin-to-creatinine ratio and protein 1
• Blood pressure assessment to screen for hypertension 1
• 72-hour bladder diary if you're also experiencing nighttime urination (nocturia) 1

Physical Examination Findings to Assess

• Peripheral edema (ankle swelling suggesting cardiac or renal issues) 1
• Reduced salivation or dry mouth (xerostomia, which can indicate autoimmune disease or diabetes) 1
• Neurological signs: tremor, gait abnormalities, or speech changes 1

Management of Your Vaginal Infection Recovery

Since you're recovering from a vaginal infection, ensure complete resolution:

Follow-Up Requirements

• Return for evaluation if symptoms persist or recur within 2 months of completing treatment 1, 2
• If you were treated for vulvovaginal candidiasis and symptoms resolved, no routine follow-up is needed unless symptoms return 1
• If you were treated for bacterial vaginosis or trichomoniasis, test of cure is generally not recommended unless symptoms persist 1, 3

Prevention of Recurrence

• Hygiene measures: Use only warm water for cleansing the vulvar area, avoid soaps and irritants 2
• Clothing modifications: Wear cotton underwear changed daily, avoid tight-fitting clothing or synthetic materials 2, 4
• Front-to-back wiping after toileting 2, 4

Spinal Gel-Filled Cyst Management

Your spinal cyst requires monitoring by your treating physician (likely neurosurgery or spine specialist). While this is outside the scope of the provided evidence, ensure:

• Regular follow-up with your spine specialist as scheduled
• Report any new neurological symptoms immediately (weakness, numbness, bowel/bladder changes)
• The cyst itself is unlikely to cause night sweats unless it's affecting neurological function

Common Pitfalls to Avoid

• Don't assume night sweats are "just menopause" at your age without ruling out other causes - thyroid disease, sleep apnea, cardiovascular disease, and diabetes can all present with night sweats 1
• Don't self-treat recurrent vaginal symptoms with over-the-counter preparations without medical evaluation - this can delay diagnosis of other conditions 1
• Don't ignore sleep quality - obstructive sleep apnea is common in postmenopausal women and can cause night sweats, daytime fatigue, and cardiovascular complications 1

Next Steps Algorithm

1. Schedule appointment with your primary care provider for night sweats evaluation
2. Request the baseline blood and urine tests listed above 1
3. Complete a 72-hour bladder diary if experiencing nighttime urination 1
4. Answer the screening questions about sleep, cardiac, and endocrine symptoms 1
5. If vaginal symptoms persist or recur, return for re-evaluation rather than self-treating 1, 2
6. Continue follow-up with your spine specialist for the spinal cyst as directed

The most likely causes of persistent night sweats in your demographic are menopause-related vasomotor symptoms, sleep disorders (particularly obstructive sleep apnea), thyroid dysfunction, or cardiovascular disease - all of which are treatable once identified 1.