Cold Flashes During Perimenopause

Hot flashes are one of the hallmark symptoms of perimenopause and menopause, but did you know that many women often experience cold flashes as well? While they might not be discussed as often as hot flashes, cold flashes aren't necessarily rare.¹ While there haven’t been many clinical studies conducted with the general population, research focused on women with breast cancer found that 22% of premenopausal patients and 24% of postmenopausal patients experienced cold flashes.² There are, however, plenty of perimenopausal and menopausal women who've spoken up about cold flashes they've experienced during this transitional period.^3,4

If you're noticing that you’re experiencing cold flashes, you're not alone. You also don't have to simply accept this unpleasant symptom as a part of your daily life. In this article, which includes insights from Bonafide Chief Medical Officer, Dr. Alyssa Dweck, we’ll explain what cold flashes are, why you might experience them, how they relate to other menopause symptoms, and how you can manage them.

What's a Cold Flash?

A cold flash is a sudden feeling of being cold in regardless of being in a setting with a comfortable temperature.⁵ Dr. Dweck notes, “Cold flashes can be accompanied by intense shivering and/or total body chills, and often last no more than a few minutes – they can follow a hot flash day or night or present as a stand alone symptom” Additionally, you may notice yourself shivering, shaking, turning pale, or wanting to bundle up in order to feel warmer.^6,7 While you feel chilly, your body temperature is usually normal during a cold flash.⁸ This symptom of cold flash is temporary, usually lasting no more than a few minutes,⁹ and you might notice that you experience them randomly or immediately after a hot flash.¹⁰

Can Menopause Cause Cold Flashes?

Dr. Dweck continues on to explain that: "’Cold flashes,’” in some cases, are related to the typical vasomotor symptoms (i.e. hot flashes and night sweats) of menopause.  Naturally, after profuse perspiration following a hot flash or night sweat, evaporation occurs and shivering with chills may be experienced as a result.  A cold flash usually refers to diffuse shivering and a total body feeling of being cold.  As they relate to menopause, the underlying mechanism of action is also most likely due to low estrogen causing alterations in the hypothalamic thermoregulatory zone and a narrowing window of comfortable temperatures experienced in the body.”

Cold flashes can occur when estrogen levels fall during perimenopause and menopause.¹¹ When levels of this hormone drop, the hypothalamus gland, the part of the brain that regulates body temperature, may temporarily malfunction and make you feel either too cold, triggering a cold flash, or too hot, which can cause a hot flash.¹²

Cold Flashes and Other Vasomotor Symptoms

While it's not always the case, cold flashes can go hand-in-hand with other vasomotor symptoms experienced during menopause. As noted above, women may experience cold flashes directly after a hot flash subsides.¹³ When you experience a hot flash, the blood vessels near your skin's surface dilate in order to try to get rid of the excess heat. When they do this successfully, and your hot flash subsides, it can subsequently result in a cold flash. ¹⁴

According to Dr. Dweck, “Vasomotor symptoms are most notable towards the end of perimenopause and into early menopause.  This would include hot flashes, night sweats and potentially cold flashes.”

Cold flashes are typically more common at night, when you're less likely to be actively participating  in physical activities that often help to keep your body warm.¹⁵ That's why cold flashes during menopause often follow night sweats. As with a regular hot flash, you might find yourself reaching for your blankets once the sweats subside and a cold flash begins.¹⁶

Tips for Managing Cold Flashes

If it feels like cold flashes are a disruptive symptom impacting your quality of life, remember, there are ways to regain control. Here are some strategies you can try in order to manage your menopause cold flashes and feel more comfortable: ^17,18,19

• Dress in layers so you can add on clothing during a cold flash, then remove it once it passes.
• Practice relaxation techniques such as meditation and yoga, as staying calm can reduce the risk of cold flashes.
• Exercise regularly, as keeping your mind and body active may also help to improve your mood.
• Cut back on or avoid alcoholic and caffeinated beverages, spicy and sugary foods, and cigarettes, as these can make it harder for the body to regulate its temperature.
• Wear socks to bed, as they'll help keep your body warm without overheating.

Take Control of Your Cold Flashes

While fluctuating hormone levels can trigger cold flashes during perimenopause and menopause, the changes in your body during these periods may not be the only culprit. Cold flashes can also be linked to anxious moods and high stress levels.²⁰ Chatting with a healthcare provider, who knows more about your detailed health history, can help you work out why you're experiencing cold flashes and how to manage them better to improve your quality of life.

Resources:

1. https://health.clevelandclinic.org/premenopausal-cold-flashes-real-thing
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10882569/
3. https://www.yahoo.com/lifestyle/menopausal-hot-cold-flashes-normal-091322830.html
4. https://www.everydayhealth.com/menopause/what-are-menopause-cold-flashes/
5. https://www.healthshots.com/preventive-care/reproductive-care/cold-flash-could-be-a-symptom-of-menopause/
6. https://www.healthline.com/health/cold-flashes
7. https://www.everydayhealth.com/menopause/what-are-menopause-cold-flashes/
8. https://www.healthshots.com/preventive-care/reproductive-care/cold-flash-could-be-a-symptom-of-menopause/
9. https://www.healthline.com/health/cold-flashes
10. https://www.everydayhealth.com/menopause/what-are-menopause-cold-flashes/
11. https://www.everydayhealth.com/menopause/what-are-menopause-cold-flashes/
12. https://www.everydayhealth.com/menopause/what-are-menopause-cold-flashes/
13. https://www.everydayhealth.com/menopause/what-are-menopause-cold-flashes/
14. https://www.everydayhealth.com/menopause/what-are-menopause-cold-flashes/
15. https://health.clevelandclinic.org/premenopausal-cold-flashes-real-thing
16. https://www.everydayhealth.com/menopause/what-are-menopause-cold-flashes/
17. https://healthnews.com/womens-health/menopause/cold-flashes-during-menopause-is-it-normal/
18. https://health.clevelandclinic.org/premenopausal-cold-flashes-real-thing
19. https://www.healthline.com/health/cold-flashes
20. https://www.anxietycentre.com/anxiety-disorders/symptoms/hot-and-cold-flashes/#:~:text=Yes.,including%20hot%20and%20cold%20flashes