Menopause Cold Flashes (aka Perimenopause Cold Flashes): What's the Deal?

Most of us have heard of hot flashes during menopause or (more specifically) perimenopause. But did you know that cold flashes can be a thing too?

A cold flash is exactly what it sounds like - that to-the-bones kind of chill that sweaters, blankets, or cranked heat can’t seem to chase away. They can happen on the heels of a hot flash or in isolation. And they can last mere moments to about 20 minutes.

Why We Don’t Hear As Much About Cold Flashes

Cold flashes may be more common than you think. 

They often happen at night and might be underreported because sometimes we just think a room is chilly or there’s a draught. We’ll tend to reach for an extra blanket or a robe. Or we may think the temperature outdoors has dropped suddenly around sunset and attribute our sense of cold to that and simply raise the thermostat a bit.

We may even attribute it to hunger or put the kettle on for a warming cup of tea and simply never connect the dots that it could be a perimenopausal symptom.

Finally, they may be perceived as less disruptive than hot flashes (though of course, it can be hard to sleep if you’re shivering and can’t seem to get warm, so they’re not exactly a breeze either.) 

Overall, though, they probably are less common than hot flashes, even considering the fact they’re likely underreported.

What Are Hot Flashes / Night Sweats?

In contrast to cold flashes, a hot flash (aka hot flushes) is characterized by a sudden feeling of warmth or intense heat rising throughout the body, often accompanied by sweating, rapid heartbeat, and flushing of the skin.

What can trigger hot flashes? A variety of things, including hormonal changes, stress, alcohol consumption, spicy foods, and caffeine. They can vary in duration and intensity, with some women experiencing only mild hot flashes that last for a few seconds, while others may have more severe hot flashes that last for several minutes or longer.

Night sweats are episodes of excessive sweating during the night that can drench the bedding and clothing, leading to discomfort and interrupted sleep.

Hot Flashes and Cold Flashes: What They Have in Common

So they’re at opposite ends of the heat spectrum but hot flashes and cold flashes in perimenopausal and menopausal women share a common cause: It’s all about the hypothalamus.

The hypothalamus is a small but important area of the brain located just above the brain stem. It plays a crucial role in maintaining the body's internal balance, or homeostasis, by regulating various bodily functions including body temperature, hunger, thirst, sleep, and more... 

But here’s the kicker: Guess which hormone plays a crucial role in keeping the hypothalamus in tip-top condition? You got it: Estrogen.

And we all know that during our perimenopausal and menopausal years, there’s a decrease in estrogen levels. (Actually, estrogen also fluctuates over the course of your monthly cycle, which is also why your temperature can rise and fall during your cycle.) So, the decrease in estrogen can lead to body temperature instability.

The menopausal fluctuation of estrogen can cause your temperature regulation to become a bit whacky, resulting in sudden surges of heat and cold; aka hot/cold flashes. 

Cold flashes may also be caused by anxiety or a panic attack, as the body releases adrenaline (and other stress hormones), which can impair your body's ability to regulate its temperature.

So What Can You Do to Manage Cold Flash Symptoms?

As it’s happening, these are the things you can do to manage cold flashes. You probably have the right instincts here: 

• Add layers: Reach for an extra blanket, and pull on a pair of socks. If you find you’re susceptible to cold flashes, carry an extra layer (sweater, jacket) even on warm nights.
• Get moving: You may also find that movement helps to increase blood flow. So go for a walk or do some gentle stretching. 
• Change damp clothing or nightwear: If your cold flashes tend to follow night sweats or hot flashes, make sure you’re not sitting or lying around in damp clothing. Have a change of clothes or nightwear handy to prevent this.
• A warm shower or bath: Whenever I have that deep-in-my-bones chill, a hot shower usually works wonders (beware of intense heat that might scald this skin.) It may seem counter-intuitive (and a little masochistic), but I also find a final blast of cold water helps my temperature regulate. 
• Snuggle your hot water bottle: A hot water bottle against your feet may also help chase away those chills.

While the above tactics can help you regulate body temperature in the moment, there are lifestyle changes you can make that may mitigate the occurrence of cold flashes. 

Meditation

Meditation can help you manage the emotional symptoms of menopause, including feelings of panic  (or panic attack) and anxiety. By practicing mindfulness meditation, menopausal women can learn to observe their thoughts and emotions without judgment or reactivity.

Meditation can help you notice when anxiety starts to build, you can learn to pause and respond in a more intentional and constructive way, rather than simply reacting in the moment. And because a cold flash can be caused by anxiety or panic attacks, learning to regulate those feelings can minimize the occurrence of cold flashes.

Regular meditation can help to reduce stress and promote feelings of calm and relaxation, which can have a positive impact on overall well-being.

Avoid or Minimize Spicy Foods, Alcohol, and Caffeine

The same foods that can cause changes to your body temperature on a regular day, can set off a hot or cold flash. Taking care of how much caffeine, spicy foods, and alcohol you consume (and the time of day you consume those things) can offset your chances of experiencing both hot and cold flashes.

This doesn’t mean you have to cut those things out altogether (though that’s fine too) but cultivating some awareness of your physical reactions may help you make wise choices about what you choose to eat and drink.

When to See Your Doctor About a Cold Flash

If cold flashes (or any other perimenopausal symptoms are disrupting your lifestyle (including your sleep), it can start a chain reaction or vicious cycle of symptoms. E.g. hot and cold flashes can disrupt sleep, lack of sleep can cause anxiety, anxiety can cause hot or cold flashes…

Ideally, you’re seeing your doctor for an annual checkup and having conversations about the stage of life you’re in, what’s considered medically ‘normal’, how to optimize your health, and other medical options for more extreme physical symptoms. If you're experiencing a lot of perimenopause symptoms, definitely bring it up at your next checkup.

Hormone Replacement Therapy to Treat Menopause Symptoms

Hormone replacement therapy (HRT) is a medication to replace the estrogen that your body starts to lose during perimenopause. Hormone therapy can be used to treat severe hot/cold flashes and other menopause symptoms. It can also prevent bone loss and prevent fractures in women after menopause.  

However, hormone therapy has associated risks too, including a risk of heart disease, stroke, and breast cancer. Overall, HRT is neither all good nor all bad. Whether it’s right for you will depend on a number of factors, including your medical history, general health, and the severity of your symptoms. It’s advisable to work with your healthcare provider to determine if hormone replacement therapy is right for you.

Selective Serotonin Reuptake Inhibitors

Selective serotonin reuptake inhibitors (SSRIs) are a class of medications that are commonly used as antidepressants. They work by increasing the levels of the neurotransmitter serotonin in the brain, which can improve mood, reduce anxiety, and alleviate symptoms of depression. 

SSRIs can also be used to alleviate some of the symptoms of menopause, such as hot flashes and mood changes. SSRIs can also improve mood and reduce symptoms of anxiety and irritability that are commonly associated with menopause, which may trigger a cold or hot flash. However, as with any medication, it is important to discuss the risks and benefits with a healthcare provider before starting treatment.

Take Our Perimenopause Quiz

The symptoms of menopause and perimenopause - including cold flashes - are numerous. But they can also be easily confused with other things going on in our bodies. Perimenopausal women may also wonder:

• Am I just stressed (work, world events, family life, etc.)
• Am I just run down?
• Maybe I’m coming down with the flu/cold/COVID?
• Maybe my body is just a little out of whack?

This means it can be difficult to say decisively if one is experiencing perimenopause or something else. To help you navigate these uncertainties, we’ve devised a little quiz. Check it out here…

We hope you found this post informative — but remember: we’re not doctors and this post is not medical advice! While all posts are fact-checked and well researched, we always recommend you chat with your doctor about any questions or concerns you might have regarding a medical condition. We’re here to support and educate, but never with the aim of disregarding professional medical advice you’ve been given. Phew, now that that’s out of the way, you can go on living unapologetically free.