Perimenopause Cold Flashes



When most of us think of menopause, we usually conjure up an image of a woman sweating in front of her open freezer. Hot flashes are one of the main symptoms experienced by perimenopausal and menopausal women. But what about its counterpart, cold flashes? Well, cold flashes are also a symptom women can experience in their menopause transition, although it is much less common. Let’s get to the root of what can cause cold flashes and what is actually going on inside you.


Why are menopause cold flashes even a thing?


Menopause marks the end of a woman’s reproductive years. A woman is considered menopausal when she has not had a period in at least 12 months. At this point, her ovaries are no longer performing their duties regulating the menstrual cycle and preparing her body for pregnancy.



Estrogen and progesterone are produced in the ovaries. These two key female sex hormones decline to minimal levels in a woman’s body after menopause. Estrogen and progesterone do not steadily decline, but instead can be quite erratic during perimenopause, which marks the years leading up to menopause.


Fluctuations and overall changes in your hormones can disrupt several systems in your body. This is because our bodies have estrogen and progesterone receptors all over, so hormone changes can be felt from your brain to your bones. And speaking of your brain, this is where hot and cold flashes come in.


Changes in your hormones can disrupt functions in your hypothalamus, thus making it more sensitive. The hypothalamus is a region of your brain that produces hormones that regulate body temperature, hunger and thirst, sleep, heart rate, sex drive, mood, and the release of hormones from your pituitary gland. Dysfunction in your hypothalamus can lead to severe temperature changes such as hot and cold flashes. Nearly 85% of women report having hot flashes at some point during their menopause transition. However, fluctuations in hormones can easily cause you to have feel temporarily chilled.



Hot flashes are often described as:

  • A sudden feeling of warmth or intense heat concentrated in the upper region of your body or sometimes widespread

  • Flushing across your face, neck, and chest

  • Perspiration

  • Increased heart rate

  • Feeling a surge of anxiety



On the other hand, women describe cold flashes as a temporary feeling of chill all over your body that is often accompanied by tingling, shivering, and sometimes perspiration. Some women even turn pale during a cold flash.


What causes hot and cold flashes other than menopause?


We now know that hormone fluctuations can disrupt your hypothalamic function, causing hot and cold flashes. Therefore, aside from natural hormone fluctuations that occur in menopause, pregnancy (yep, many pregnant women report hot flashes, too!), postpartum, and even in PMS, other causes can throw off your internal thermostat.


Generalized Anxiety and Panic Disorder - People who struggle with episodes of anxiety often report feeling chilled when they are anxious. Sometimes, anxiety can increase into full-blown panic attacks. People with a panic disorder often experience a sudden onset of chills at the beginning of a panic attack. A panic attack is a rapid onset of intense fear that is not warranted as there is no real present danger.

Illness - Extreme temperature fluctuations can also be a sign of infection. Our immune systems use temperature as one mechanism for fighting off pathogens.


Medications - Some medications and therapies can cause temperature instability, including some cancer treatments.


What Can I Do If I Have Cold Flashes?


Once a cold flash starts, there really isn’t anything you can do to make it go away. Fortunately, cold flash episodes are short-lived. However, if you find you suffer through cold flashes, try the following:


  • Keep layers on hand so that you can bundle up until it goes away

  • If you sweat, remove the wet clothing or bedding right away so that you can warm back up

  • Rather than shivering in place, get up and walk around to increase your body heat

  • If cold flashes are caused by anxiety, try activities that reduce stress, including exercise, meditation and mindfulness, cognitive behavioral therapy, self-talk, and other stress-relieving activities (say, a warm bath anyone?).



If you are concerned about hot flashes or if you find they are disrupting your quality of life, connect with your doctor. Be prepared to tell your doctor about how frequent your cold flashes are, what symptoms accompany them, and information about your menstrual cycle. Your doctor may recommend blood tests to look at your hormones and other chemical markers in your system.


Disclaimer: This is not medical advice, does not take the place of medical advice from your physician, and is not intended to treat or cure any disease. Patients should see a qualified medical provider for assessment and treatment.



Meet The Author


Perry Babe Julia ( RN, BSN, BA) is a registered nurse based in Colorado. Julia's nursing background in women’s health has ranged from neonatal and postpartum care to labor and delivery, to outpatient gynecological medicine for both adolescent and adult populations. Much of her education and clinical experience are related to educating women on women’s health topics ranging from lifestyle improvements, disease management, and general health education.

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