Cold flashes: A lesser known symptom of menopause

Most people know that hot flashes are a common symptom of menopause, but did you know that you may also experience cold flashes? Both symptoms, despite seeming like exact opposites, are linked to the same root cause — temperature instability due to hormonal changes. 

In the years leading up to menopause, dropping estrogen levels make your brain’s internal thermostat more sensitive. You may suddenly notice either hot or cold sensations due to the body’s inability to regulate temperature. 

Both hot and cold flashes are considered a vasomotor symptom, which means they’re related to the dilation or constriction of blood vessels. Other vasomotor symptoms of menopause include palpitations and migraines. About 75% of people going through menopause experience vasomotor effects.

What a cold flash feels like

Cold flashes tend to occur right before bed or in the middle of the night. Typically, they come on quickly, and you’re suddenly shivering. Or in some cases, you may experience a hot flash first, and then as your body reacts to the sweat that’s produced, you become cold. Unlike the chills, which occur when you’re sick, cold flashes only last for a few minutes, although they can sometimes last as long as 20 minutes.

Ways to cope with cold flashes

There are some things you can do to help manage your cold flashes:

  • Try not to consume caffeine and alcohol close to bedtime, as both can disrupt your thermoregulatory system.
  • Similarly, it’s a good idea to limit foods that are sugary or spicy, as they can make your temperature regulation more irregular.
  • Regular exercise as well as mindfulness techniques can help to reduce stress and anxiety, something else that can cause sleep problems for menopausal women.
  • To prevent and lessen cold flashes, wear thick socks to bed to help you stay warm. You may also want to consider layers that can be added or removed. 
  • When a cold flash comes on, try moving your limbs to increase your body temperature. 

Yes, there are treatment options

Just as hot flashes can lead to ongoing sleep issues, so can cold flashes. If you find that your cold flashes are negatively impacting your daily life, ask your healthcare provider about treatment options, including antidepressants, which can address vasomotor symptoms, as well as hormonal treatments. 

Estrogen replacement therapy (ERT) boosts your estrogen levels while hormone replacement therapy (HRT) increases both estrogen and progesterone. They can both effectively treat hot or cold flashes as well as insomnia in menopausal women, but talk to your provider about the risks and benefits.

Reviewed by the Ovia Health Clinical Team


Peacock K and Ketvertis K. Menopause. StatPearls Publishing. 2022. Print.

“Are Premenopausal Cold Flashes a Thing?” Cleveland Clinic. Cleveland Clinic. July 22, 2020. 

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