Yes, You Can Also Get Cold Flashes In Menopause

Your menopausal friends are dealing with hot flashes, but you’re just chilling. Shame it isn’t soaking in the tub with a rose sheet mask on. You’re having actual chills every so often, sometimes along with tingling or goosebumps when nothing fun is happening. Congrats on inventing a whole new menopause symptom: menopause cold flashes! Joking—it isn’t only a you problem. Both hot and cold flashes are signs of menopause—the latter just isn’t as well known.

What Are Cold Flashes?

As their name suggests, cold flashes come out of nowhere, like sub-Arctic tsunamis. They start in your chest before spreading to your neck and potentially the rest of your body. Within a few minutes, they’re over. 

“Some people liken them to chills. They make you shiver suddenly and can happen at any time of day, but it’s especially frustrating when they happen during sleep,” says Yves-Richard Dole, M.D., a general OB/GYN at Mercy Medical Center in Baltimore. 

Like lunch with an ex, these episodes can be both icy and strange. Most people associate being inappropriately freezing with periods of fever or sickness, but this is not that. These cold flashes stem from menopause, though they’re not nearly as common as symptoms like hot flashes, insomnia, and mood swings.

“In the women who have described to me what might be cold flashes, they report chill-like symptoms that occur randomly,” says Natasha Spencer, M.D., a general OB/GYN at Orlando Health Physician Associates in Altamonte Springs, FL. 

The good news is that your discomfort will probably be brief. You can definitely live with cold flashes. Um, yay?

About the Experts
Yves-Richard Dole, M.D., a general OB/GYN at Mercy Medical Center in Baltimore. 

Natasha Spencer, M.D., a general OB/GYN at Orlando Health Physician Associates in Altamonte Springs, FL.

What Causes Hot and Cold Flashes?

Chills and hot flashes stem from the Tilt-a-Whirl of hormones your body is experiencing during the menopause transition, says Dole. “Estrogen decreases, and so can progesterone.”

At the same time, two other hormones, called follicle-stimulating hormone and luteinizing hormone, increase. They help women ovulate. When the ovarian reserve is low, they work overtime, he explains. 

This quad squad of hormones does more than just influence menstruation. “They affect the hypothalamus, which is the temperature-regulating part of the brain,” says Spencer. As they begin to behave erratically—think Elon Musk on X—your hypothalamus may not function properly. Depending on its reaction, you can suffer from chills or overheating. 

Yep, it’s ironic, but although hot and cold flashes are total opposites, they have the same underlying cause. According to experts at the University of Utah, you can even have chills in perimenopause, as hormone levels first start to shift. Sometimes, though, it won’t be your whole body that’s affected. You may just have flashes of cold hands and feet.

More on Flashes

Do Cooling Sheets Really Put the Chill on Menopause Night Sweats?

Can a Tech-y Wrist Strap Really Tackle Hot Flashes?

Treating Cold Flashes During Menopause 

Visiting your doctor or OB/GYN isn’t up there having an afternoon to yourself with a glass of wine and a sheet mask. But if you have cold flashes, contact your physician. That way, she can rule out other possible causes for your chills, such as low blood pressure or thyroid issues.

If it’s menopause-related, treatments for cold flashes include:

Hormone therapy

“Hormone replacement therapy essentially replaces the estrogen that you’re losing, and that can stabilize some of your symptoms or alleviate them,” says Dole.

If your doctor thinks you’re a candidate for HRT (also called HT—hormone therapy—or MHT—menopause hormone therapy) then depending on your individual needs, she’ll prescribe systemic estrogen in a skin patch, pill, ring, gel, spray, or cream. Alternatively, you might get a script for low-dose vaginal estrogen in ring, cream, or tablet form. (You and your doctor will decide which is right for you, based on your history.)

If you haven’t had your uterus removed, your doctor may also prescribe progesterone or a form of it called progestin. That’s because estrogen alone, without progesterone, can raise your risk of endometrial cancer.

Other medications

Non-hormonal options can also help your body’s overall temperature regulation, including certain antidepressants called SSRIs. A popular SSRI choice is paroxetine (the brand name is Brisdelle).

Recently, another non-hormonal medication, called fezolinetant or Veozah, was approved by the FDA for hot flashes. Because it works on a receptor that plays a role in the brain’s regulation of body temperature, it is possible that it could help with cold ones as well.

Natural options 

Over-the-counter dietary supplements potentially may be useful, too. One of the more popular ones is black cohosh, which is made from a member of the buttercup family. A 2017 review of existing research suggested it has the potential to ease general menopause symptoms, including your body’s ability to control its temperature, but the research is not conclusive (1). Don’t start using black cohosh (or anything else) before checking with your physician. They may not approve, or if they do, they may recommend a particular brand.

Managing Menopause

Can I Take Progesterone Without Estrogen in Menopause?

7 Signs Perimenopause is Finally Ending

Tips for Managing Cold Flashes  

Things you cannot control: the supermarket checkout line, interminable flight delays,  and whether next season’s Bachelorette picks a guy with obvious mommy issues. But when it comes to both chills and hot flashes, you can manage them pretty effectively.

In addition to whatever plans you and your physician come up with, some lifestyle changes often can keep that deep freeze feeling from setting in. 

1. Eat a balanced diet and stay well hydrated to help your body function at its best, stresses Dole. 
2. Practice deep breathing, keeping yourself mindful of your surroundings and the present moment.
3. Limit sugar, spicy foods, and nicotine, all of which may make your temperature regulation wonky.
4. Manage stress by regularly stretching and prioritizing relaxation through yoga and other grounding activities.
5. Set yourself up for a good night’s snooze. Don’t scroll through your phone, or take it to bed with you,” Dole says. “Avoid caffeinated foods or drinks after five o’clock in the afternoon [alcohol can mess with your body temp, too] and make sure your bedroom is dark when it’s time to go to sleep.” 
6. Work out regularly. Combos of aerobic and breathing exercises, along with weight-bearing ones, can decrease the kind of stress and anxiety that leaves you wide awake in the wee hours. 
7. Wear nice, warm socks to bed. Don’t worry: If they have little unicorns and rainbows on them, we’ll never tell.