While hot flashes are practically synonymous with perimenopause, some women experience the other extreme: a bone-deep cold that no matter how many blankets you layer on, you just can’t warm up. Or you may be in a warm room and suddenly feel chilled and begin shivering. Sometimes cold flashes come on the heels of a hot flash when damp, sweaty clothes only make them worse. Other times, they come alone and mysteriously. Cold flashes usually pass within a few minutes, but they can last for up to 20 minutes and are more common at night.

Cold flashes are considered an unusual perimenopause symptom, but given the number of women we’ve heard from who are experiencing them, we're starting to think that cold flashes are more common than doctors realize.

Cold flashes: What’s happening?

Much like hot flashes, cold flashes are likely caused by the hormone havoc going on in your body. As estrogen levels drop, the hypothalamus–the part of your brain responsible for regulating your body temperature–gets overly sensitive, and therefore temperature regulation can be unstable.

Cold flashes can also be triggered by a panic attack or anxiety. During a panic attack, your body releases adrenaline and other stress hormones that can affect its ability to regulate body temperature.

Although they’re less common than hot flashes, cold flashes are no less disruptive, especially at night. And given how rare a decent night's sleep can be during this time of life, learning how to manage cold flashes may give you a shot at some vastly improved rest.

What to do about cold flashes

Here are some steps you can take to help even out your body temperature:

Limit caffeine and alcohol. Not only can they disrupt your sleep, but these substances also influence your body’s temperature regulation system.

Avoid sugar, spicy foods, and nicotine. All can be triggers for cold or hot flashes.

Be prepared. Stash extra clothes at work, in the car, or carry some with you.  You can don another layer when a cold flash strikes. If it’s a hot flash, you can change out of damp clothes, which may reduce the chances of a follow-up cold flash. At night, keep extra blankets handy. Moisture-wicking bedding and pajamas can help, too, and keep a spare pair next to your bed for a quick change if needed.

Get active. When you’re in the throes of a cold flash, hop out of your seat and start moving. This will increase blood flow to help warm you up.

Practice relaxing. Easier said than done, right? Especially if you’re thinking that it means meditating for a half hour or taking an hour-long yoga class. It is easier than that. You can start with just a minute or two. Set a timer for every hour or so and when it goes off, stop and take a few deep breaths. Before each meal, do a few stretches. Or every time you’re in your car alone, close your eyes and pay attention to how your body feels—of course, do this before you start driving or once you reach your destination. Even small steps can help to ease anxiety that may precipitate a number of perimenopausal symptoms.

Slip on socks. If cold flashes haunt you at night, keeping your feet warm may help.

Keep in mind that sometimes the things you do to survive a cold flash may trigger a hot one. If that’s your M.O., proceed with caution. Drink warm beverages instead of hot ones. Pile on one blanket at a time instead of half a dozen. Turn up the thermostat a degree or two, not 10.

When to get help with cold flashes

If you’re having disruptive cold flashes, a trip to the doctor is recommended. Poor blood circulation, thyroid dysfunction, anemia, and low blood sugar can cause cold flashes and can be more serious than a typical hormonal imbalance due to perimenopause. If they are strictly perimenopause related, you and your doctor can discuss hormone replacement therapy (HRT),antidepressants, or low-dose birth control pills, which can offer relief. 

We can help you manage your cold flashes

  • Meet with a Menopause-certified Doctor to understand cold flash symptoms, and their impact on your overall health and wellness
  • Black Cohosh is a dietary supplement may help relieve hot flashes, cold flashes, night sweats
  • Vitality is our nutrient-packed multi-vitamin supplement that that supports, mood, energy, stress response, immune health, joint pain, and inflammation


The information on the Gennev site is never meant to replace the care of a qualified medical professional. Hormonal shifts throughout menopause can prompt a lot of changes in your body, and simply assuming something is “just menopause” can leave you vulnerable to other possible causes. Always consult with your physician or schedule an appointment with one of Gennev's telemedicine doctors before beginning any new treatment or therapy.


Shannon Perry

June 2, 2021
Director of Programming & Media

Medically Reviewed By

Dr. Lisa Savage

Board-Certified Obstetrician & Gynecologist

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