Everyone warns you about hot flushes. But what about the opposite? Sudden shivering, goosebumps and a bone deep chill in a room that has not changed temperature. Cold flushes are a real and surprisingly common menopause symptom that almost nobody talks about. Here is why they happen, and what helps.
If you have found yourself reaching for a jumper while everyone around you is perfectly comfortable, or waking up shivering for no obvious reason, you are not imagining it. While hot flushes get all the attention, their lesser known opposite, the cold flush, is a genuine menopause symptom. And because so few people mention it, many women quietly wonder what on earth is wrong with them. The answer, reassuringly, is nothing.
What are cold flushes?
A cold flush, sometimes called a cold flash, is a sudden wave of cold, shivering or goosebumps that comes over you even when the room temperature has not changed. Some women describe a bone deep chill they simply cannot warm up from, no matter how many layers they add. They usually pass within a few minutes, though they can occasionally last longer, and they tend to be more noticeable at night.
They are what is known as a vasomotor symptom, which puts them in exactly the same family as the hot flush. In other words, they are two sides of the same coin.
Why does menopause make you feel cold?
It all comes back to oestrogen and your body's internal thermostat. Deep in your brain sits the hypothalamus, the gland responsible for regulating your body temperature. As oestrogen falls and fluctuates through perimenopause and menopause, the hypothalamus becomes more sensitive and a little less precise, and it starts to overcorrect.
Push that faulty thermostat one way and it convinces your body you are overheating, triggering a hot flush. Push it the other way and it decides you are freezing, when in truth the room is perfectly comfortable, and you get a cold flush. Falling oestrogen also affects your circulation, making blood vessels slightly less elastic, which is why cold hands and feet often come as part of the package.
The link between hot flushes and cold flushes
Interestingly, cold flushes often arrive hot on the heels of a hot flush. After your body has worked hard to cool itself down through a hot flush or a night sweat, it can overshoot, leaving you suddenly chilled and shivering in your damp clothes. This afterburn effect is why many women experience the two together, particularly at night, a hot flush followed by a cold, clammy chill.
How common are cold flushes?
More common than you might think. While hot flushes affect the majority of women around menopause, studies suggest that somewhere around a quarter to a third of women also experience cold flushes. They simply get talked about far less, which is exactly why they can feel so bewildering when they happen to you. Rest assured, you are in good company.
What helps with cold flushes?
Dress in layers
The same trick that helps with hot flushes works just as well in reverse. Wearing layers you can easily add or remove lets you respond quickly when your thermostat throws a curveball, whether it decides you are too hot or too cold.
Watch your triggers
The usual suspects that set off hot flushes can trigger cold flushes too, including caffeine, alcohol, stress and low blood sugar. Keeping your meals regular and your blood sugar steady, and managing stress where you can, may help smooth out these temperature swings.
Keep your circulation moving
Because cold hands and feet often come down to circulation, gentle regular movement, keeping active, and simple comforts like warm socks and a hot water bottle can all help take the edge off. A warm drink held between your palms is a small pleasure that genuinely helps too.
Consider HRT
Because cold flushes stem from the same hormonal changes as hot flushes, HRT, which tops up oestrogen and helps settle the vasomotor symptoms of menopause, can help many women with both. If your temperature symptoms are affecting your quality of life, it is worth discussing with your GP whether HRT might be right for you.
Keeping your patch routine simple
If you use HRT patches to manage your menopause, keeping the daily routine easy helps. The sticky grey residue patches leave behind is one small irritation you can happily do without. Nudi Spray removes leftover patch adhesive in seconds, leaving clean, comfortable skin with no scrubbing. A little kindness to yourself, whatever your thermostat is doing. You can explore the range here.
When to see your GP
Cold flushes are usually harmless and a normal part of the menopause transition. However, feeling cold can have other causes, so do see your GP if the cold is new, frequent, or getting worse, or if it comes with other symptoms such as extreme tiredness, weight changes or a low mood. Conditions like an underactive thyroid or anaemia can also make you feel cold and are worth ruling out. For trusted information, the NHS menopause pages and Balance by Dr Louise Newson are good starting points.
Frequently asked questions about cold flushes
Can menopause make you feel cold?
Yes. As well as hot flushes, menopause can cause cold flushes, sudden waves of cold, shivering or goosebumps. They happen because falling oestrogen disrupts the hypothalamus, the brain's temperature control centre, which can overcorrect and make you feel cold when the room is perfectly warm.
Are cold flushes a normal menopause symptom?
Yes, they are a recognised menopause symptom, in the same vasomotor family as hot flushes. Around a quarter to a third of women experience them, though they are talked about far less. They are usually harmless, but see your GP if they are new, frequent or worsening.
Why do I feel cold after a hot flush?
After a hot flush, your body has worked hard to cool itself down, and it can overshoot, leaving you suddenly chilled and shivering, often in damp clothes. This afterburn effect is very common, particularly at night, which is why hot and cold flushes often go hand in hand.
Does HRT help with cold flushes?
It can. Because cold flushes come from the same hormonal changes as hot flushes, HRT helps many women with both by topping up oestrogen and settling the body's temperature regulation. Speak to your GP about whether HRT is suitable for you.
When should I worry about feeling cold?
Feeling cold in menopause is usually harmless. See your GP if it is new, frequent or getting worse, or comes with symptoms like extreme tiredness, weight change or low mood, as conditions such as an underactive thyroid or anaemia can also cause it and are worth ruling out.
This article is for general information and is not medical advice. Always consult your GP or a qualified professional about persistent or worsening symptoms or before making changes to your treatment.