Cold Flashes: Causes, Management, and When to Seek Help

Cold flashes often occur in reaction to:

• hormonal changes, particularly those that come with menopause and perimenopause
• panic or anxiety attacks

Menopause marks the end of menstruation and your ability to become pregnant. For most women in the United States, this happens, on average, between the ages of 51 and 52.

Up to 85 percent of women in menopause report having hot flashes, which are sudden and brief periods of intense heat rising in your face and chest, but cold flashes may also occur.

That's because the fluctuating hormones during menopause and perimenopause can cause a dysfunction in the hypothalamus. The hypothalamus is the part of the brain that regulates body temperature.

A dysfunction of the hypothalamus can cause your body to temporarily become over heated (hot flash) or chilled (cold flash). Sometimes, chills and shivering may occur as a hot flash fades, causing you to feel hot and cold.

Menopause and perimenopause are not the only reasons you may experience hot and cold flashes.

Cold flashes may be a sign of menopause or perimenopause if you are also experiencing the following:

• changes to your menstrual cycle, include less frequent or a cessation of menstruation
• irritability and mood swings
• fatigue
• weight gain
• vaginal dryness
• thinning hair

Just as in menopause, the hormonal fluctuations that occur during pregnancy and after the birth of a baby can create temperature changes within your body.

However, many pregnant women report having hot, not cold, flashes. Cold flashes may occur right after giving birth, though. These cold flashes are called postpartum chills.

Postpartum chills can temporarily produce intense and uncontrollable shivering. In one small study of 100 women who had just given birth, 32 percent had these chills. Some researchers believe the chills are caused by the mix of maternal and fetal blood during labor.

Outside of hormones, anxiety attacks are a common cause of cold flashes.

Panic attacks often occur unpredictably and for no apparent reason. During a panic attack, your body releases adrenaline and other chemicals that trigger your body's 'fight-or-flight' reaction. In response to what it sees as imminent danger, your body ramps itself up, which can affect various systems, including your ability to control temperature.

Common symptoms of a panic attack may include:

• a racing heart
• trembling
• fear of dying
• trouble breathing
• chills or hot flashes due to the release of stress hormones that impact your body's ability to control its internal temperature

There isn't much you can do to stop a cold flash once it's set in. Instead, you'll need to wait for it to pass and your temperature to re-regulate. However, there are some things you can do to help reduce the symptoms or lower your risk for cold flashes:

• Add layers during a cold flash to help you feel more comfortable.
• Move around during a cold flash. That can help raise your body temperature, which may make you feel less chilled.
• If you've had a hot flash, change wet clothing or bedding immediately. That can help prevent a subsequent cold flash.
• Manage stress. Try yoga, medication, deep breathing, or other things you find relaxing.

If you're concerned at all about your cold flashes, contact your healthcare provider. If they are affecting your daily life, such as interrupting sleep or keeping you from enjoying social activities, you'll also want to contact your doctor.

Your doctor may recommend tests to help determine the underlying cause. For example, they may order a blood test to determine hormone and other chemical levels.

Be prepared to answer questions such as what happens before, during, and after the cold flash. For example, were you nauseous or dizzy, did you eat or exercise, how regular are the cold flashes, and are you under a lot of stress? You'll probably also be asked questions about your last menstrual cycle, if relevant.

Depending on the cause, your doctor may be able to recommend treatments targeted at the underlying condition. Treating the cause of the cold flash is the first step to stopping them.

Hormonal imbalances, and anxiety and panic are the primary causes of cold flashes, and they can be as disruptive as hot flashes. Talk to a doctor if your cold flashes are a new occurrence, are affecting your quality of life, or they worry you.