Cold flushes in menopause: why you're suddenly freezing, and what helps

A cold flush (called a cold flash in the US) is a sudden feeling of intense cold, chills or shivering during perimenopause or menopause that isn't caused by the temperature around you. Cold flushes usually pass within a few minutes and often follow a hot flush or night sweat.

It's three in the afternoon. The heating is on and everyone else in the room is in a T-shirt. You're hunting for a jumper.

Ten minutes ago you were fine. Now there's a chill running down your back, goosebumps on your arms, and your hands feel as if you've been scraping ice off the car.

If you've spent months throwing off the duvet and opening windows, being the coldest person in the room can feel like your body is having a laugh at your expense.

It isn't. Cold flushes are the lesser known side of the same thermostat changes that cause hot flushes, and the colder months make them much harder to ignore.

In short: are cold flushes a menopause symptom?

Yes, they can be. A cold flush is a sudden wave of chills, shivering or feeling freezing that the temperature of the room doesn't explain.

• Many cold flushes arrive on the tail of a hot flush or night sweat, when sweat cooling on your skin drops your temperature too far.
• Some women get them on their own, with no heat beforehand.
• The likely cause is the same in both cases: changing oestrogen levels make the brain's thermostat react to very small shifts in temperature, in both directions.
• Feeling cold all day, every day is a different thing. That is worth a conversation with your GP.

What does a menopause cold flush feel like?

A menopause cold flush feels like a sudden chill that spreads through the body, often with shivering, goosebumps and cold hands and feet. It comes on quickly, lasts a few minutes, and happens even in a warm room.

Women describe cold flushes as:

• a wave of cold down the back or across the shoulders
• shivering or chattering teeth that seems out of proportion to the weather
• icy fingers and toes
• cold, clammy skin, especially straight after sweating
• waking in the night damp and freezing after a night sweat

What is the difference between a hot flush and a cold flush?

A hot flush is the body trying to lose heat. A cold flush is the body trying to keep or make heat. Both are short, sudden and driven by the same temperature control centre in the brain.

Why does menopause cause cold flushes?

Menopause causes cold flushes because changing oestrogen levels affect the hypothalamus, the part of the brain that controls body temperature. The range of temperatures your body tolerates without reacting gets much narrower, so a tiny dip can set off shivering just as a tiny rise sets off a hot flush.

Think of the hypothalamus as a thermostat with two triggers. Go above the upper one and you sweat. Drop below the lower one and you shiver. The comfortable gap between the two is called the thermoneutral zone.

In women without hot flushes that gap is about 0.4°C. In women who get hot flushes, research by Robert Freedman found it almost disappears. With next to no gap, your body is always close to one trigger or the other.

The brain cells behind this are called KNDy neurons. We covered how they work in why Bonfire Night can trigger hot flushes.

Why do I get chills after a hot flush?

You get chills after a hot flush because the cooling response overshoots. During a hot flush your skin's blood vessels widen and you sweat. That sheds more heat than you needed to lose, your core temperature dips, and your body shivers to bring it back up.

This has been measured. Studies that tracked core body temperature found a small rise just before a hot flush, followed by a larger drop once sweating and flushing kicked in. It is why researchers list chills as part of a hot flush, alongside the heat and the sweating.

Damp skin and clothes make it worse. Sweat carries on cooling you after the flush has finished.

Can you have cold flushes without hot flushes?

Yes. Some women get cold flushes with no hot flush beforehand. These are less well understood, because cold flushes have not been studied on their own in the way hot flushes have.

The most likely explanation is the same narrow comfort zone: a small drop in temperature crosses the lower trigger and you shiver. Stress can also play a part. When adrenaline is released, blood moves away from the skin, which is why chills are a recognised symptom of anxiety and panic.

Why am I so cold at night during menopause?

Night time chills in menopause usually follow a night sweat. You sweat, the sweat soaks into your nightwear and bedding, and you wake up cold and clammy once the heat has passed.

If broken nights are the bigger problem, read still not sleeping during menopause? 7 things worth investigating.

Does gut health affect hot and cold flushes?

Yes, gut health and menopause flushes are linked. Gut bacteria help recycle oestrogen, the hormone that keeps the body's thermostat steady, and early studies connect changes in gut bacteria with fewer hot flushes. It is why the gut is now a serious focus of menopause research.

Inside your gut lives a group of bacteria known as the estrobolome. When your liver packages up oestrogen for removal, these bacteria can switch it back on so your body can use it again.

As oestrogen falls in perimenopause, the gut changes with it and tends to become less varied. Because oestrogen helps keep the brain's thermostat steady, researchers are now asking how much a well fed, diverse gut can help.

The early results are encouraging:

• A 2025 review pooled seven trials and found that women taking probiotics reported better menopausal symptom scores than women taking a placebo.
• In a 12 week trial, women who ate a high fibre, plant-based diet with soy had far fewer hot flushes, and the improvement tracked with changes in their gut bacteria.

Cold flushes have not been studied on their own yet. But hot and cold flushes come from the same thermostat, so the gut is a good place to start looking after both.

How can I support my gut during menopause?

You can support your gut during menopause by eating more fibre, a wider range of plants and some fermented foods each day. Your gut bacteria feed on what you eat, so small, steady changes add up.

• Eat a wide range of plants. Vegetables, fruit, beans, wholegrains, nuts and seeds all count.
• Add fermented foods. Live yoghurt, kefir, sauerkraut and kimchi are easy places to start.
• Include soy a few times a week. Tofu, edamame and soya milk all work.

The link between the gut and hormones is the reason we made Better Gut, our flagship supplement, developed specifically for women in perimenopause and menopause. Each daily capsule contains six clinically studied bacterial strains, delivering 50 billion live cultures, and it can be taken alongside HRT.

You can read more in our guides to the estrobolome and your gut hormone connection and what's inside Better Gut.

Better Gut is a food supplement, not a treatment for hot or cold flushes.

Can menopause make you feel cold all the time?

Menopause usually causes cold in short waves, not constant cold. If you feel cold all day, every day, something else may be going on. The most common other causes are an underactive thyroid, anaemia and Raynaud's, and a GP can check for the first two with a blood test.

Several of these are easy to mistake for menopause because they show up at the same stage of life and share symptoms such as tiredness and low mood.

When should I see a GP about feeling cold?

See your GP if:

• you feel cold most of the time, not in short waves
• your chills come with a fever
• you are also very tired, gaining weight without explanation, or your skin and hair have changed
• your fingers or toes change colour in the cold
• hot or cold flushes are spoiling your sleep, your work or your day to day life
• you are worried, for any reason

How do you stop a menopause cold flush?

You can't switch a cold flush off once it has started, but you can shorten it and make it less likely to return. Get out of damp clothes, add a thin layer, warm your hands and feet, and move around. Longer term, having fewer hot flushes usually means having fewer chills.

Six things that help:

1. Wear thin layers you can add and remove. A cold flush can follow a hot one within minutes, so one thick jumper leaves you stuck. A vest, a long sleeved top and a cardigan give you more control.
2. Change out of anything damp. Sweat keeps cooling you long after a flush has ended. Keep a spare top by the bed and choose nightwear and bedding that breathe.
3. Warm your hands and feet first. Socks, gloves, or a warm (not scalding) hot water bottle on your feet will settle you faster than turning up the heating.
4. Move. Walk up and down the stairs or around the room for a couple of minutes. Working muscles make heat.
5. Look at what sets off your hot flushes. Alcohol, caffeine, spicy food, a warm room and stress are common triggers, although they differ from woman to woman. Our article on perimenopause and alcohol explains one of them.
6. Keep a short diary for two weeks. Note the time, what you were doing, and whether a hot flush came first. Patterns show up quickly, and the notes are useful if you see your GP.

What is the treatment for cold flushes in menopause?

There is no treatment aimed only at cold flushes. Treatment is aimed at hot flushes and night sweats, which doctors call vasomotor symptoms. If your chills follow your flushes, treating the flushes should reduce both.

HRT is the established treatment for hot flushes and night sweats. There are also options that don't involve hormones. We set these out in our practical guide to hot flushes in perimenopause. Your GP or a menopause specialist can talk you through what suits you.

A calmer evening routine

If night sweats and chills are breaking up your sleep, a regular wind down routine and a cool, well aired bedroom are a good place to start.

Better Night is our evening supplement, made with KSM-66 ashwagandha, Affron saffron, magnesium, Montmorency cherry, lemon balm and chamomile, alongside selected vitamins. Magnesium contributes to a reduction of tiredness and fatigue, and vitamin B6 contributes to the regulation of hormonal activity.

Better Night is not a treatment for hot flushes, cold flushes or night sweats, and should not replace medical assessment or prescribed treatment.

Frequently asked questions about menopause cold flushes

Are cold flushes a sign of perimenopause?

Cold flushes can be a sign of perimenopause, particularly if you also have hot flushes, night sweats, irregular periods or disturbed sleep. On their own they are not enough to tell, because thyroid problems, anaemia and anxiety can also cause chills.

Is a cold flash the same as a cold flush?

Yes. Cold flash is the American term and cold flush is the British one. Both describe a sudden, short spell of chills or shivering that isn't caused by the temperature around you.

How long do menopause cold flushes last?

Most menopause cold flushes last a few minutes. If you feel cold for hours at a time, or all day, that is not a typical cold flush and is worth mentioning to your GP.

Are cold flushes and cold sweats the same thing?

Not quite. A cold flush is a wave of chills or shivering. A cold sweat is clammy sweating without feeling hot. In menopause the two often arrive together after a night sweat. A sudden cold sweat with chest pain or breathlessness is different and needs urgent medical help: call 999.

Does HRT help with cold flushes?

HRT is an established treatment for hot flushes and night sweats. There is no research on HRT for cold flushes specifically, but if your chills follow your hot flushes, having fewer flushes should mean fewer chills.

Can Better Night help with cold flushes?

No. Better Night is an evening wellbeing supplement, not a treatment for hot flushes, cold flushes or night sweats. If flushes of either kind are affecting your daily life, speak to your GP about treatment.

The bottom line

Cold flushes are a real menopause symptom. They come from the same sensitive thermostat that causes hot flushes, and most of them are your body overcorrecting after it has tried to cool you down.

Layers, dry clothes and warm hands and feet deal with the moment. Fewer hot flushes deal with the cause. And if you are cold all the time, not in waves, ask your GP for a blood test.

You are not imagining it, and you are not the only one reaching for a jumper in a warm room.

This article is for general information and education. It does not replace individual medical advice.