It is June, the fan is on, and you are freezing. Your hands are cold, you are shivering, and you reach for a shawl while everyone else in the room is fanning themselves. Or it comes straight after a hot flush: the heat breaks, the sweat cools on your skin, and suddenly you cannot stop shaking.

Most women have heard of hot flushes. Far fewer know that the same change can run the other way. Cold flushes are real, and they belong to the same family.

What a cold flush is

A cold flush is a sudden feeling of cold or chills, sometimes with shivering, that nothing in the room explains. It can come on its own, or straight after a hot flush (a sudden wave of heat). Some women get them at night, and wake chilled rather than soaked.

The NHS website describes hot flushes as your face, neck and chest suddenly feeling very hot or cold. The cold is in the description, not an afterthought.

Why it happens

Your brain has its own thermostat, in an area called the hypothalamus. It keeps your body inside a comfortable band of temperature: sweating when you are too warm, shivering when you are too cold.

Estrogen helps keep that thermostat steady. A 2021 review by Zhang and colleagues in the journal Endocrinology describes how estrogens act at several points in the brain's temperature-control circuits, and calls hot flushes and night sweats the archetypal symptoms of perimenopause. As estrogen rises and falls, the thermostat can misjudge, and a small change in temperature can set off a reaction it does not need, in either direction. That is how you can swing from too hot to too cold in a matter of minutes.

Doctors group hot flushes, night sweats and these swings under one name, vasomotor symptoms, which is the word you will find in the guidelines.

How common are they?

Cold flushes are studied far less than hot flushes, and women mention them less often, so they are easy to miss. A 2023 HealthShots report put the share of women who get cold flushes or chills during menopause at as many as 50 to 70%, and noted that they are underreported.

If you have been getting them and thought it was just you, it is not.

The patterns women describe

  • a chill that follows a hot flush, as the body overcorrects on its way back to normal
  • waking in the night cold and shivery, then lying awake trying to warm up
  • cold hands and feet in a warm room
  • shivering that comes in waves and passes within minutes
  • more chills in the same weeks the hot flushes are worse

If you are tracking your hot flushes, note the cold ones too. Roshara's daily check-in counts hot flushes, and the notes box is the place for the chills, so your doctor sees both.

What helps

Layers you can change fast. A cardigan, a shawl or a dupatta you can put on and take off in seconds. At night, a light sheet with a blanket folded at the foot of the bed, so you can pull it up when the chill comes and push it away when the heat does.

Warm feet. Socks at night help if your feet go cold.

A warm drink, at the right time. Something warm helps a chill pass. If your sleep is suffering, keep strong chai and coffee to earlier in the day.

Slow breathing. Some women find that slow, steady breaths help a wave pass sooner, and it costs nothing to try. The Australasian Menopause Society says there is not enough evidence that paced breathing, slow breaths at a set pace, eases hot flushes, so count it as a comfort, not a treatment.

Treatment. NICE NG23 recommends offering HRT for vasomotor symptoms associated with menopause. The Pakistan Menopause Society's 2026 recommendations name MHT, their word for HRT, as the first-line medicine for hot flushes in women who are eligible. Cold flushes sit in the same vasomotor family, so if they come along with hot flushes or night sweats, ask your doctor whether the same options apply to you. Whether HRT fits you is your doctor's call.

When it may be something else

Feeling cold and shivery can have other causes. The NHS website says to see a GP if night sweats come with a very high temperature, or feeling hot, cold or shivery, a cough or diarrhoea, or weight loss you cannot explain.

Feeling cold all the time, rather than in waves, is worth raising too. A doctor may want to check your thyroid, or test for anaemia, before putting it down to the menopause.

Questions women ask

Are cold flushes a real menopause symptom?

Yes. They are part of the same temperature changes as hot flushes, and the NHS description of a hot flush includes feeling suddenly very cold.

Can I have cold flushes without hot flushes?

Yes. Some women get chills on their own, and others only after a hot flush. Both are worth noting.

How long will they go on?

Like hot flushes, they are tied to changing hormones, and how long they last differs from one woman to the next.

At your next appointment, ask: "Could these chills be part of my menopause, and is there anything else they could be?" Our page on cold flushes has more, and hot flushes covers the other side of the swing.