Are these “cold flashes” normal?

Q: Now that I’m going through perimenopause, I sometimes get hot flashes, but other times I feel chilled to the bone. Is this typical?

A: Yes on both counts! Many women in the throes of perimenopause experience hot and cold flashes, feeling suddenly fiery or chilled before the sensation gradually dissipates. And although hot flashes are more typical—impacting nearly 80% of women—the cold flashes you’re describing can be just as disruptive.

Both changes are likely caused by the hormonal roller coaster your body is on, with estrogen and progesterone levels going up and down dramatically, fluctuations that destabilize your body’s internal thermostat. The good news is that your body’s ability to regulate your temperature will eventually steady itself once you go through menopause and the hormone fluctuations stop.

Fortunately, I can recommend a few strategies that can bring relief in the meantime. Getting regular exercise (such as walking briskly, lifting weights or practicing yoga), avoiding smoking and limiting your alcohol intake can help improve your body’s temperature-regulation abilities. Diet changes can be helpful too: Consider including more plant estrogens, called isoflavones, in your diet (from soybeans, tempeh, tofu and other soy-based foods), assuming you’re not allergic to soy. You can also try supplementing with Relizen, a pollen extract product, which many of my patients find relieves hot flashes within three months. I suggest taking two pills a day.

Finally, to be prepared for these body-temperature swings, I recommend dressing in layers, even for bed, and keeping an extra pair of socks handy so you can add or remove clothes as you need to.