Is this normal?
Are cold flashes (chills) normal in perimenopause?
Last reviewed: 2026-07-10 · Reviewed by Kindr Health (NPI 1609792902)
Yes — sudden chills or 'cold flashes' are a documented perimenopause pattern. They often follow a hot flash as the body over-corrects: the thermoregulatory system swings past neutral in the opposite direction. Some women experience cold sensations without a preceding hot flash. It's part of the same vasomotor system going off-baseline.
Why it happens
- The narrowed thermoneutral zone lets both hot and cold triggers cross the response threshold easily.
- After a hot flash, sweat evaporation and blood-vessel dilation can produce a rebound chill.
- Autonomic nervous system shifts in the transition affect temperature control on both ends.
When it's not just menopause — see a provider
- Chills with fever or shivering that lasts more than a few minutes — screen for infection.
- Persistent cold intolerance with fatigue or weight change — screen thyroid.
- Chills with sweating and unexplained weight loss.
- Chills accompanied by chest pain or shortness of breath.
If you're in the U.S. and in crisis, call or text 988.
Frequently asked
Why after a hot flash?
It's a physiological over-correction — the same system that dumped heat now feels cold as it recalibrates.
Layers really help?
Yes. Removable layers let you adjust to both directions of the swing.
Will they stop?
For most women, both cold and hot flashes ease as the transition stabilizes.
Talk it through with Dot — 7 days free →
Educational companion — not a medical provider. Not a diagnosis.
Related
Go deeper
Dot is an AI companion providing educational wellness information and supportive conversation. Dot is not a medical provider and does not offer medical advice, diagnosis, or treatment. If you have a medical concern, consult a licensed healthcare professional. If you are in crisis, call or text 988.