Are Menopausal Hot and Cold Flashes Normal? What an Ob/Gyn Wants You To Know

When it comes to menopause, you thought you knew what to expect: mood swings, hot flashes, sleepless nights. And those are extremely common menopausal symptoms—but there are plenty of unexpected ones, too, like hot and cold flashes.

Here, ob/gyn Laura Corio, M.D., author of The Change Before The Change: Everything You Need to Know to Stay Healthy in the Decade Before Menopause (Buy from Amazon, $15.80) answers common questions about surprising, weird, and wacky menopausal symptoms and how to cope with them.   

Are these ‘cold flashes’ normal?

Q: Now that I’m going through perimenopause, I expected some of my menopausal symptoms, like hot flashes, but other times I also 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, the cold flashes you are describing can be just as disruptive.

Both hot and cold flashes are likely caused by the hormonal roller coaster your body is on. As estrogen and progesterone levels go up and down dramatically, the fluctuations 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.

Fortunately, I can recommend a few strategies that can bring relief for this menopausal symptom in the meantime. Getting regular exercise (walking, lifting weights, or practicing yoga), avoiding smoking, and limiting your alcohol intake can help improve your body’s temperature-regulation abilities. Diet changes can help too: Consider eating more plant estrogens i (from soybeans, tempeh, tofu, and other soy-based foods), assuming you’re not allergic to soy. You can also try supplementing with Relizen (Buy from Amazon, $58.50), which many of my patients find relieves hot flashes within three months. I suggest taking two pills a day.

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

Why is my mouth burning?

Q. Since starting menopause I’ve felt burning mouth pain. My doctor said drinking more water would help, but it hasn’t. What’s  going on?

A. This sounds like burning mouth syndrome, a condition that is 13 times more common in menopausal women. The reason? Waning estrogen causes the tongue’s bitter taste buds, which are surrounded by pain-conducting neurons, to atrophy, making nerves more sensitive and triggering burning.

Your doctor is right that sipping water can help, but I also advise limiting spicy foods, which can increase irritation. And since zinc shortfalls can trigger or worsen symptoms, try eating more zinc-rich foods like beef, pork and beans. Finally, in a study, supplementing with 600 mg a day of alpha-lipoic acid (Buy from Amazon, $23.32) eased symptoms in two months for 64 percent of people. But if you don’t feel better within this time frame, see your doctor for more solutions.

Why do I feel these little electric ‘shocks’ in my body?

Q: I’m 54, and lately I feel electrical shocks in my calves whenever a hot flash hits. Should I worry?

A: There’s no need for concern. This is one of many unexpected but common menopausal symptoms. Leg shocks can be caused by several factors, but since yours coincide with hot flashes, I suspect waning estrogen is to blame. Estrogen helps regulate the nervous system, so the dips that trigger hot flashes can also jumble nerve signals sent between the brain and muscles, causing the shocks you describe.

Keeping hormones balanced helps, so I suggest taking 1,300 mg. of evening primrose oil (Buy from Amazon, $12.20). The supplement can stabilize hormone levels and restore nerve function. Plus, daily dosing reduced hot flash frequency, severity, and duration by as much as 42 percent in a study published in the Archives of Gynecology and Obstetrics. Also smart: Eat more foods rich in magnesium (leafy greens, avocados, and almonds), a mineral key to nervous system activity. But if the shocks persist after four weeks, or if they become more frequent or severe, see your doctor for more options.

Why did my period return after menopause?

Q: I’m 52 and I haven’t had a period for nearly a year, so I assumed I was in menopause. But out of the blue I started to have menstrual-like cramps and a dark red vaginal discharge. Should I be concerned?

A: What you’re experiencing is very common. In fact, there’s even a name for this: a “last hurrah” or a reappearance of your period for a few cycles before going into full menopause. This can be caused by a number of factors like stress or a recent health issue. I’ve even had patients whose periods returned when an adult daughter came home for a visit. The reason? Exposure to a younger woman’s pheromones can cause the body to release just enough estrogen to cause a period.

Still, I suggest seeing your doctor to rule out other causes of bleeding. That’s particularly true if it’s heavy enough to require that you frequently change your pad or it’s been going on for two weeks or longer. Other possible culprits include polyps, fibroids, vaginal atrophy and certain medications such as blood thinners and hormone therapy.  

What are these leg cramps?

Q. I’m 56 and since my periods have stopped, I’ve been getting leg cramps that wake me at night. What’s up?

Many of my patients experience this symptom. The reason: Estrogen promotes intestinal absorption of calcium, a mineral crucial for nerve and muscle function. So when levels of the hormone wane at menopause, it can lead to a calcium deficiency, causing cramps in the legs or feet.

Boosting calcium levels is key to relief, so I advise eating several servings of calcium-rich foods like broccoli, kale, and yogurt and supplementing with 1,000 mg each day. For best results, choose a supplement that also contains vitamin D3, which is crucial for calcium absorption. One to try: Mason Natural Oyster Shell Calcium 500 mg with D3 (Buy from Amazon, $15.76). And since the intestines can only absorb 500 mg of calcium at a time, it’s best to take it in two 500 mg doses — one with dinner and one with a bedtime snack to ensure high levels while you sleep.

Finally, I recommend taking a daily dose of 325 mg of magnesium. The muscle-relaxing mineral that has been shown to ease leg cramps and spasms. A brand we like: Natural Vitality Natural Calm powder (Buy from Amazon, $24.42).

If these strategies don’t calm your cramps within two weeks, your doctor can offer other remedies.

Is menopause making me anxious?

Q: I’m 51 and thought I wouldn’t have to deal with premenstrual anxiety once my periods stopped. It’s been more than 8 months since I menstruated and I’m constantly anxious and jittery. What’s going on and how can I fix it?

A: Many of my patients report upticks in anxiety as they transition into menopause. In fact, a study in the journal Menopause found that women were more likely to have increased anxiety and nervousness as menopause approached. That’s because estrogen enhances the activity of serotonin, the brain chemical that protects against anxiety, while progesterone breaks down in brain tissues to allopregnanolone, a substance that has calming effects. So natural dips in these hormones at menopause can produce the nervousness you’re feeling.

The good news? Your anxiety should ease naturally post-menopause. In the meantime, while you are experiencing these symptoms, I’d advise eating two to three daily servings of foods like nuts, lentils, bananas, salmon, and turkey. These foods are high in vitamin B6 and the amino acid tryptophan, both of which boost serotonin production.

Also smart: cutting back on caffeine and sipping two to three cups of passionflower tea daily. To try: Alvita Organic Herbal Passionflower Tea (Buy from Amazon, $8.89). The caffeine-free brew contains chrysin, a flavonoid that enhances the activity of the calming brain chemical GABA. You may also want to consider supplementing with 5-hydroxytryptophan, or 5-HTP, an amino acid that revs the production of serotonin to reduce anxiety. One to try: Natural Factors 5-HTP 100 mg (Buy from Amazon, $15.07).

These steps should help you feel calmer within a few weeks. If they don’t, see your doctor. She can suggest other treatments (such as progesterone cream) to alleviate your anxiety.

A version of this article originally appeared in our print magazine, First for Women.

This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.

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