Why am I so hot and cold during menopause?

If you find yourself peeling off layers one minute and reaching for a sweater the next, you’re not alone. Many women describe menopause and perimenopause as living with a faulty internal thermostat. Sudden heat, flushing, chills, night sweats, cold hands and feet—sometimes all in the same day—can feel confusing and unsettling.

It’s important to say this gently and clearly: this is common. It’s not a personal failing, a sign you’re “doing menopause wrong,” or your body betraying you. What you’re experiencing is a predictable response to real biological and neurological shifts happening behind the scenes.

Understanding why this happens can soften the experience. It doesn’t make the sensations disappear, but it can bring relief from the worry that something is wrong with you.

What’s happening in the body and brain

At the center of these temperature swings is change—specifically, hormonal fluctuation. During perimenopause and menopause, estrogen levels don’t simply decline in a straight line. They rise and fall unpredictably, sometimes dramatically.

Estrogen plays a quiet but powerful role in temperature regulation. It helps the brain interpret signals about whether you’re too warm or too cold and how the body should respond. When estrogen becomes erratic, the brain’s temperature control center—located in an area called the hypothalamus—can become more sensitive.

Think of the hypothalamus as your internal thermostat. In midlife, it begins to work with tighter margins. Small changes in body temperature that were once ignored may now trigger a strong response. A slight increase can lead to flushing, sweating, or a sudden feeling of heat. A small drop can bring chills or feeling cold to the bone.

This sensitivity is partly why you can feel hot and cold in quick succession. The system is still working—it’s just more reactive than it used to be.

The nervous system adds another layer. Hormonal change influences how the brain processes stress and safety. During menopause, the nervous system can become more vigilant, more easily activated. When the body perceives a stressor—physical or emotional—it may respond with a burst of heat, sweating, or even shivering. These are classic nervous system responses, not signs of danger.

Why it often shows up at night

Many women report that temperature swings feel worse in the evening or disrupt sleep altogether. This isn’t random.

At night, your core body temperature naturally drops as part of the sleep cycle. For a nervous system already operating with narrow margins, this change can trigger a reaction. The brain may misinterpret normal cooling as a problem and overcorrect with heat, leading to night sweats or sudden awakenings.

Sleep itself becomes more fragile during menopause. When sleep is lighter or more fragmented, the brain spends more time in stages where it’s easily aroused. This makes it more likely that temperature shifts are noticed—and amplified.

There’s also less distraction at night. In the quiet and stillness, bodily sensations take center stage. What might have passed unnoticed during the day can feel intense at 3 a.m.

Common amplifiers

While hormonal changes set the stage, certain factors can turn up the volume on temperature swings. These don’t cause menopause symptoms, but they can make them more noticeable.

Stress is a major one. Emotional load, decision fatigue, caregiving, work pressure—all activate the nervous system. A sensitized system is more likely to trigger hot or cold sensations in response.

Sleep debt compounds everything. When the brain doesn’t get enough restorative sleep, it becomes less resilient. Temperature regulation, mood, and stress tolerance all suffer.

Alcohol can temporarily widen blood vessels and interfere with the brain’s ability to regulate temperature, particularly overnight. Many women notice more pronounced hot-and-cold swings after drinking, even in small amounts.

Daily rhythms also matter. Skipping meals, long stretches without rest, or constant stimulation can subtly stress the system, making it react more strongly when change occurs.

None of these mean you’re doing something wrong. They simply interact with a body already adapting to a new hormonal landscape.

What tends to help most women (at a high level)

While there’s no single fix, many women find relief by approaching the experience with steadiness rather than force.

Understanding what’s happening often helps first. When the brain knows that a surge of heat or chill is a familiar menopausal pattern—not an emergency—it can dial down its response. Naming the sensation without judgment can be surprisingly regulating.

Supporting nervous system calm, in general, tends to make temperature swings less disruptive. This doesn’t mean striving for constant calm—an unrealistic goal—but creating more moments of safety, rest, and predictability throughout the day.

Consistency helps. Regular sleep and wake times, steady nourishment, and gentle transitions between activities all signal stability to the brain. Over time, this can widen the thermostat’s margins again.

Many women also benefit from self-compassion. Resisting or resenting symptoms often increases distress. Meeting them with curiosity—“Oh, this is that hot-cold thing again”—can soften their impact.

What helps most is rarely dramatic. It’s usually small, supportive shifts that accumulate, helping the body feel less on edge in a season of change.

A gentler way forward

Menopause is not a malfunction. It’s a recalibration. Your body and brain are learning to operate under new conditions, and like any complex system, there can be some overshooting and undershooting along the way.

Feeling hot and cold is one of the most common expressions of this transition. It doesn’t mean your body has lost its wisdom. It means it is adapting.

If this season feels uncomfortable or unfamiliar, you’re not weak for noticing it. You’re perceptive. And you’re sharing an experience with millions of women navigating the same terrain—often quietly.

A gentler way forward begins with understanding, patience, and respect for the intelligence of a body in change. You don’t need to conquer these sensations. You can learn to live alongside them, with a little more steadiness and a lot more kindness toward yourself.