Perimenopause, menopause and the surprising role of heat & cold

Your friendly guide by Emma Burton

If you’re moving through perimenopause or menopause, a transition that can begin as early as your mid-30s, you’ve likely noticed some subtle (or not so subtle) changes: irritability, brain fog, PMT that feels worse, anxiety, hot flushes, night sweats, restless sleep, shifts in energy, unexpected weight gain, or even new aches and stiffness. What you might not know is that simple, intentional temperature therapies – sauna and cold immersion are becoming popular tools for symptom relief, mood and overall resilience during midlife. Here’s a practical guide to what we know, what’s promising, and how to use contrast therapy safely.

A whistle-stop tour of what’s happening in perimenopause & menopause

Perimenopause is the transitional time before periods stop; menopause is officially diagnosed after 12 months without a period. Hormone fluctuations entailing falling oestrogen and progesterone, shifting adrenal and neurotransmitter balance are the main drivers of symptoms. These hormonal changes also affect the body’s thermoregulatory systems (why hot flashes happen), sleep cycles, mood, cardiovascular and metabolic health. Lifestyle approaches (sleep, movement, diet, supplementation, stress reduction) and medical options such as HRT are the foundation of symptom management, but many women are also exploring alternative approaches like sauna, cold-water plunging and a combination of both (contrast therapy)  to feel better day-to-day. I am one of those women!

What the research says about sauna, heat & midlife

Sauna bathing has a growing evidence base for general cardiovascular and metabolic benefits, regular sauna use has been associated with improved vascular function and lower long-term cardiovascular risk in observational cohorts, and heat therapy is being studied as a potential exercise-mimetic for metabolic health (Science Direct). 

Some early studies suggest that repeated passive heat exposure may help metabolic health and body composition in ageing, which is relevant to fluctuations in weight and insulin-sensitivity.

While direct, high-quality randomised trials specifically in menopausal women are still limited, the cardiovascular and mental health signals from sauna research make it an intriguing, low-effort option for many midlife women. 

Sauna bathing can support vascular function and metabolic resilience that can be helpful during this phase of life, but it’s not a stand-alone treatment for hot flashes or mood changes, and individual responses can vary.

What the research says about cold water immersion & cold water swimming

You may have noticed that the interest in cold water swimming and plunging has exploded. In a recent survey of 1,114 women including 785 who were perimenopausal, University College London (UCL) researchers found that regular cold water swimming appeared to significantly ease several common symptoms. Nearly half of the perimenopausal women reported reduced anxiety (46.9%), and substantial proportions noted improvements in mood swings (34.5%) and night sweats (20%). A majority (63.3%) said they swam specifically to relieve their perimenopausal symptoms. In open-ended survey responses, women described the cold water as calming and mood-boosting.

Nearly half of the perimenopausal women reported reduced anxiety (with cold exposure)

Here’s an important nuance: Cold exposure creates a short, controlled stress response, releasing adrenaline and cortisol, the very hormones that can leave you feeling alert, uplifted, and a bit euphoric. After that initial spike, the body settles and begins to adapt. Over time, with consistent practice, you become less reactive to the shock of cold water. And the magic is that this resilience doesn’t stay in the plunge: it carries into everyday life, helping you meet daily stressors with a little more ease, steadiness and grace.

Contrast therapy: a practical middle ground

Contrast therapy (alternating heat and cold) aims to combine the relaxation and vascular dilation of heat with the invigorating, anti-inflammatory and circulation-boosting response cold delivers. Anecdotally, our clients report hat contrast therapy helps balance hot-flush episodes, eases muscular tension and improves sleep. But, the timing, duration and health of an individual all matter and should always be considered.

Practical protocols to try

These are gentle starting points and can be adapted based on tolerance:

Beginner contrast therapy (total time 15–25 minutes)

• • 10–12 minutes sauna.
  • 30–60 seconds cool shower.
  • 60–90 seconds cold plunge at a tolerable temperature.
  • Repeat.
  • Calm rest and rehydration.

Moderate contrast therapy (25–40 minutes)

• • 12–15 minutes sauna.
  • 30–60 seconds cool shower.
  • 90 seconds–2 minutes cold plunge.
  • 10–12 minutes sauna.
  • Final 2–3 minute cold plunge.
  • Calm rest and rehydration.

Cold-first option (for mood/anxiety or quick energiser)

• • 30–60 seconds cool shower.
  • 2 minutes cold plunge 
  • 10–12 minutes warm sauna 
  • Repeat. 
  • Calm rest and rehydration.

Top tip: Breathe slowly and steadily during cold exposure, avoid hyperventilating by inhaling for a count of four and exhaling for slightly longer. Sip water between the sauna and cold plunge, limit alcohol beforehand, and give yourself time to cool down and rehydrate afterwards, ideally with some electrolytes. And above all, listen to your body.

The bottom line

Midlife is a season of profound change: physically, emotionally, and hormonally, and simple, ritualised practices like sauna, cold plunges, and contrast therapy can offer steady, grounding support. Research into cold-water swimming shows promising improvements in menopausal symptoms, while sauna studies highlight cardiovascular and metabolic benefits that are especially relevant at this life stage. Still, everyone responds differently, which is why thoughtful safety screening and personalised guidance matter. At Rejoov, we offer friendly advice, a supportive environment, and clear, guided protocols. We see contrast therapy as one powerful piece of the wider wellbeing puzzle, most effective when paired with sleep-supporting habits, intentional movement and training, and medical care when needed.