Cold water immersion is becoming increasingly popular but the research on how it impacts women’s hormones is limited. Many women find cold water therapy and sea swimming to be helpful for their PMS and perimenopausal symptoms, but some experts suggest that women should avoid cold water for a few days before and during their periods.
Cold Water Therapy
Cold water therapy has been part of the naturopath’s natural health tool box for centuries. In the 19th and 20th centuries there were naturopathic sanatoriums all over Europe and America, which were basically fancy health retreats of yore; and water therapy – both hot and cold water therapy, was usually a big part of the health regime at these olden day health spas. Thanks to modern day proponents like Wim Hof, cold water therapy particularly is having a big come back! But I have started to see some push back online from women’s health practitioners saying that the cold water does more harm than good to our female bodies.
The main discussion seems to be arguing that cold water immersion increases cortisol and adrenaline levels, which has a negative effect on progesterone levels. Progesterone is a lovely calming hormone that we need to support in the second half of our cycle, our luteal phase, after ovulation and before we bleed. Lower progesterone levels can lead to worse PMS symptoms and impacts the overall ratio of oestrogen to progesterone, which is so important for hormonal balance.
Recently I took to Instagram to ask my community of period-positive women what their experience was. I also started diving into the research to see what the science says. In this blog, I will share what I found. If you have anything to add to this discussion, please add your comments below and join the conversation, because our understanding of the topic is ever-evolving!
In Traditional Chinese Medicine, it is recommended that we avoid cold water and even cold food, when we are menstruating. It is also important to keep the womb space warm and avoid any cold when trying to conceive. Acupuncturist Fiona O’Farrell told me that, “in Chinese Medicine we have the heebies about women and cold exposure,” especially during the luteal phase and during menstruation. She also added that she isn’t sure female adrenals are too happy with it either, and noted that “most of the studies are male-focused; we are different beasts...”
I dove into the research and managed to find a few studies focused on women which I will highlight below.
The research on cold water immersion in women
I was fascinated to find that so many of the studies done on this topic don’t even specify if the subjects being studied are men or women. For example, in this study on, “Effects of winter sea bathing on psychoneuroendocrinoimmunological parameters”. This big word essentially means the effect on our mental health, nervous system, endocrine system and immune systems (which are all connected). And when women and men have such profoundly different endocrine systems, I think it would be helpful to know how many of the 228 people in this study were women. (1)
A 2014 survey-based study interviewed 1,114 women and asked about the impact of cold water swimming on their menstrual and perimenopausal symptoms. (2) The research found that, “The majority of women with symptoms swam specifically to reduce these symptoms (56.4% for period and 63.3% for perimenopause symptoms).”
Here are some more specific results from the survey:
- Women reported that cold water swimming reduced the following menstrual symptoms:
- anxiety (46.7%)
- mood swings (37.7%)
- irritability (37.6%).
- Perimenopausal women reported a significant improvement the following symptoms:
- anxiety (46.9%)
- mood swings (34.5%)
- low mood (31.1%)
- hot flushes (30.3%)
Another 2014 study, in the journal Cryobiology, found that men and women have different neuroendocrine and immune responses, specifically that the responses were larger in men, with men having greater spikes in adrenaline than women. They found that women in general have a better insulative response, which may be our body's way of dealing with the stressor of cold water and looking out for our hormones.(3)
In 2000, a study looked at the influence of gender and menstrual phase on thermosensitivity (our sensitivity to temperature) during cold water immersion. They found that women were not more sensitive to temperature and cold at different stages of their cycle, compared to men. While I love that this study took our menstrual cycles into account, the fact that we feel cold the same way as men doesn’t mean the cold water impacts our bodies and hormones the same way as it does for men. (4)
A small study of 9 men and 7 women found that cold water therapy reduced negative feelings and reduced cortisol levels in both sexes – (5) This is interesting because one of the reasons it is suggested cold water is bad for our female hormones is working off the assumption that cold-water exposure increases cortisol levels, which negatively impacts progesterone levels.
Cold water therapy is often suggested for women with PCOS as it is known to help balance the body’s fat stores. Let me explain! We have 2 different types of fat: brown adipose tissue and white adipose tissue. Brown adipose tissue is the type which is more easily used by the body and is said to help you burn calories while you sleep! And women with PCOS have significantly less of this brown fat tissue compared to women without PCOS. (6) Cold water therapy is one way to increase your stores of this more helpful, more metabolically active brown fat, which in turn can help to rebalance hormones in women with PCOS.
A 2020 paper in the journal Medical Hypothesis, suggested that cold water swimming for pregnant women may lead to fewer negative birth outcomes, by reducing the stress response and improving mood in pregnant mothers. (7) As a woman who swam in cold water throughout my pregnancy, I did feel like it reduced my stress, and I always felt better after a swim, but again there are no actual studies on how these bursts of cold exposure actually affect pregnant women. I think it really is a case of listening to your own body and deciding what is best for you and your body.
Women’s firsthand experience of cold water swimming
All of that being said, many women that I know find cold water therapy so beneficial for easing PMS, reducing inflammation, regulating their cycle and easing perimenopause. Many women note that they avoid the cold water just before and during their periods, while one woman said she prefers to just put her feet in the cold water, because any more than that puts her completely out of balance. Like so many things when it comes to our health, it can be different for everyone.
Here are some of the first-hand responses I got when I asked women how they found cold water swimming impacted their hormones:
- “I have found it hugely helpful and also I skip the few days before and during my cycle”
- “I swim most days but always feel major resistance the week of my bleed and if I do swim, I find it very hard to warm up so I try to honour that as my hormones’ way of speaking to me.”
- “It really depends on the person and how you're feeling on that particular day, but generally speaking it's a thumbs up for me! Cold water exposure (whether going from hot to cold in the shower or actually getting into a cold body of water) has been fantastic for so many things for me personally including repairing muscles/injury, decreasing pain and inflammation in the body and regulating sweat too! However, there are days when I'm just not feeling it and you've got to listen to your body, especially when menstruating! I do find it takes me a lot longer to warm up after cold water exposure when menstruating too so I'm very mindful of this and would tend to spend less time in cold water as a result during this time - and make sure to take extra care of myself afterwards with warm clothing, teas and getting heat back into the body swiftly!”
- “I find it throws me totally out of balance if I go in with my whole body, but love just the feet”
- “It’s a thumbs up for me. I go weekly throughout the year and more often in the warmer months (as I have access to a river). I also have cold showers - but this week I haven’t as I’ve not been feeling 100%. I think we have to listen to our body and specifically our nervous system. The cold is amazing to activate the vagus nerve and parasympathetic nervous system but only if we are able to switch.”
“I don’t think I can say it’s the one thing that has affected my menstrual cycle or perimenopause symptoms but it’s certainly part of the puzzle, I think. Back to 29-day cycles with no need for painkillers ? I do a lot of other stuff given what I know and advise clients, but for me the cold exposure, especially the sea with friends is part and parcel. We call it our mental health swim and are all nearly running into the sea (yep even in February) because of the amazing dopamine hit 1 minute in ?” - “I was trying for a baby and cold plunging. I was seeing an acupuncturist who recommended I stop as I probably need the oven to be warm ?. I stopped and got pregnant that month. Could be coincide but my gut felt like that helped”
- “I found that the regular cold exposure (doesn't have to be just swimming) helped regulate my body's inflammatory response, and I felt better in particular with old injuries. This, in turn, improved my day 1 and the start of my cycle. I do notice it when I don't cold plunge regularly. I don't have any other symptoms except cramps on days 1 and 2, it's easy for me to read the response from my body. It gets 2 thumbs up from me! I have to manage diet and stress also for my cycle.”
If you want to join the conversation or see more responses check out the original post on my Instagram page @SiobhanTalksPeriods.
As always, listen to your own body and your own intuition. Keep in mind the information I have shared here about the potential impact of cold water on your adrenals and cortisol levels, and the TCM advice to keep warm before and during your period; but ultimately the best research is that which you do on yourself.
If you love sea swimming or cold plunging and have a fairly regulated nervous system and balanced hormones, then you may be able to reap the benefits of cold plunging without any negative impact on your hormones. But if you have a huge aversion to the cold, or if it doesn’t feel good at a particular time of the month, then don’t do it just because the so-called experts on the internet say it is the next best thing for your health!
As menstruating women, our intuition often gets stronger during our periods. Listen to what that voice inside is telling you and decide for yourself whether cold plunging is for you!
Here’s to happy, healthy hormones and balanced menstrual cycles, beautiful ladies!
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