Cold plunges are everywhere—but the advice most women are following was never designed for female physiology. In this episode, we break down why women’s bodies respond completely differently to cold exposure than men’s, why colder is not better, and the one temperature range that actually works best for women.

We explore how the menstrual cycle changes cold tolerance, why those shifts are protective rather than weak, and when cold exposure can support recovery, metabolism, and stress resilience—and when it backfires by increasing cortisol, disrupting hormones, and blunting muscle growth. Drawing from female-specific research and the work of Dr. Stacy Sims, we explain how extreme cold pushes women out of hormetic stress and into chronic stress, especially when sleep, fueling, or recovery aren’t dialed in.

You’ll leave with a practical, non-biohacky cold exposure protocol that respects your cycle, your nervous system, and your long-term health—plus the most common mistakes women make with cold plunging and how to avoid them.

Episode with Dr. Felice Chan:

https://wellness-big-sis-the-pod.captivate.fm/episode/dr-felice-chan/

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00:00- 00:17 Intro

00:18- 00:45 Introduction to Cold Therapy for Women

00:46- 01:47 Foundations of Health and Wellness

01:48- 03:47 Differences in Cold Exposure: Men vs. Women

04:58- 10:07 Physiological Responses to Cold in Women

10:08- 12:30 Optimal Cold Exposure Protocols for Women

12:31- 15:03 Common Mistakes and Myths in Cold Therapy

15:04- 17:07 Traditional Chinese Medicine Perspective

17:08- 18:33 Conclusion and Upcoming Episodes

should we even be doing cold therapy or cold plunges as women?

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Let's chat about it.

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Welcome back to Wellness Pick is the pod.

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I'm your host, Dr.

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Kelsey Vic, a board certified

orthopedic doctor, physical therapy,

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and a pelvic floor physical therapist.

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And I figured at the beginning of the new

year it would be fun to chat about some

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more biohacking things in sauna, cold

plunge, things like red light, all of the.

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Adjuncts that we can add to our

health and wellness routines.

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I am going to preface this.

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I never want to be a biohacking podcast..

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I wholeheartedly believe that if you

do not have the foundations of sleep,

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exercise, fueling stress management and

good quality relationships, that these

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little extras, like red light, like sauna,

like cold plunge, won't necessarily move

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the needle in the way that you want it to.

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If you have the foundations down, these

little extras, these sprinkles on the

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top might be beneficial, but again.

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They're not going to be near as effective

in most of your health and wellness goals

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compared to just mastering the basics.

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But I know you guys are

probably interested in them.

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I'm interested in them.

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I think there's new research and

science coming out all of the

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time on a lot of these things just

because they are so trend right now.

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And I figured what better time to

dive in than in the new year when a

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lot of people are probably wondering.

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Should I add a new device or invest

in my health and wellness in this way?

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Is it going to help me towards

whatever goals I have for the new year?

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So today's episode we're gonna chat about

why women's bodies respond completely

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differently to cold than men's bodies do.

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The one temperature that actually

works best for women and why it's

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not necessarily as cold as you

can go, how our menstrual cycles

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and general hormonal physiology

actually changes our cold tolerance.

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The truth about cold exposure and

things like recovery, inflammation,

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our metabolism, our ability to burn

fat, and at the end, we will chat

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about a practical protocol for those

of you guys who want to incorporate

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cold exposure therapy or cold plunges

into your health and wellness routine.

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So the mainstream narrative that I've

heard is this, the colder you can go, as

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long as you build up to it, the better.

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The more adaptations that happen,

the better it is for your body.

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popular protocols revolve around 39

degrees Fahrenheit or four degrees

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Celsius for max metabolic benefits.

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And that might be the case for

some, but not necessarily for women.

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For men.

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That broad statement really is more

effective for the male physiology in the

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way that men handle cold exposure When

males are exposed to extreme cold, their

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sympathetic nervous system is activated,

and that cold is sensed as a stress.

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So that sympathetic nervous system is

that fight or flight nervous system.

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It is sensing that cold as a

stress, norepinephrine is released.

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Brown fat is activated.

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Which creates a stronger thermogenic

response where glucose and fatty acids are

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actually utilized as fuel to produce heat,

which creates long-term metabolic gains.

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and that is how the male physiology

responds to cold brown fat's.

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Job is to generate heat,

not to store energy.

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So through cold exposure, men have a

higher uptick of brown fat activation

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for help with that heat generation.

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Thermogenesis is the process through

which our body actually creates heat.

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So it basically helps to convert calories

and use those as energy to create heat.

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And in men, all of this

is a very positive thing.

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So cold activation of brown fat in

men is associated with increased

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glucose uptake and insulin sensitivity

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higher acute energy expenditure during

cold exposure and improved lipid or

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fat clearance from the bloodstream.

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So this mainstream view of cold exposure

actually really works for men, except

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if their foundations aren't solid.

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If they are in a period of extremely

high stress where adding even more

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stress onto that might tip them

over the edge a little bit more.

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And they shouldn't use it after

strength training, which all of these

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exceptions for when cold exposure

might not work for men are also.

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Consistent with what

doesn't work for women.

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If we are in a high stress environment

or a high stress time in our life, cold

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exposure might tip us over the edge.

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If we use it after strength training,

it might blunt some of the gains

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and the rebuilding that we want

after that strength training.

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And if we don't already have those

preexisting, solid foundations,

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again, cold exposure will not benefit

us in the way that we want it to.

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So to contrast that, what happens

to women's bodies when presented

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with extreme cold exposure?

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If you guys think back to our episode on

fasting, and the guest experts that we've

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had on that have mentioned why fasting

is different for women compared to men.

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They mention this term of energy

availability, and our bodies

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as women are extra sensitive

to low energy availability.

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So when we sense.

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Low fuel sources for

whatever we're about to do.

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Our body kicks into this survival

mode a little bit quicker.

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So think of that concept and

apply it to cold exposure therapy.

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And that is exactly what happens

within our bodies as women.

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Women's bodies sense that fight or flight

and start to mobilize resources even

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quicker, meaning the stress response

tips from good stress to bad stress

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and dangerous stress really quickly.

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Our body's threshold for sensing that

stress is a lot lower than men's.,

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So that good stress turns really

quickly to bad stress, especially

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with extreme cold exposure.

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So our fight or flight activates

more quickly and way more intensely.

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Our adrenaline and norepinephrine rise.

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Our heart rate and

blood pressure increase.

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Breathing becomes more rapid and

shallow, and we vasoconstrict so our

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blood vessels decrease in diameter and

circumference faster and more intensely.

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Metabolically, we produce less cold

induced thermogenesis than men.

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Glucose is mobilized quickly to

help maintain core temperature, so

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rather than utilizing it, our bodies

sense that we need that for survival

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to maintain that core temperature.

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So we mobilize that

glucose a little quicker.

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Fat oxidation might increase, but not

as reliably as in men, because as women.

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Remember that fasting episode, we

hold onto that fat in order to store

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it up for survival, for reproduction.

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That's why when we fast, if we do

fasted exercise, our body doesn't

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immediately mobilize the resources

we want it to mobilize like fat.

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It might utilize things like muscle in

order to help fuel whatever we are about

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to do because we need to hold onto that

fat for certain processes within our body.

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The same thing can be said

about cold exposure in women.

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So overall the cold might increase the

energy demand, meaning it's placing

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a stress on our body that our bodies

are going to have to respond to.

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But our bodies as women are more

sensitive to energy mismatch.

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So if we don't have enough fuel

or our body is not sensing enough

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fuel, our bodies will start to

conserve whatever it can and get

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rid of non-essential processes.

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Something like reproduction

and our reproductive hormones.

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That help to regulate our

cycles will become affected.

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So hormonally, our bodies will

prioritize survival over reproduction.

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So cortisol will increase because we

are sensing that stress, our thyroid

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hormonal signaling slows down in order

to conserve energy with chronic extreme

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cold exposure, estrogen and progesterone

communication might slow down.

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which can lead to cycle irregularities.

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Our core temperature is also influenced

by the different phases of our cycles,

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so we are most likely going to be less.

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tolerant to cold in our luteal phases, our

high progesterone phases compared to our

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follicular phase where we might feel that

cold is a little bit more approachable.

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The same thing happens with menopause,

where we might feel a little bit less

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tolerant to cold during menopause

because of those hormonal shifts.

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So the bottom line when it comes to

cold exposure for women, specifically

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in extreme cold, women's bodies conserve

heat, aggressively elevate our stress

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hormones and reduce non-essential outputs.

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Sometimes opting for survival over less

essential processes like reproduction,

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which again is very hormonally driven,

so our hormones will be affected.

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So this all sounds really.

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Great.

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Like why would someone even do it?

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There are of course benefits, but the

benefits to that extreme cold exposure

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are not the same in men versus women.

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Women benefit from cold exposure at

a lot higher temperatures of cold.

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So rather than that four degrees Celsius,

that 39 degrees Fahrenheit, we might

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need to do cold exposure at more that.

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Mid 50 degree Fahrenheit to 60 degree

Fahrenheit range, or around that

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like 14 to 15 degrees Celsius mark.

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So if we do it at these moderately

cold temperatures, we might

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find benefits within our bodies

with decreased inflammation.

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Cold still does help with inflammation.

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Our bodies might induce mild shivering

thermogenesis that can trigger some

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brown fat activation, but again,

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. Not to the extent that a man's body will.

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We might experience menstrual

cycle symptom relief, stress

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training in small doses.

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I have heard, I'm not recommending this.

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I have heard that some pregnant women

expose themselves to cold in order

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to prep for labor and delivery and

physically challenging tasks that their

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body's about to have to go through.

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As a way to help them build resilience.

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I have not looked into that at all,

but I do know that some women do that.

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And then lastly, we might

experience improved mood through

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release of catecholamines like

norepinephrine and dopamine.

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So , if you like cold exposure

therapy, if you've been doing

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it for a while, how can you.

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optimize the protocol you're currently

doing, and if you'd like to add

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it for some of these benefits.

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Here's a protocol from someone

that I trust in this field, Dr.

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Stacy Sims, who has done a lot of

research on heat therapy specifically,

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but a lot of research on female

physiology and how a woman's body

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handles things differently than men.

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So for general health and metabolic

resilience, the temperature should be

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about 14 to 15 degrees Celsius, which

is about 57 to 59 degrees Fahrenheit.

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Duration of two to five minutes, three to

four times a week, morning or post sauna.

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So something like a contrast therapy

situation, but avoid right after

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strength training, as I said.

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Men and women who do cold therapy

right after strength training won't

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receive the benefits from that strength

training as much as they would if

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they didn't do the cold therapy.

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After with this protocol, you get a little

bit of a mood boost, a little bit of a

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focus boost, mild shivering thermogenesis

for that mild metabolic boost, and you

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do all of this Without tipping into that

bad stress side of the equation, if you

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have menstrual symptoms, it's recommended

to not get into a cold plunge, do more

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local cold, whether that's an ice pack

or some form of localized cooling,

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not full body plunges.,

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And this helps to just modulate

certain pains and symptoms that are

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associated with your menstrual cycle.

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So what is it about strength training?

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Why should we not do it?

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After strength training?

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With exercise specifically, what's

happening is you are breaking down

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those muscle tissues With skeletal

muscle strengthening specifically,

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you're breaking down those muscle

tissues that then signals the

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subsequent repairing and rebuilding.

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Of those skeletal muscle

tissues and the bone underneath.

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So with cold exposure therapy,

that communication is altered.

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It's hindered.

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there's not as efficient of signaling

between that muscle breakdown, that

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acute inflammation that happens with that

breakdown to cue the subsequent rebuilding

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and the signaling of all of the chemicals

and modulators and proteins that need to.

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Be activated in order to

rebuild that muscle stronger,

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so cold.

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Basically dampens that communication,

which can dampen the results

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that you wanna get from that

strength training session.

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I.

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So let's work through a few of the

mistakes and debunk some of the

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myths when it comes to cold exposure

therapy for women specifically.

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Mistake number one we've mentioned

is chasing the coldest temperature.

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If zero degrees Celsius works for

someone like Andrew Huberman, then

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it's gotta work for meat, right?

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When in reality, you're not actually

maximizing your adaptations.

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As a female, you are.

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Triggering that chronic stress, our

bodies switch to that bad stress with

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cold exposure therapy a lot quicker than

Andrew Huber man's body does as a male.

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So that is mistake number one.

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instead stick to that mid fifties to

low sixties range Fahrenheit, or that

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14 to 16 degrees Celsius range for

moderately cooled temperatures for cold

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exposure therapy for our bodies as women.

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Awesome.

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Mistake number two is

ignoring your menstrual cycle.

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Our cold tolerance changes throughout

our cycle, so if we are doing

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extremely cold therapy in our luteal

phase, our body is going to sense

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that need for survival even quicker.

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So possibly taking out cold therapy

in your luteal phase, or if you

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are going through menopause or

perimenopause because of those hormonal

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shifts, Might actually benefit your

body better than pushing through.

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If you do wanna do cold exposure

therapy throughout your cycle, maybe

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modifying the temperature a little

bit in your luteal phase compared to

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your follicular phase, because in that

follicular phase, your body will be able

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to handle that cold a little bit better.

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You can also just skip

it in your luteal phase.

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It's okay to only do it in

one phase of your cycle.

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It's actually great that you are

able to listen to your body and know

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what's happening physiologically

to know when your body's able to

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tolerate cold throughout your cycle.

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Mistake number three, cold plunging

after every strength session.

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I get it.

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It's like habit stacking, but again,

we are really affecting the cues

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that muscle breakdown is supposed to

be giving to the rest of our body.

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So reserve cold exposure therapy for

recovery or heavy training blocks,

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not necessarily daily post-workout.

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Mistake number four, doing cold exposure

therapy when you're already stressed.

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Especially chronically stressed, and

this works for both men and for women.

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If our bodies are already in a high

stress state, what good is putting

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another stressor on top of it?

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There are some things that work that

way in the body, but cold exposure

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therapy seems to be one of those where

both a man's body and a female's body

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are going to respond more negatively

with that stress of cold on top of

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an already stressed environment.

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So if you're sleep deprived or under

chronic stress, cold exposure therapy

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might not be for you right now.

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I also had the pleasure of talking

to a doctor of traditional Chinese

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medicine back in the spring, Dr.

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Felice Chan, and she mentions her views

on cold therapy and heat therapy saunas

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and cold plunges from more of an Eastern

medicine perspective, and I loved that.

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So I wanna include that clip here just to

give her perspective on it since we did

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get the chance to ask her opinion from

a perspective I'm not as familiar with.

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Speaker 4: So again, there's the

feminine, the masculine and women are

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more feminine energetically as well,

and meaning that we are more yin.

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Men are more young.

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Young again, is hot.

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Guin is cold.

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So when you put cold and cold, it

puts you further off balance, right?

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It makes you even colder.

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Hence why a lot of research now is showing

that women do need more warmth, and even

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just the way that our body metabolizes

and deals with homeostasis, we don't need.

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As cold from a Chinese men's

perspective, I would say if you're

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in your period do not cold plunge,

it's going to make your period worse.

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Because we need a warm uterus, we

need warm womb and physically putting

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our body in cold is gonna stagnate

everything and cause more issues.

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However, not to say woman can't

cold plunge, and from like my

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perspective, and I know it's a

specific perspective to start hot.

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So contrast therapy is something that

I do recommend, but not just a cold

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plunge for women because it can be too

shocking to their body, which then spikes

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their cortisol, affects their hormones,

creates more issues in the long run.

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Speaker 7: So to end on a few red

flags to cold exposure, if you start

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experiencing menstrual irregularities,

persistent fatigue, even though

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you're getting good sleep, an elevated

resting heart rate, or things like

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fatigue, hair loss, or increasing cold

intolerance, of course, all of those are

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reasons to stop cold exposure therapy.

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This is something we have to be a

little bit more cautious with this woman

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just because our bodies really do have

this fine balance between what's good

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for us and what's not so good for us.

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So I hope you guys enjoyed this episode.

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Take a listen to our Sauna Heat therapy

episode just to compare the two and learn

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something about our bodies as women from

the perspective of heat and cold acting

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as adjuncts into our wellness routine.

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So I hope you enjoyed this episode.

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I hope you learned a lot.

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I am so excited.

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Our podcast festival is just around the

corner, so stay tuned for all of our fun.

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Episodes that we'll be releasing with

different experts on different goals

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that we all have within the new year,

and ways that we can approach those goals

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in a science backed way understanding

the education and science behind them.

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So I am very excited for

that in the next few weeks.

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As always, my goal is to.

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share the knowledge and education that our

experts are going to give us over the next

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few weeks with as many people as possible.

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So if you would be so kind to share

the episode with someone you think

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would enjoy it, rate, comment, review

on whatever platform you listen on.

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We are on YouTube if you prefer to watch.

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Not that it's very interesting,

I'm just talking right now.

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But I know I've become

more of a podcast watcher.

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So if you prefer that form of

listening or watching to your

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podcast, we do have that option.

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I would really greatly appreciate

any sort of sharing, commenting,

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supporting, through subscribing, or

following the podcast on whatever

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platform you're listening on, reviewing

it on whatever platform as well.

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That really helps.

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Thank you guys so much and I'll

see you guys again on the next

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episode of Wellness Fixes the pod.