Beating the Heat: A Guide to Hydration and Cooling for Women in Menopause

​As the UK braces for increasingly frequent heat waves, the challenge of staying cool and properly hydrated becomes even more critical, especially for women navigating perimenopause and menopause. What I learned during my recent UltraQuad challenge, when I experienced the early warning signs of heatstroke, reinforced just how essential it is to understand our changing bodies and arm ourselves with science-backed strategies for thermal regulation.
When Your Body's Cooling System Changes
Our bodies are remarkable machines, using water as nature's most efficient cooling system. When we exercise or face high temperatures, we sweat to release heat and maintain our core temperature. It's a beautifully orchestrated process—when it's working optimally.
But as we enter perimenopause and menopause, hormonal changes throw our internal thermostat into chaos. The research is clear: our bodies' relationship with heat and hydration fundamentally shifts during this life stage.
The hormonal reality check:

• Thirst sensation diminishes - that internal alarm bell that tells us to drink becomes quieter, making conscious hydration efforts essential
• Thermoregulation goes haywire - with declining oestrogen, we start sweating much earlier than we used to, often without the usual warning signs that we're overheating
• Dehydration risk skyrockets - hot flushes and night sweats compound the problem, creating a perfect storm for fluid loss

The Science Behind Female Hydration
Dr. Stacy Sims' groundbreaking research has illuminated why hydration isn't just about drinking more water—it's about understanding how hormonal fluctuations affect our body's water management systems. Her work reveals that women in menopause face unique challenges:
When oestrogen levels drop, our bodies lose their efficiency at conserving sodium and maintaining blood volume. This means we're fighting an uphill battle against dehydration, even when we think we're drinking enough. With less water in our blood, the blood becomes more viscous, forcing our hearts to work harder. Heart rate climbs, power output drops, core temperature rises, and fatigue sets in faster than it used to.
The solution isn't just drinking more—it's drinking smarter. When we maintain higher body water levels, our temperature control improves dramatically because our bodies can more effectively move heat around our system.
Strategic Cooling: The Glabrous Skin Advantage
Enter the fascinating research from Dr. Andrew Huberman on strategic cooling through our glabrous skin areas! I found this really interesting as someone who has for years thought that pouring water over my head in hot conditions is helpful, in fact this is not very effective at all. We now know that there are specialised regions—the palms of our hands, soles of our feet, and upper cheeks, which contain unique blood vessel structures that make them incredibly efficient at heat exchange.
Unlike regular skin, these glabrous skin areas have  arteriovenous anastomoses (AVAs)—special blood vessels that can rapidly shunt blood close to the surface for cooling. When we apply cold to these areas, we're essentially turbocharging our body's natural cooling system.*.

My UltraQuad Reality Check
This science became intensely personal during my recent UltraQuad challenge. Despite thinking I was well-prepared, I found myself experiencing the early warning signs of heatstroke after the event ended. The feeling of disorientation, overheating but not sweating,  and a elevated heart rate were unmistakable red flags.
Thanks to my First Aid training, I immediately reached for my emergency ice pack and applied it to the palms of my hands and my cheeks—targeting those crucial glabrous skin areas. The relief was almost immediate. My heart rate began to drop, the nausea subsided, and I could feel my core temperature stabilising.
This experience was a stark reminder that even when we think we're hydrated and prepared, our changing bodies can surprise us. It reinforced the importance of having both prevention strategies and emergency protocols in place.
Your Heat Wave Action Plan
As we face more frequent extreme temperatures, here's your science-backed strategy:
Before the heat hits:

• Start each day with intentional hydration—don't wait for thirst
• Include electrolytes, not just water, especially if you're experiencing frequent hot flushes
• Plan cooling strategies for your most vulnerable times of day

During hot weather or exercise:

• Apply cold to glabrous skin areas: palms, feet, and upper cheeks
• Carry cooling towels or ice packs specifically for these zones
• Monitor your body's signals more closely than you used to—they may be more subtle now

Emergency protocol:

• Know the signs of heat stroke or heat exhaustion: dizziness, nausea, rapid heart rate, excessive sweating or sudden cessation of sweating
• Always carry an emergency cooling method (instant ice pack, cooling towel)
• Apply cold immediately to palms and cheeks while seeking shade and hydration

The Bigger Picture
Understanding these changes isn't about limitation—it's about adaptation and empowerment. When we know how our bodies are changing, we can work with these changes rather than against them. The research from experts like Stacy Sims and Andrew Huberman gives us the tools to not just survive but thrive during this transition.
As someone who coaches women through these life stages, I've seen time and again how knowledge becomes power. When we understand why our bodies respond differently to heat and hydration, we can adjust our strategies accordingly and continue pursuing the activities and challenges that bring us joy.
Your body is still capable of incredible things—it just needs different support strategies than it used to. With the right knowledge and preparation, even the most challenging heat waves become manageable.
Stay cool, stay hydrated, and stay informed. Your future self will thank you for the investment in understanding and supporting your changing body.
​Thankfully I can very much smile about my achievement in my UltraQuad in the extreme heat and that I could apply this knowledge!
* https://www.hubermanlab.com/episode/supercharge-exercise-performance-and-recovery-with-cooling