Was the push to combine sauna with cold exposure a fad that rose up in the mainstream, or was there really substance to all the hype? Recent research that focused on women’s cardiovascular response to heat and cold therapy combined demonstrates there is real data to support the use of sauna and cold plunge, or ice bath together as a collective therapy. So, before believing everything you see in your social media feed, or on the news, cold plunge, especially for women, is definitely not out!
The ancient practice of combining cold exposure with heat has long been practiced by various cultures. It is now widely practiced around the world, but in the last year many self proclaimed experts have questioned its validity, especially for women.
When looking to maximize current health and fitness, as well as future longevity, it appears that including cold exposure with your sauna should probably remain a pivotal aspect of your weekly routine. If you are doubtful about the use of cold exposure in combination with sauna, find out the details of the most recent publication from the reputable journal ‘Nature’.
Further review the details of the study that definitively changed the conversation around cold exposure, sauna and women’s cardiovascular health, as well as how you may use this protocol at home even if you do not have a cold plunge.
Follow our easy to use at home step by step guide that includes temperatures, time, and how to practice sauna and cold exposure safely at home to increase cardiovascular health as well as aerobic capacity.
The Benefits of Sauna & Cold Exposure Are Stand Alone Therapies, but What Happens to Cardiovascular Health When They are Combined?
There is no doubt that sauna as a singular therapeutic modality is essential to maintaining health throughout a lifetime. Similarly, cold exposure as a health protocol also initiates many of the same biochemical responses as its warmer counterpart. The combination of the two modalities is not recent; however, a new study from the journal ‘Nature’ suggests that the combination of the two therapies may enhance overall cardiovascular health in women.
In late December of 2025 the scientific journal ‘Nature’ published a peer reviewed paper entitled ‘Acute Finnish sauna heating and cold water immersion effects on cardiovascular dynamic response in normotensive women’ (1) the authors aimed to find legitimate data on the combination of heat and cold therapy on women’s cardiovascular health. The authors begin their review by outlining the very clear data that shows that both modalities stand alone as viable and powerful healing tools for the body. The authors write this about the health benefits of sauna.
“It has also been shown that regular sauna bathing can be beneficial to health, reducing the risk of sudden cardiac death, fatal coronary heart disease, fatal cardiovascular disease, all-cause mortality, dementia, and Alzheimer’s disease” (1,2)
There is not a complete overlap of health benefits derived from cold exposure and sauna, and it appears that each modality compliments the other slightly asymmetrically in favor of sauna. There are, however, benefits derived from cold exposure that saunas cannot accomplish as effectively as cold therapy.
“On the other hand, cold environments also force the body to make acute adaptive responses to maintain thermal balance, primarily by reducing heat loss. Reflexively and via local mechanisms, cutaneous blood vessels constrict, which reduces heat transfer from the core to the skin and other distal parts of the body” (1)
The authors describe the symbiotic effect that cold exposure combined with sauna has on the body when they write this.
“Alternating heat and cold has a bidirectional effect on the human body, depending on the heat-to-cold ratio and the intensity of heat and cold exposure” (1)
The aim in the study was to discover if the combination of cold therapy and sauna had a meaningful impact on cardiovascular function.
“The study aims to evaluate the acute effects of sauna heating and cold immersion on cardiovascular dynamic response in normotensive women.” (1)
The authors describe the need to perform this study when they state that there has not to date been a specific examination into the effect of both heat and cold on cardiovascular health.
“...to date, and to the best knowledge of the authors, there is a lack of results for the course of dynamic cardiovascular responses in blood pressure and heart rate to the several cycles of the alternate heating and cooling down sauna bathing phases.” (1)
What is the exact effect that cold exposure combined with sauna use has on women’s cardiovascular health, and why did the study primarily focus on female participants?
Why Use Women as the Primary Participants?
- Thermal Sensitivity in Women
- Thermoregulatory Research Has Primarily Focused on Men Historically
For several decades the vast majority of studies that focused on thermal therapy have used male subjects. This means there are extensive studies that show results on how sauna use affects male cardiovascular health, but very little that highlights the female physiological response. Additionally, due to how sensitive female physiology is to temperature changes, the authors believed that this may highlight the benefits for the greater population.
The authors write an overarching statement regarding their use of female only subjects in the study when they write.
“Moreover, to minimize physiological variability associated with sex-based differences in thermal and cardiovascular responses, the present study was conducted exclusively in women.” (1)
For a very wide range of reasons women’s bodies tend to be more sensitive to temperature changes. The reasons for this are a combination of an increased level of estrogen, higher body fat just below the skin which may have an insulating effect for internal temperatures, but not for the experience of the sensations on the surface of the skin. It is still not entirely understood why women are more sensitive to temperature changes when compared to men, but nevertheless the authors of this study believed that it served the study well.
The authors describe how thermal sensitivity differs between men and women when they write this.
“Thermal sensitivity differs between men and women. Women report greater discomfort or thermal sensations at the same absolute temperature compared to men and often detect these changes earlier. In addition, women have an increased perception of skin wetness, which modifies thermal sensations. Differences in skin temperature between men and women are likely due to differences in body composition and blood flow regulation.” (1)
The researchers decided that ultimately, it was best to use only female participants for these two reasons.
Thermal Sensitivity in Women –
“This heightened sensitivity may allow for more pronounced and detectable changes in response to repeated sauna and cooling exposure, making female participants a particularly relevant group for investigating dynamic cardiovascular adaptations.” (1)
Thermoregulatory Research Has Primarily Focused on Men Historically –
“Moreover, women still constitute a very small proportion of participants in thermoregulation research.” (1)
Having established the reason for a female only study on cold and heat therapy, find out how the study was conducted and what the results were.
What Does The Research Tell Us About Using a Combination of Heat and Cold Therapies in Conjunction For Cardiovascular Health?
The contrast of heat versus cold elicits similar effects on the body, but using distinctly different physiological mechanisms. If one can imagine a pendulum that is pulled far to the right, it will in turn move a further distance when it swings to the left, and equally as it continues to sway back and forth. Imagine a similar concept of the pendulum superimposed upon the use of the hot sauna and cold exposure. The net result of this polarized experience improves cardiovascular function. As the body works to maintain and regulate internal temperatures in both directions the cardiovascular system must be engaged 10-fold.
The all female participants in this study totaled 28 between the ages of 22 to 63 years old. The participants had their vitals measured before the first sauna session, in between sauna and cold exposure, as well as at the completion of the entire session. Heart rate, blood pressure, as well as other critical bio markers were measured to determine the adaptability of the cardiovascular system to the severe changes in external temperature.
The women used a sauna for 10 minutes, followed by a cooling off period in a room set to 70 degrees Fahrenheit for 6 minutes. They then took a cold shower (59 degrees Fahrenheit) followed by 2 minutes in a cool pool (59 degrees) up to their necks. After this they entered the sauna for a final 10 minutes.
The contrasting temperatures engaged the cardiovascular system far more than if each modality was performed independently of the other.
The authors describe the details of the physiological response to the extreme temperature changes here.
“Heat stimulation leads to a diversion of blood, and therefore heat, to the skin by opening multiple arteriovenous anastomoses.. Blood flow through the skin can increase to 7–8 l/min in response to acute heat stress. In addition, it has been proven that during heat exposure, blood flow also increases in skeletal muscle and bone marrow. On the other hand, cold environments also force the body to make acute adaptive responses to maintain thermal balance, primarily by reducing heat loss.” (1)
In addition to the physiological changes that occur to adapt to the external temperature changes, it was also noted that the cooling off allowed the participants to spend more time in the sauna. This evidently, led to increased health benefits as a result of more time spent in the sauna.
The authors concluded that, indeed, the combination of the contrasting therapies does improve cardiovascular function in women, and presumably men as well.
“ Alternating exposure to heat and cold, which elicits contrasting cardiovascular responses, can thus be regarded as a form of conditioning for the cardiovascular system.” (1)
Find out how you can safely mimic what the participants did during the research. The exact recipe is an easy detailed step by step guide that you can follow from home, even if you do not have a cold plunge.
How Can You Use Cold Therapy From Home to Compliment Your Sauna Bathing
Yes, it appears that adding some cold exposure to your sauna routine does in fact improve cardiovascular function for health reasons, but also presumably for performance in aerobic based activities. The very good news is that you do not need to have your water set to an extreme temperature to do the trick!
In fact, you may not need a cold plunge at all to receive the benefits of contrast therapy!
You will certainly need to have a sauna available, perhaps some friends to join in, and access to a body of water that can get down to 60 degrees Fahrenheit. This may require ice, a bathtub, or even a bucket. You may have access to an ocean, lake, pool, or other natural body of water that is safe to dip into up to your neck. (Proceed with caution in all uncontrolled bodies of water.)
If you are interested in upscaling your cardiovascular capacity then follow this recipe at home.
The Contrast Therapy Recipe to Improve Cardiovascular Health
- Set your sauna to a temperature that is as hot as your sauna will go
- Enter the sauna
- Stay in for 2-10 minutes. If you need to leave the sauna, then please do. If you feel dizzy or overheated, step out as needed and return to the sauna if you feel you can safely return.
- Rest in a room temperature (around 70 degrees Fahrenheit) space on a bench, floor, or other piece of furniture for 6 minutes
- Shower off in a cold shower- Ideally 60 degrees Fahrenheit. (This may be hard to control at home depending on the time of year and geographical location.)
- Enter a cold bath, bucket, pool, or other body of water up to the neck. The temperature should be set to 60 degrees Fahrenheit. Stay in for 2 minutes
- Enter the sauna again for 2 to 10 minutes
- Exit the sauna and rest in a comfortable position in a room set to 70 degrees more or less.
- Shower off at a comfortable temperature.
Despite the hype surrounding cold plunges, it is evidenced by the study examined in this article that the water temperature of your cold exposure does not need to be lower than 60 degrees Fahrenheit to effectively stimulate your cardiovascular system. This means that a bathtub with ice, a cold pool, or sometimes just a tall bucket of water, and perhaps even a cold shower will get the job done without the investment of a cold plunge that goes down to 33 degrees Fahrenheit.
Listen to your body, pay attention to how YOU are feeling with your own experience, and leave the sauna or cold exposure at any time that you feel is appropriate.
Make sure that you engage your contrast therapy with friends or helpers close by. If you have any doubt please consult your medical care professional to ensure that this is a safe modality for you.
Finally, yes it appears that contrast therapy will likely improve aerobic performance and cardiovascular health in women, and very likely men as well, so don’t skip it entirely!
Sources Cited:
- https://www.nature.com/articles/s41598-025-29035-w
- https://pubmed.ncbi.nlm.nih.gov/25705824/
- https://journals.physiology.org/doi/abs/10.1152/physiol.2025.40.S1.1227