Beyond One-Size-Fits-All: Why It’s Time to Rethink Contrast Immersion Protocols for Women
Nicholas FaddenBy Nick Fadden, BHSc (Musculoskeletal Therapy)
Founder, The Cove Sports Recovery
Contrast Water Immersion (CWI)—alternating between hot and cold water—has earned its reputation as a powerhouse for recovery. At The Cove, our four contrast cycles have been built from both scientific evidence and hundreds of hours observing what actually works in real life. But emerging research is urging us—and other recovery providers—to ask harder questions:
Should contrast immersion look different for women? Should it change based on where someone is in their cycle, how much they train, or even how they feel that day? Could facilities offer specific sessions tailored to support these differences better?
The evidence is growing, and the answer seems to be a resounding yes.
Understanding the Science: Why Sex and Hormones Matter in Recovery
Men and women don’t recover the same way—and that’s not just anecdotal. Research shows that estrogen and progesterone (the primary female sex hormones) affect everything from vasodilation and vasoconstriction, to core temperature regulation, perceived fatigue, and pain thresholds (Charkoudian & Stachenfeld, 2016; Giersch et al., 2020).
These hormonal shifts, which fluctuate throughout the menstrual cycle, can drastically influence how a woman responds to both cold and hot immersion:
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In the follicular phase (menstruation to ovulation), body temperature is lower, and cold tolerance is slightly better. This phase is more similar to male physiology in response.
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In the luteal phase (after ovulation), core temperature rises due to progesterone, which reduces tolerance to cold and changes fluid retention and thermal stress responses.
The menstrual cycle isn’t a simple, predictable pattern either—each woman experiences it differently. For some, a cold plunge during the luteal phase might feel shocking or unmanageable. For others, it might feel just fine. That variability is key.
Does Training Volume & Intensity Affect Response?
Yes. Recovery isn’t just about sex or hormones—it’s about load and lifestyle. A highly trained female athlete will tolerate more stress—whether it's a tempo run or a 9°C cold plunge—than someone who trains casually twice a week.
Exercise status and recent training impact how the autonomic nervous system responds. Those with high training loads might benefit more from cold-dominant recovery cycles, while general population clients may benefit from protocols that focus more on circulation and downregulation (Stephens et al., 2018).
This means recovery should be personalized—not just for men vs women, but for each individual’s phase of life, training, stress, and preferences.
Rethinking Protocols at The Cove
Here’s a quick look at The Cove’s current contrast immersion protocols:
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Cycle A: 4 rounds of 2min cold / 2min hot + 5min hot finish
Use within 2hrs of exercise (add 1min cold at end to upregulate the nervous system). -
Cycle B: 3 rounds of 5min hot and cold (starting on cold)
Best for use 4+ hrs post-exercise for circulation and muscle flush. -
Cycle C: 2 rounds of 5min cold / 10min hot
Designed for general recovery when no exercise has occurred for 4+ days. -
Cycle D: 2min hot / 5min cold / 5min hot / 2min cold / 5min hot
Designed for jet lag, hangovers, and nervous system reset.
Temperatures:
Cold sits at 11°C, decreasing to 7–8°C over summer. Hot remains at 40–42°C year-round.
The Big Question: Do We Need Women-Specific Days or Adjusted Sessions?
Should We Adjust Temperatures or Protocols?
Realistically, changing water temps daily is operationally tough, especially in shared-use environments. However, adjusting protocols is simple and impactful. We can educate clients and guide them toward the most appropriate cycle based on their physiology, activity level, and stage of cycle—without changing the tub temperature at all.
Should We Offer Women’s-Only Recovery Sessions?
Potentially, yes. A ladies-specific day or time block could allow:
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More guided, personalized recommendations
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Slightly warmer cold water (if viable)
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A space that feels safer for exploration and feedback
This is less about exclusion and more about honoring the uniqueness of women’s recovery needs—something science is just beginning to catch up with.
Would These Adjustments Help Everyone?
Absolutely. While women stand to benefit the most from personalized recovery options, men and non-binary individuals also have varying needs. By offering more education and guided sessions, we improve outcomes across the board. The key shift? Moving away from “set it and forget it” protocols to intentional, adaptable recovery.
What The Cove (and Recovery Culture) Can Do Next
✅ Educate: Offer brief guides on which cycle works best for various training phases, goals, or cycle stages.
✅ Listen: Collect feedback from our female clients on their experience during different cycles and protocols.
✅ Test: Trial a women-specific session weekly with optional protocol variations.
✅ Evolve: Adjust protocols—not just based on temperature, but intention (stress vs soreness vs fatigue vs travel).
✅ Lead: Share our findings to help other recovery centers rethink their approach.
Final Thoughts
We’re at the beginning of a smarter, more inclusive era in recovery. It's no longer enough to base protocols on studies that mostly involve male athletes. Facilities like The Cove—and the broader wellness world—must take these insights seriously.
By offering more responsive, intentional recovery strategies, we not only serve women better—we improve outcomes for everyone.
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References
Charkoudian, N. & Stachenfeld, N. (2016). Sex hormone effects on autonomic mechanisms of thermoregulation in humans. Autonomic Neuroscience, 196, 75–80.
Giersch, G.E.W., Charkoudian, N., Stearns, R.L., Casa, D.J., & Ganio, M.S. (2020). Fluid balance and thermoregulation in women: Considerations across the lifespan. Nutrients, 12(8), 2435.
Hohenauer, E., Taeymans, J., Baeyens, J.P., Clarys, P., & Clijsen, R. (2015). The effect of post-exercise cryotherapy on recovery characteristics: A systematic review and meta-analysis. PLoS One, 10(9), e0139028.
Notley, S.R., Park, J., Tagami, K., & Ohnishi, N. (2022). Cold exposure tolerance in women across the menstrual cycle. European Journal of Applied Physiology, 122(4), 927–936.
Stephens, J.M., Halson, S.L., Miller, J., Slater, G.J., & Askew, C.D. (2018). Cold-water immersion for recovery from exercise: A meta-analysis. European Journal of Sport Science, 18(2), 193–206.