Author(s)

Fumihiro Omasu¹, Minami Saitoh¹, Nana Satoh¹, Hiyori Iida², Yukina Ishimoto², Marina Ohgushi², Tomomi Gotoh³

¹Department of Health and Nutrition, Faculty of Health and Nutrition, Yamagata Prefectural Yonezawa University of Nutrition Sciences, Yamagata, Japan.
²Department of School Health, Faculty of Education, Kumamoto University, Kumamoto, Japan.
³Department of Lifelong Health Education, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.

Background: Cold hypersensitivity (CH), often referred to as hiesho in Japan, is a common but poorly understood condition characterized by pronounced cold sensations predominantly in the extremities. It is prevalent among young women and associated with autonomic imbalances, reduced peripheral circulation, and lifestyle factors. Despite its prevalence, diagnostic standards remain inconsistent, and discrepancies between subjective symptoms and objective measures complicate clinical assessments. We investigated the prevalence, subjective experiences, and physiological correlates of CH among female university students using questionnaire-based assessments and objective physiological tests. Methods: One hundred sixteen female university students were recruited. Participants completed a self-administered questionnaire based on established diagnostic criteria and prior studies on CH, autonomic function, and circulation. Objective assessments included heart rate variability (HRV) for autonomic balance, peripheral circulation indices (stroke volume, vascular elasticity, and residual blood volume), blood pressure, and fingertip skin temperature. Thermal recovery was evaluated by a cold-water immersion test (10˚C, 1 min). Data were analyzed using chi-square tests, Mann-Whitney U tests, and Welch’s t-tests, with significance set at p < 0.05. Results: CH was identified in 92 (79.3%) participants. Relative to non-CH (NCH), CH individuals had a higher mean age and lower BMI. CH was associated with significantly more autonomic symptoms (mean 3.2 vs. 2.2) with severe extremity coldness and numbness. Autonomic assessments of this group revealed sympathetic predominance and reduced parasympathetic activity. Stress levels did not differ significantly, but irritability and depressed mood were more common in CH. Circulatory indices showed no significant group differences, although CH tended be associated with lower vascular elasticity. In the cold-water immersion test, baseline fingertip temperature was slightly higher in CH individuals; however, recovery at 10 min was incomplete, with poor recovery in 20.6% (relative to 4.2% in NCH individuals). Conclusions: CH is highly prevalent among young women and associated with lower BMI, autonomic imbalance, and impaired thermal recovery. While objective circulatory measures showed limited group differences, recovery patterns following cold stress revealed impaired regulation in CH. These findings underscore the multifactorial nature of CH and highlight the need for preventive health education and supportive interventions targeting lifestyle, thermoregulation, and self-care practices among young women.

Cold Hypersensitivity, Autonomic Nervous System, Peripheral Circulation, Body Mass Index, Young Women

Omasu, F. , Saitoh, M. , Satoh, N. , Iida, H. , Ishimoto, Y. , Ohgushi, M. and Gotoh, T. (2026) Analysis of Cold Hypersensitivity in Female University Students Using Subjective and Objective Indicators. Journal of Biosciences and Medicines, 14, 382-395. doi: 10.4236/jbm.2026.143029.