Thermal Therapies and Peptide Signaling in Women’s Health: A Systems-Based Review

Background: Cold water immersion (CWI), sauna bathing, and peptide-based interventions are increasingly used to support recovery, cardiometabolic health, and overall well-being among women. Despite widespread adoption, the evidence base—particularly in female populations—remains heterogeneous, shaped by sex-specific differences in thermoregulation, hormonal physiology, and autonomic responsiveness. Objective: This narrative review synthesizes current clinical and mechanistic evidence across these three modalities, with emphasis on female-specific physiological pathways, hormonal interactions, and translational health outcomes. Methods: Relevant literature was identified through searches of PubMed, Scopus, and Web of Science, with an emphasis on studies published from 2015 to 2025 and supplemented by landmark earlier work where appropriate. Results: Sauna bathing demonstrates the most robust evidence base, with dose-dependent reductions in cardiovascular mortality and improvements in endothelial function mediated by heat shock protein upregulation, nitric oxide synthase activation, and autonomic modulation. Cold water immersion shows moderate evidence for exercise recovery and emerging data on brown adipose tissue activation and hormesis-driven metabolic adaptation, though female-specific protocols remain understudied. Peptide therapies span a broad spectrum: GLP-1 receptor agonists are clinically validated for metabolic and cardiovascular outcomes; collagen peptides show evidence for musculoskeletal support; and experimental compounds such as BPC-157 and mitochondrial peptides demonstrate mechanistic promise but lack human clinical trial data. All three modalities converge on shared physiological pathways including autonomic regulation, mitochondrial adaptation, vascular remodeling, and cellular stress signaling. Conclusion: These approaches represent a complementary systems-based framework for women’s health, particularly during the perimenopausal and postmenopausal transitions. Female-specific clinical trials and standardized protocols are urgently needed to advance translational application.