Women's hot flashes are multifactorial but the most common reason they occur is estrogen dominance. As a women ages and enters into perimenopause her eggs are aging and they have shortened telomeres. Leptin actually helps select the egg for maturation and control fecundity. When that egg is older and it is choosen as the dominant follicle because it is the best choice of what is left it gets ovulated after the first two weeks of estrogen release from the ovary. Estrogen is pro growth for the breast and uterus. Once the egg is released it secretes progesterone to support the possible pregnancy.

Older eggs produce less progesterone. There there is an imbalance of estrogen to progesterone. The common symptoms is loss of energy, vitality, headaches, change in sleep, and vasomotor reactions (hotflash) Hotflashes are also symptoms of that a women is no longer controling her UCP1 because she is becoming leptin resistant due to a lack of balance.

Most women seeking care get a CW doc who wont treat....and if they do they treat with an SSRI, ambien, valium and pain med......to cover all the complaints. What the women needs is bioidentical progesterone replacement to balance her out. You can easily get tested for this with a salivary study. Once diagnosed it is easy to treat. Many OB's wont give a women with a uterus progesterone because they fear CA. Well if you give Medroxy Progestin (synthetic) you do need to worry. But prometrium in small doses or a transdermal cream works best.

And Dexter the reason Paleo makes total sense for women is this.....When perimenopause occurs it also happens because as progesterone falls, sleep worsens.......cortisol rises over ten to fifteen yrs and the CRH from the pituitary directly feed backs and lowers the release of GNRH. GNRH lowers the sex steroid hormones more. So it actually gets worse if it goes untreated. The high chronic cortisol leads to central and peripheral leptin resitance and that causes the weight gain. If you eat paleo.....you control NPY and you handle energy metabolism correctly. NPY is a modulator of the reward tracks and hypocretin neurons that control satiety and food seeking behavior.....specifically carb craving behavior. Increased NPY means a women seeks carbs to eat. Do it long enough you get fat just like Gary Taubes says you will. Carbs need to be monitored by perimenopausal women because they become sensitized to it.

The story gets tougher when you get a perimenopausal women who is also in BCP's. Then we have to talk about liver metabolism for estrogen. And that is complicated and will have to wait til I start writing. But it is critical to understand if your a woman or a doctor treating these women. Women want contraception but if they really knew what it does to the liver I bet they would choose a condom or a diaphragm. They are paying a steep price for convenience.

Sorry it was long and complicated but it is vital to paleo women.......

People dont care what you know until they know you care more.

THE Quilt.

Edit: For Glossary by Dexter

Glossary of abbreviations:

CRH Corticotropin-releasing hormone (CRH), originally named corticotropin-releasing factor (CRF), and also called corticoliberin, is a polypeptide hormone and neurotransmitter involved in the stress response. It belongs to corticotropin-releasing factor family.

Its main function is the stimulation of the pituitary synthesis of ACTH. http://en.wikipedia.org/wiki/Corticotropin-releasing_hormone

TSH Thyroid-stimulating hormone (also known as TSH or thyrotropin) is a peptide hormone synthesized and secreted by thyrotrope cells in the anterior pituitary gland, which regulates the endocrine function of the thyroid gland. http://en.wikipedia.org/wiki/Thyroid-stimulating_hormone

NPY "NPY has been associated with a number of physiologic processes in the brain, including the regulation of energy balance, memory and learning, and epilepsy."[1] The main effect is increased food intake and decreased physical activity. NPY is secreted by the hypothalamus, and, in addition to increasing food intake, it increases the proportion of energy stored as fat and blocks nociceptive signals to the brain.[2] NPY also augments the vasoconstrictor effects of noradrenergic neurons http://en.wikipedia.org/wiki/Neuropeptide_Y

BCP Birth Control Pills

UCP1 Thermogenin (called uncoupling protein by its discoverers and now known as uncoupling protein 1, or UCP1)[1] is an uncoupling protein found in the mitochondria of brown adipose tissue (BAT). It is used to generate heat by non-shivering thermogenesis. Non-shivering thermogenesis is the primary means of heat generation in hibernating mammals and in human infants http://en.wikipedia.org/wiki/Thermogenin

GNRH Gonadotropin-releasing hormone (GnRH), also known as Luteinizing-hormone-releasing hormone (LHRH) and luliberin, is a tropic peptide hormone responsible for the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the anterior pituitary. GnRH is synthesized and released from neurons within the hypothalamus. The peptide belongs to gonadotropin-releasing hormone family. http://en.wikipedia.org/wiki/Gonadotropin-releasing_hormone

SSRI Selective serotonin reuptake inhibitors or serotonin-specific reuptake inhibitor[1] (SSRIs) are a class of compounds typically used as antidepressants in the treatment of depression, anxiety disorders, and some personality disorders. The efficacy of SSRIs is disputed. A 2010 meta-analysis states that "The magnitude of benefit of antidepressant medication compared with placebo ... may be minimal or nonexistent, on average, in patients with mild or moderate symptoms. For patients with very severe depression, the benefit of medications over placebo is substantial. http://en.wikipedia.org/wiki/SSRI