Women with histories of trauma or adverse childhood experiences are at significantly elevated risk for depression, anxiety, and cognitive difficulties during perimenopause. This is not a coincidence. The biology of trauma and the biology of hormonal transition interact in specific, documented ways and understanding that interaction changes what support should look like.

The cultural narrative about postmenopausal sexuality is largely one of decline and loss. The research tells a more complicated — and in important respects, more hopeful — story. Understanding the distinction between what changes and what doesn't changes everything about how to approach sexual health after menopause.