The Perimenopausal Physician: When the Doctor Becomes the Patient
Women physicians navigating perimenopause face a cruel double bind: they’re trained to be expert diagnosticians for everyone else while minimizing their own symptoms. This post examines the neurobiology, identity disruption, and systemic failures driving this crisis — and offers a multi-layered path toward healing that honors both the physician and the woman.
- A Night Shift at 4:12 a.m.
- What Is the Physician Patient Paradox?
- The Neurobiology of Doctoring and Perimenopausal Cognitive Load
- How Perimenopause Shows Up in Driven Women Physicians
- The Identity Crisis of a Physician Who Built Her Self on Cognitive Excellence
- Both/And: Your Intellect Is Temporarily Affected and You Are Still a Superb Physician
- The Systemic Lens: Hospital Systems, 24-Hour Call, and the Pipeline Problem
- How to Heal: A Multi-Layered Path Forward
- Frequently Asked Questions
A Night Shift at 4:12 a.m.
It’s 4:12 a.m. in the dimly lit hospital ward. Jordan, a hospitalist in her mid-40s, blinks at her computer screen, willing the letters to stay still. She’s just finished rounding on the man in room 312 — congestive heart failure, third admission this month — but when she opens his chart to write her note, his name won’t come. Not buried deep, not foggy at the edges. Simply gone, like smoke clearing from a room she can’t reenter.
Jordan rubs her eyes and tries again. The name is there somewhere. She knows it is. She just spoke with him eleven minutes ago. But the retrieval mechanism that used to work instantaneously — the one that pulled names, lab values, medication interactions from some internal database with flawless speed — now requires effort she doesn’t have at 4 a.m. This is different from tired. This is something else entirely.
She’s been noticing this for eight months now: a slow, insidious erosion of the mental sharpness she spent two decades building. Hot flashes that soak through her scrubs during morning rounds. A hair-trigger irritability she doesn’t recognize. Sleep so fractured she’s stopped expecting it to be restorative. Jordan is a perimenopausal physician, and unlike her patients — for whom she has thoughtful, evidence-based protocols — she has no roadmap for the transition she’s living through right now.
In my work with driven women physicians, Jordan’s experience is far from unique. They are the caretakers of other people’s bodies, often at the expense of their own. The culture of medicine trains female doctors to be expert patients for everyone else — and deeply inadequate patients for themselves. If you’re reading this as a physician, a surgeon, a hospitalist, or any driven woman in medicine, I want you to know: what you’re experiencing is real, it’s neurobiological, and it doesn’t mean you’re losing your edge forever.
What Is the Physician Patient Paradox?
The physician patient paradox refers to the clinical and cultural phenomenon whereby physicians, despite their medical expertise, systematically under-recognize and under-treat their own health concerns. This paradox is shaped by medical training that emphasizes patient care above self-care, professional identity tethered to invulnerability, and institutional barriers that discourage vulnerability among doctors. As documented by research from the American Medical Association and peer-reviewed literature on physician mental health, female physicians are disproportionately affected by this dynamic, leading to higher rates of burnout, mental illness, and career attrition compared to their male counterparts.
In plain terms: Even though you know medicine inside and out, you’ve been trained to put everyone else first — even at the expense of your own health. This means you often ignore your body’s warning signals and push through, even when you’re genuinely falling apart.
Physicians are, statistically, among the worst patients they’ll ever treat. The culture of medicine valorizes endurance, stoicism, and the projection of unshakeable control. Female doctors, in particular, are socialized to minimize symptoms and keep moving — a deeply gendered version of the same training that teaches all doctors not to complain. During perimenopause, this conditioning becomes a double bind. The very skills and identity formations that made these women successful are turned against their own wellbeing.
Research consistently shows that women physicians face significantly higher rates of burnout and depression than their male colleagues, and perimenopause often coincides with a sharp escalation of these symptoms. The cruel irony: the perimenopausal physician is often less hormonally literate about herself than many of her patients. She can explain the HPA axis in detail during morning rounds and then go home and chalk up her own cortisol dysregulation to “stress.” The system trains her to know everything about disease — and very little about her own midlife transition.
What makes this especially difficult is the shame layer. In a profession that prizes certainty and competence, admitting that you don’t know what’s happening in your own body — or that your body is changing in ways that affect your performance — feels like a fundamental betrayal of professional identity. So many of the women physicians I work with waited months, sometimes years, before naming what was happening. They blamed overwork. They blamed anxiety. They blamed themselves. Perimenopause as an identity crisis is real, and it’s particularly acute for women whose professional self-concept is built on cognitive precision and physical reliability.
The Neurobiology of Doctoring and Perimenopausal Cognitive Load
Cognitive load refers to the total amount of mental effort being used in working memory at any given time. In perimenopause, fluctuating estrogen and progesterone levels disrupt neural circuits critical for attention, working memory, and executive function. Lisa Mosconi, PhD, neuroscientist at Weill Cornell Medicine and director of the Women’s Brain Initiative, has demonstrated through neuroimaging research that estrogen modulates hippocampal and prefrontal cortex function — areas essential for memory consolidation and cognitive flexibility. The hormonal fluctuations of perimenopause compromise these brain regions, producing the subjective and objective cognitive difficulties commonly called “brain fog.”
In plain terms: The parts of your brain you rely on for multitasking, remembering patient details, and making split-second clinical decisions are being directly affected by hormone shifts. This makes your usual mental sharpness feel like it’s slipping — a terrifying experience when your job literally depends on it.
Doctoring is cognitively demanding under ideal conditions. The perimenopausal physician faces what can only be described as a perfect neurobiological storm: the relentless mental load of clinical decision-making layered over a brain that is navigating significant hormonal flux. Pauline Maki, PhD, professor of psychiatry and psychology at the University of Illinois Chicago and one of the leading researchers on perimenopausal cognition, has shown that these changes are linked specifically to estrogen withdrawal’s effects on prefrontal cortex function — the region responsible for the kind of rapid information processing and executive reasoning that medicine demands daily.
Sleep deprivation, endemic in medicine, compounds every one of these effects. The hypothalamic-pituitary-adrenal (HPA) axis — which regulates the body’s stress response — becomes dysregulated during perimenopause, leading to elevated cortisol levels that further impair cognition, exacerbate anxiety, and disrupt restorative sleep cycles. For women physicians managing overnight calls, complex patient loads, and simultaneous family responsibilities, the neurobiological burden is immense. And it’s cumulative. Each bad night makes the next day harder. Each cognitively demanding shift leaves less reserve for recovery.
What’s often missed — and what I want to name clearly — is that these cognitive changes are not signs of intellectual failure or early dementia. They are the predictable, documented, neurobiological consequences of a hormonal transition happening in a brain that has been working at maximum capacity for decades. Understanding that distinction is not just clinically important; it’s the difference between a woman physician seeking support and one who quietly exits medicine altogether because she believes she’s broken. You can read more about the intersection of perimenopause and brain fog and understand why this is a treatable transition, not a permanent decline.
The hypothalamic-pituitary-adrenal (HPA) axis is the central stress-response system of the body, governing cortisol release in response to perceived threats. During perimenopause, fluctuating estrogen levels can destabilize HPA axis regulation, leading to prolonged cortisol elevation, disrupted circadian rhythms, and impaired recovery from stress. Bessel van der Kolk, MD, psychiatrist and trauma researcher at Boston University and author of The Body Keeps the Score, has documented how chronic HPA dysregulation affects the entire nervous system — impairing memory, increasing emotional reactivity, and compromising physical health over time.
In plain terms: Your body’s stress system is running hotter than it should right now — and that affects your sleep, your mood, your focus, and your ability to bounce back from hard days. It’s not a character flaw. It’s a biological reality that can be treated.
How Perimenopause Shows Up in Driven Women Physicians
What I see consistently in my work with driven women physicians is a particular pattern of symptom presentation that’s shaped by both the biology of perimenopause and the specific demands of medical culture. These women don’t typically come in saying, “I think I’m perimenopausal.” They come in saying things like: “I think I’m losing it.” “I’m terrified I’m going to make a mistake.” “I don’t recognize myself anymore.”
Jordan, whose 4 a.m. moment we opened with, is a composite of many women I’ve sat with. Over the course of several months in our work together, she described what she called “a slow theft” — the gradual erosion of the mental quickness that had always been her superpower. She started double-checking calculations she’d trusted instinctively for years. She began asking colleagues to confirm details she should have been able to retrieve herself. She’d never needed to do either before, and the need itself felt humiliating.
What Jordan was doing, without knowing it, was compensating. And compensating well — her patient outcomes hadn’t changed. Her colleagues hadn’t noticed anything. But she had noticed, and the internal toll of maintaining performance while feeling internally compromised was enormous. That gap — between external presentation and internal experience — is where a lot of perimenopausal physician suffering lives, mostly invisible and completely unaddressed.
Nadia, an academic surgeon in her early 50s at a large teaching hospital, presented differently. For her, it was the emotional dysregulation that came first — the hair-trigger irritability, the sudden tearfulness in the locker room after particularly long procedures, a sense of being overwhelmed by things that had never overwhelmed her before. She’d been a famously unflappable surgeon for twenty years. The idea that she might cry in front of a resident was, she told me, “the most terrifying thing I could imagine.” The rage and emotional intensity of perimenopause is real — and for physicians, it collides with a professional culture that pathologizes any emotional display as unprofessional.
Both Jordan and Nadia illustrate something crucial: the symptoms of perimenopause don’t arrive in a neutral context for women physicians. They arrive in an environment where showing vulnerability has historically cost women professionally, where self-disclosure is culturally discouraged, and where the internalized standard is literally perfection. This is the crucible. And it’s why many driven women physicians don’t just suffer through perimenopause — they suffer alone, in silence, while performing flawlessly for everyone watching.
The Identity Crisis of a Physician Who Built Her Self on Cognitive Excellence
It’s 6:48 p.m. and Nadia has just scrubbed out of a twelve-hour procedure. She sits in the locker room, surgical cap in hand, reviewing the operative note she dictated an hour ago. Reading it back, something feels off. The words are clinically accurate — she knows they are — but the sentence structure feels fragmented, the usual flow of her prose interrupted. She rewrites two sentences. Then rewrites them again. The document is fine. She isn’t sure she is.
For Nadia, cognitive precision isn’t just a professional skill. It’s a core identity structure. She became a surgeon partly because she trusted her mind — its speed, its reliability, its capacity to hold complexity and produce elegant solutions under pressure. When perimenopause begins to affect that capacity, even temporarily and partially, it doesn’t feel like a medical symptom. It feels like an existential threat.
Rebecca Thurston, PhD, professor of psychiatry, psychology, and epidemiology at the University of Pittsburgh and director of the Women’s Biobehavioral Health Research Center, has documented that cognitive complaints during perimenopause are not trivial “brain fog” but measurable neuropsychological changes affecting working memory, attention, and processing speed. Pauline Maki, PhD, similarly notes that these changes are directly linked to estrogen withdrawal’s impact on prefrontal cortex function — the exact cognitive architecture that surgical precision and clinical reasoning depend on.
The question I hear most often in this space is: “Who am I if I can’t think the way I used to?” That’s not a dramatic question. For women who have spent thirty years organizing their entire identity around cognitive excellence, it’s an entirely rational one. And it deserves a real, honest answer — not reassurance, but genuine engagement with the depth of what’s being asked. This kind of identity disruption is one of the most underexplored dimensions of perimenopause for driven women, and it’s one that most clinical settings don’t know how to hold.
Professional identity disruption refers to the psychological destabilization that occurs when a person’s core sense of self — built around vocational competence, role, or achievement — is threatened by circumstances beyond their control. In perimenopausal physicians, this manifests when hormonal shifts affect cognitive function in ways that challenge their self-concept as precise, reliable, and intellectually formidable clinicians. The disruption is compounded by medicine’s cultural valorization of mental acuity and its historical stigmatization of vulnerability.
In plain terms: When your thinking shifts during perimenopause, it can feel like the very foundation of who you are as a doctor is shaking. You’re not just struggling with symptoms — you’re grappling with what those symptoms mean about your identity, your worth, and your future.
This identity crisis is not a weakness. It’s a predictable consequence of having built a life around one particular expression of capability, and then encountering a temporary biological disruption of that capability in a culture that has no tolerance for anything less than peak performance. The work — in therapy, in coaching, in any genuine support space — is helping women physicians find the floor underneath the crisis. And there is one. It just doesn’t look like what they expect.
Both/And: Your Intellect Is Temporarily Affected and You Are Still a Superb Physician
When I sit with women like Jordan and Nadia, I hold space for a difficult paradox — one that medicine’s binary thinking doesn’t easily accommodate:
You are experiencing real, measurable cognitive changes due to perimenopausal neuroendocrine shifts and you remain a skilled, experienced, and effective physician. Both things are true. Simultaneously. Without contradiction.
This Both/And framework is essential, because the all-or-nothing thinking that so many driven women default to — “either I’m sharp or I’m failing” — is a trap that will swallow you whole during this transition. The cognitive impairment of perimenopause is real and it’s temporary. Lisa Mosconi, PhD, emphasizes that the brain’s estrogen receptors fluctuate during perimenopause, impacting memory circuits transiently rather than permanently. The brain is remarkably plastic. With appropriate support — including therapy, hormonal intervention when appropriate, and genuine rest — it recalibrates.
Nadia illustrates this beautifully. Even during her most cognitively uncertain months, her surgical outcomes remained excellent. Her teams trusted her judgment implicitly. What had changed was her internal experience of herself, not her actual performance. She adapted — dictating notes more slowly, building in review time, asking for verbal confirmation from her residents more than she had before. Not because she was less capable, but because she was working with her brain rather than against it. That’s not failure. That’s advanced clinical reasoning applied to one’s own neurology.
“At midlife, the question is no longer ‘What do I want?’ but ‘Who am I?'”
James Hollis, PhD, Jungian analyst and author of The Middle Passage
The Both/And reality also applies to the broader identity question. You can be a different version of yourself right now — less certain, more physically present to your body’s signals, less invulnerable — and still be excellent at what you do. In fact, the physicians I’ve worked with who emerge from this transition with the most integrated sense of self are often the ones who let perimenopause teach them something. Not because suffering is instructive, but because being forced to slow down and pay attention to your own inner life — often for the first time in decades — opens something that wasn’t accessible before.
If you’re in this space, I want to invite you to consider working with a therapist who understands both relational trauma and the specific pressures of driven women navigating midlife. Trauma-informed therapy can provide the holding environment you need to process both the cognitive changes and the identity disruption without adding shame to an already heavy load. Executive coaching for driven women physicians can also offer practical frameworks for navigating this transition while maintaining professional effectiveness.
The Systemic Lens: Hospital Systems, 24-Hour Call, and the Pipeline Problem
Physician perimenopause doesn’t happen in a vacuum. It unfolds inside hospital systems, academic medical centers, and clinical environments that were designed by and for men — and that remain remarkably ill-equipped to support women navigating the specific challenges of midlife hormonal transition.
The 24-hour call schedule, relentless patient loads, and productivity-based metrics collide directly with the neurobiological realities of perimenopause. Sleep disruption, vasomotor symptoms, cognitive fluctuations, and mood instability are all exacerbated by night shifts and chronically fragmented rest. Institutional policies around physician wellness still rarely acknowledge perimenopausal needs — no scheduling accommodations for women managing severe vasomotor symptoms, no protected rest periods during peak symptomatic phases, no training for department chairs on how to support women physicians through this transition.
Rebecca Thurston, PhD, has called attention to how trauma history compounds menopause symptoms, especially in high-stress professions like medicine. For many women physicians, the cumulative weight of decades of caregiving, emotional labor, professional sacrifice, and systemic gender discrimination intersects with perimenopausal vulnerability in ways that create a genuine crisis. The reactivation of older trauma during perimenopause is a real clinical phenomenon — and in women physicians who’ve spent their careers in high-stakes, emotionally demanding environments, the trauma layer is often significant and unprocessed.
The systemic consequences are already visible. Data from the American Medical Association and published peer-reviewed research reveal alarming trends: women physicians are leaving medicine at disproportionate rates during their 40s and 50s, many citing burnout, cognitive concerns, and what they describe as institutional inflexibility. This “pipeline problem” threatens not just individual careers but the future of equitable healthcare leadership. We lose women physicians not because they’re incapable of navigating perimenopause, but because the systems they work within are incapable of supporting them through it.
Until hospital systems and medical institutions treat the perimenopausal physician as a distinct occupational health category — with the same seriousness they’d bring to any other clinically significant health condition affecting workforce function — women will continue to suffer in silence, adapt in isolation, and exit careers that took decades to build. This isn’t a personal failing of individual physicians. It’s a structural failure of the institutions that claim to value diversity while making it impossible for women to stay.
How to Heal: A Multi-Layered Path Forward
Healing through perimenopause as a physician requires what I think of as a genuinely multi-layered response — biological, psychological, relational, and systemic. No single intervention is sufficient. But the good news is that this transition is navigable, and women who engage with it directly — rather than trying to power through it invisibly — consistently describe profound changes not just in symptom management but in their relationship to themselves and their work.
Hormonal support: For many perimenopausal physicians, discussing hormone replacement therapy with a menopause specialist is a reasonable and often transformative first step. The decision needs to be individualized and evidence-informed, but for women whose symptoms significantly impact cognitive function or quality of life, HRT can stabilize the hormonal environment in ways that allow the brain to recalibrate. The key is finding a provider who understands the specific demands of physician schedules and can tailor timing and delivery method accordingly. The HRT conversation from a therapist’s lens is worth reading as you explore this option.
Psychological support: Scheduling therapy amidst 60- to 70-hour work weeks can feel impossible, and I hear that. But psychological support during this transition isn’t a luxury — it’s a clinical necessity. Trauma-informed, somatic, and attachment-based approaches can help you process the identity shifts, grieve the version of yourself that felt more certain, and develop practical strategies for cognitive compensation and self-advocacy. Teletherapy and flexible scheduling models exist specifically to meet the constraints of demanding medical careers. If you’re a driven woman physician who’s never been in therapy, perimenopause may be the moment that finally creates the opening. Working one-on-one with a therapist who specializes in driven women can provide the specific holding environment this transition requires.
Strategic communication with leadership: Disclosing perimenopausal symptoms to a chief of staff or department chair feels risky, and in some environments it is. But strategic, clinically-framed disclosure can sometimes open the door to accommodations without meaningful career consequences — particularly if you approach it with clear language about the temporary nature of the transition, potential interventions in progress, and specific requests (adjusted call coverage during peak symptomatic periods, for example). Building allies among colleagues and senior mentors who understand perimenopause is invaluable groundwork.
Self-compassion and boundary renegotiation: The internalized mandate to power through must be actively challenged, because it won’t loosen its grip on its own. Setting boundaries around workload, sleep, and self-care isn’t softness — it’s a sophisticated clinical intervention applied to your own nervous system. This may mean renegotiating roles, delegating tasks you once held tightly, or reprioritizing career goals without guilt. The Fixing the Foundations course offers tools specifically designed for driven women rebuilding their psychological foundations — including those navigating identity disruption in midlife.
Finally, peer support among perimenopausal physicians is something I advocate for consistently. The isolation of going through this transition without community is its own kind of suffering. Finding even one or two colleagues who are willing to name what’s happening — to say “I’m in this too” — can be genuinely healing. You deserve the same quality of care you give your patients. Starting with that belief is the most important first step.
The goal isn’t to return to a pre-perimenopausal version of yourself. It’s to evolve into a more integrated physician-self — one who honors both intellectual excellence and physical embodiment, who has survived a genuinely hard transition and emerged with more self-knowledge, more compassion, and more depth than she had before. I’ve watched this happen, consistently, in the women I work with. I believe it can happen for you. Stay connected with our community through the Strong & Stable newsletter — it’s the weekly conversation that many physicians say finally made them feel less alone in this.
You are not broken. You are in transition. And transitions, handled with care, have a way of making us more of who we already are.
PERIMENOPAUSE LIBRARY
This is one piece of a larger conversation. Browse Annie’s complete perimenopause library — 42 articles organized by symptom, identity, relationships, profession, and treatment.
Q: Should I disclose my perimenopausal symptoms to colleagues or supervisors?
A: Disclosure is a deeply personal decision shaped by your work environment, professional culture, and personal boundaries. Concealing perimenopausal challenges can intensify isolation and increase stress, which paradoxically worsens cognitive and emotional symptoms. Thoughtful disclosure to a trusted supervisor or peer can open pathways for accommodations — adjusted call schedules, protected time for medical appointments, access to wellness resources. That said, approach it strategically: frame it clinically and professionally, emphasizing your commitment to patient care while requesting specific support. If your workplace culture is unsupportive, consider confidential advice from occupational health or physician wellness programs before deciding.
Q: Will hormone replacement therapy help my clinical performance during perimenopause?
A: When indicated and carefully managed, HRT can meaningfully mitigate many perimenopausal symptoms that impair cognition, sleep, and mood. Lisa Mosconi, PhD, neuroscientist at Weill Cornell Medicine and director of the Women’s Brain Initiative, has shown that estrogen supports brain energy metabolism and the memory circuits most vulnerable during the menopause transition. For physicians, clearer cognition and better sleep translate directly to safer clinical decision-making and reduced burnout risk. HRT isn’t a panacea and requires personalized risk assessment, but it’s worth a serious, individualized conversation with a menopause-informed provider who understands your clinical demands.
Q: Is it safe to work overnight call during perimenopause?
A: Perimenopause often brings disrupted sleep, heightened fatigue, and impaired stress regulation — all of which complicate the demands of overnight call and extended shifts. Working call while symptomatic can amplify the risk for cognitive errors and emotional strain. Many physicians feel pressured to maintain full clinical loads to avoid stigma or career consequences, but your safety and your patients’ safety require you to advocate for boundaries that reflect your current neurobiological reality. Consider negotiating call modifications during peak symptomatic periods, prioritizing restorative sleep hygiene, and building in recovery time wherever possible.
Q: I’ve been misattributing my symptoms to burnout or anxiety for years. How do I recalibrate?
A: This is extraordinarily common among driven women physicians. The culture of medicine conditions you to be the expert diagnostician for others while being a poor patient to yourself. You may have attributed forgetfulness, mood shifts, or fatigue to stress rather than perimenopause for years. The first step is compassionate recognition — your body and brain are changing in ways that aren’t your fault. Recalibration means seeking education on perimenopause through a clinical lens, getting a thorough hormonal evaluation, and embracing therapeutic support that honors the full complexity of this transition, including its identity dimensions.
Q: Are my diagnostic errors actually increasing during perimenopause?
A: Perimenopause can transiently affect working memory, processing speed, and executive function — all critical for clinical decision-making. But cognitive errors are multifactorial and often relate to systemic stressors, sleep deprivation, and emotional exhaustion as much as hormonal changes. What I see clinically is that driven physicians become hypervigilant to any cognitive slip and catastrophize it, which actually increases anxiety and self-doubt. With appropriate supports in place — HRT when indicated, psychotherapy, workload modifications — performance typically stabilizes. The key is building a safety net: peer consultation, deliberate slowing in complex cases, and genuine recovery time.
Q: How do I balance medicine’s “power through” culture with the need to actually care for myself?
A: Medicine’s unspoken mandate is endurance — the expectation that you push through regardless. But perimenopause demands a genuine renegotiation of that script. Sustained powering-through without attunement to your changing body leads to burnout, health deterioration, and ultimately diminished care quality. Reclaiming agency in your schedule and your own health decisions is a radical but necessary act of professional self-preservation. This may look like negotiating protected time for medical care, integrating psychotherapy, or selectively delegating tasks. It’s not weakness. It’s advanced self-regulation — the same kind you’d recommend to any patient facing a significant health transition.
Q: Can therapy actually help when my schedule is already 60+ hours a week?
A: Therapy in a demanding medical career can feel logistically impossible, but the clinical reality is that even focused, trauma-informed psychotherapy yields meaningful improvements in emotional regulation, sleep, and coping. Bessel van der Kolk, MD, psychiatrist and trauma researcher at Boston University and author of The Body Keeps the Score, has documented how somatic and relational approaches to trauma can produce measurable neurobiological change in a relatively small number of sessions. Teletherapy and flexible scheduling exist to meet you where you are. Prioritizing your mental health isn’t an indulgence — it’s a clinical investment in your longevity as a physician and your quality of life as a human being. Schedule a free consultation to explore what support could look like for you.
Related Reading
- Maki, Pauline M., PhD, and Nadia G. Jaff. “Menopause and Brain Fog: How to Counsel and Treat Midlife Women.” Menopause 31, no. 7 (2024): 647–649. doi:10.1097/GME.0000000000002382.
- Thurston, Rebecca C., PhD. “Trauma and Its Implications for Women’s Cardiovascular Health during the Menopause Transition: Lessons from MsHeart/MsBrain and SWAN Studies.” Maturitas 182 (2024): 107915. doi:10.1016/j.maturitas.2024.107915. PMID: 38280354.
- Mosconi, Lisa, PhD, et al. “Menopause Impacts Human Brain Structure, Connectivity, Energy Metabolism, and Amyloid-Beta Deposition.” Science Advances 7, no. 20 (2021): eabc9010. doi:10.1126/sciadv.abc9010. PMID: 34108259.
- van der Kolk, Bessel, MD. The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. New York: Viking, 2014.
- Jakubowski, Katherine, et al. “Trauma History and Persistent Poor Objective and Subjective Sleep Quality among Midlife Women.” Menopause 32, no. 3 (2025): 207–216. doi:10.1097/GME.0000000000002480. PMID: 39773930.
- Haver, Mary Claire, MD. The New Menopause: The Ultimate Guide to Perimenopause and Beyond. New York: HarperCollins, 2023.
- Porges, Stephen, PhD. The Pocket Guide to the Polyvagal Theory: The Transformative Power of Feeling Safe. New York: Norton, 2017.
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Annie Wright is a licensed psychotherapist (LMFT #95719) and trauma-informed executive coach with over 15,000 clinical hours. She works with driven, ambitious women — including Silicon Valley leaders, physicians, and entrepreneurs — in repairing the psychological foundations beneath their impressive lives. Annie is the founder and former CEO of Evergreen Counseling, a multimillion-dollar trauma-informed therapy center she built, scaled, and successfully exited. A regular contributor to Psychology Today, her expert commentary has appeared in Forbes, Business Insider, Inc., NBC, and The Information. She is currently writing her first book with W.W. Norton.
