Perimenopause and Trauma

Depth Psychotherapy for Women Navigating Perimenopause in Oakland & California

There is a particular kind of unraveling that can happen in perimenopause. You wake at 3 a.m., heart pounding. You snap at someone you love and don’t recognize your own voice. You cry at a commercial and then feel ashamed for crying. You feel rage. Or grief. Or a grief-shaped rage.

And somewhere inside, a familiar whisper returns: Something is wrong with me.

If you have a history of trauma—developmental trauma, sexual trauma, emotional neglect, complex PTSD—perimenopause can feel like being thrown back into an old house you thought you’d already renovated. The lights flicker. The floorboards creak. Doors you sealed shut start to open.

And you wonder: Why is this happening now? I’ve done so much therapy.

What Is Perimenopause—and Why Does It Feel So Destabilizing?

Perimenopause is the transitional phase before menopause when estrogen and progesterone begin to fluctuate—sometimes wildly. It can begin in your late 30s or 40s and last for years.

Common symptoms include:

Anxiety and panic
Insomnia (especially the 2–4 a.m. wake-up)
Mood swings
Irritability and rage
Brain fog
Increased sensitivity to stress
Depression
Exacerbation of PTSD symptoms

For many women, this is a biological shift. For women with trauma histories, it can feel like a psychological earthquake.

Why?

Because trauma is not only stored in memory. It is stored in the nervous system.

When hormones fluctuate, the nervous system becomes more reactive. Estrogen, in particular, plays a role in regulating serotonin, dopamine, and stress response. When estrogen drops, the buffer thins. The body feels less resourced.

If you grew up in an environment where you were unsafe, unseen, or emotionally alone, your nervous system may already have learned to brace.

Perimenopause removes some of the scaffolding.

Suddenly the old hypervigilance, shame, or despair can resurface—not because you failed at healing, but because your body is shifting.

This is not regression.

It is activation.

When Perimenopause Triggers Complex Trauma (C-PTSD)

Many of the women I work with—especially highly sensitive women and healthcare professionals—are stunned by how intense this season can be.

They’ve built careers. Families. Practices.

They’ve done deep work.

They are competent and thoughtful and self-aware.

And then perimenopause hits and they feel… destabilized.

Perimenopause can amplify:

Abandonment wounds
Attachment anxiety
Fear of aging and invisibility
Body shame
Sexual trauma triggers
Grief about not having had the love they needed
Rage that was never safe to feel

If your trauma involved a lack of attunement or protection, the hormonal volatility can recreate the internal sense of “no one is coming.”

If your trauma involved bodily violation, changes in libido, weight, or menstruation can feel deeply disorienting.

If you were the “strong one,” the caretaker, the high achiever—perimenopause can dismantle the identity you relied on for safety.

And underneath it all is grief.

Grief for youth.

Grief for what never was.

Grief for the body that carried you through survival.

The Nervous System, Hormones, and the Return of the Inner Child

In depth psychotherapy, we understand that healing is not linear.

There are seasons when the psyche brings forward new material because you are finally resourced enough to meet it.

Perimenopause is often one of those seasons.

The mood swings are not just mood swings.

The tears are not just tears.

The rage is not just irritability.

Often, it is the younger parts of you saying: I am still here.

During reproductive years, many women are hormonally buffered. In perimenopause, as that buffering changes, early attachment wounds can surface with surprising force.

You may notice:

Feeling younger than your age during emotional triggers
Longing for reassurance in ways that feel “too much”
Increased sensitivity to rejection
A resurgence of old shame narratives

This does not mean you are broken. It means the unconscious is asking to be made conscious.

Why This Season Can Also Be a Portal

In Jungian depth psychology, midlife is not simply a decline—it is an initiation.

The identities that once kept you safe begin to fall away.

The body demands honesty.

The psyche demands truth.

If trauma shaped your early life, perimenopause can become a threshold where you finally stop performing strength and begin living from something more authentic.

But this requires support.

White-knuckling it through perimenopause—especially with complex trauma—is often retraumatizing. The old voice of self-blame gets loud: “You’re too sensitive.” “Other women handle this fine.” “You should be stronger.”

But this season is not about being stronger.

It is about being more real.

Therapy for Perimenopause and Trauma in Oakland & California

If you are navigating perimenopause and noticing old trauma symptoms resurfacing, therapy can help you:

Understand the interaction between hormones and trauma
Regulate your nervous system
Work compassionately with younger parts of you
Process grief around aging and identity shifts
Develop boundaries that protect your energy
Reclaim sexuality and embodied presence
Integrate medical support (such as HRT) alongside psychological work

In my Oakland-based depth psychotherapy practice (serving clients throughout California via telehealth), I work with women who are highly sensitive, thoughtful, and often the caretakers of everyone else.

This season can feel disorienting.

It can also be sacred.

Perimenopause is not only a hormonal event. It is a psychological crossing.

And if you have a trauma history, it deserves to be approached with tenderness—not dismissal.