In need of adaptation: The intersecting role of adaptive capacity and demands during the Menopausal Transition on psycho-cognitive wellbeing.

The menopause transition involves physiological changes that may intersect with changes in identity, social roles, and relationships, as well as pressures related to ageism and sexism. These interacting demands provide a basis for considering cognitive and emotional experiences through the relationship between adaptive demands and available resources. We propose adaptive capacity as an organizing framework encompassing the physiological, psychological, interpersonal, and contextual resources that individuals may mobilize or access during this transition. This framework recognizes diverse menopausal experiences and considers how accumulating or persistent demands may give rise to different adaptive needs. It also draws attention to the resources required to engage with existing treatments and health-related behaviors. We discuss two complementary candidate processes: vagal regulation, relevant to physiological regulation and recovery, and future time perspective, relevant to perceived future opportunities, motivation, and goal-directed action. Breathing-based approaches and interventions supporting future opportunities and planning may offer ways to strengthen resources alongside existing care. Longitudinal and intervention studies are needed to establish their contribution to adaptation during the menopause transition. This framework supports integrated, person-centered, and empowerment-oriented care that combines individualized support with attention to the social and structural conditions shaping access to adaptive resources.