Women experience addiction and recovery within biological cycles and social responsibilities that shape risk, access, and outcomes. Women’s Mental Health and SUD centers care on the reproductive timeline—menarche, preconception, pregnancy, postpartum, perimenopause—and the realities of childcare, intimate partner violence, economic precarity, and stigma. Assessment maps use patterns (alcohol, opioids, stimulants, nicotine), co-occurring depression/anxiety/PTSD, sleep disruption, pain syndromes, and endocrine shifts. We align pharmacotherapy with life stage: MOUD during pregnancy with dose adjustments across trimesters; alcohol pharmacotherapies chosen for hepatic status and breastfeeding plans; nicotine treatment calibrated for sleep and mood. Contraception and drug–drug interactions matter—enzyme inducers can alter hormonal methods—so we pair prescribing with reliable family-planning options. Trauma-informed care is standard: privacy, consent, and language that avoids shame; safety screening and rapid IPV referrals; and flexible scheduling that recognizes caregiving loads. Psychotherapies blend contingency management, CBT/ACT skills, and brief couple/family sessions that share the cognitive load across the household. Postpartum pathways address sleep fragmentation, lactation plans, relapse risk, and depression screening with fast access to supports. For perimenopause, we discuss vasomotor symptoms, sleep and mood volatility, and how these changes interact with craving and medication tolerability. Equity is operational: childcare vouchers, transportation, tele-flex options, and bilingual peer support; outreach to incarcerated or recently released mothers; and collaboration with obstetrics, pediatrics, and primary care. Measurement focuses on days of non-use, cravings, sleep, lactation goals, safety events, and “connection minutes” with supportive people. Done well, Women’s Mental Health and SUD, shared strategies from a women and addiction conference, and practical perinatal pathways like perinatal substance use convert barriers into durable, family-centered recovery.