--- title: Does the menstrual cycle affect how well therapy works? | Niyora description: Yes. Women reported lower satisfaction with therapy and worse symptoms during the premenstrual and perimenstrual phases, but talking about their menstrual cyc url: https://niyora.com/research/papers/menstrual-cycle-dynamics-and-their-impact-on-psychotherapy-insights-from-a-mixed-2026/ --- - [Niyora](https://niyora.com/) - [Research](https://niyora.com/research/) - [Library](https://niyora.com/research/library/) - Does the menstrual cycle affect how well therapy works? Interview study, 2026 # Does the menstrual cycle affect how well therapy works? Yes. Women reported lower satisfaction with therapy and worse symptoms during the premenstrual and perimenstrual phases, but talking about their menstrual cycle in therapy helped. Moderate study design 425 women in therapy, mostly receiving cognitive-behavioral, psychodynamic, systemic, or humanistic therapy in outpatient settings ## What they did 425 women in therapy completed online surveys about their satisfaction, well-being, and menstrual cycle. They answered questions about how their symptoms changed across their cycle and how it affected their therapy. ## What they found Therapy satisfaction was lower during premenstrual and perimenstrual phases compared to other times. Women reported that symptoms got worse during these phases, which made them participate less in therapy and affected their thinking and mood. When they talked openly about the menstrual cycle in therapy, they felt it improved their treatment outcomes. ## What it means for you The menstrual cycle matters for therapy. Women may feel therapy is less helpful when symptoms are worse during their cycle, but discussing the cycle with their therapist can help. This was an online survey, so the results may not represent all women in therapy or in all therapy settings. 425 Women in therapy surveyed 35.5% Received cognitive-behavioral therapy ## About the study Original title Menstrual Cycle Dynamics and Their Impact on Psychotherapy: Insights From a Mixed-Methods Study Authors Anderlik M, Eifert J, Gander M et al. Journal Clinical psychology & psychotherapy Year 2026 Study design Interview study Participants 425 What was tested None, existing therapy clients surveyed Open access Yes Read the paper [doi.org/10.1002/cpp.70237](https://doi.org/10.1002/cpp.70237) Original abstract Despite substantial research on the physiological and psychological effects of the menstrual cycle (MC) on somatic and mental health, its impact on psychotherapy remains largely overlooked. Importantly, MC follows a recurring pattern of inflammatory activity. Emotional states, mood, cognitive functioning and sleep patterns fluctuate across the MC, affecting overall functioning and well-being. Additionally, hormonal shifts across the cycle are linked to the exacerbation of psychiatric symptoms, particularly in premenopausal women who exhibit heightened sensitivity to normal changes in sex steroid levels. However, MC-related hormonal fluctuations and inflammatory processes are rarely considered in psychotherapeutic settings. This exploratory mixed-methods study examined how MC-related fluctuations influence clients' psychotherapy experiences. In an online survey setting, a total of N = 425 female clients completed the Client Satisfaction Questionnaire-8 (CSQ-8) and the WHO Well-Being Index (WHO-5), alongside qualitative questions on symptom and therapy experiences. Most participants received cognitive-behavioural (35.5%), psychodynamic (14.4%), systemic (9.4%) or humanistic (6.8%) therapy, while 33.9% were unsure of their therapy orientation, mostly in outpatient settings. Quantitative findings revealed reduced therapy satisfaction during premenstrual and perimenstrual phases compared with other phases. Qualitative data highlighted symptom exacerbation during these phases, negatively affecting emotional states, therapeutic participation, cognitive functioning and perceptions of therapy's necessity and effectiveness. Participants reported that the open discussion of the MC in therapy improved treatment outcomes. They advocated for individualized consideration of MC-related factors in therapy planning. These findings underscore the need for more personalized clinical approaches that integrate MC-related dynamics into psychotherapy to optimize treatment outcomes. Reproduced under CC-BY. ## Topics [Cognition, concentration and memory](https://niyora.com/research/topics/symptom-cognition/)[Cognitive behavioral therapy](https://niyora.com/research/topics/treatment-cbt/)[Psychotherapy, counselling and education](https://niyora.com/research/topics/treatment-psychotherapy/)[Quality of life and daily functioning](https://niyora.com/research/topics/life-area-quality-of-life/) Research tells you what helps on average. Niyora helps on the day it hits. Calm down, see it another way, and decide what to say, with a PMS and PMDD app built by a doctor. ## Related studies Systematic review, 2025 Does teaching adolescent girls about their menstrual cycle and health help reduce period pain and PMS? Systematic review, 2026 Do digital tools and apps help reduce PMS and PMDD symptoms? Randomised trial, 2022 Does online counselling using cognitive-behavioral techniques help PMS symptoms? 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