--- title: How does the menstrual cycle affect women's experience of therapy? description: Women reported less satisfaction with therapy during their premenstrual and perimenstrual phases compared to other phases of their cycle. When therapists disc url: https://niyora.com/research/papers/the-influence-of-menstrual-cycle-related-processes-on-clients-psychotherapy-2025/ --- - [Niyora](https://niyora.com/) - [Research](https://niyora.com/research/) - [Library](https://niyora.com/research/library/) - How does the menstrual cycle affect women's experience of therapy? Interview study, 2025 # How does the menstrual cycle affect women's experience of therapy? Women reported less satisfaction with therapy during their premenstrual and perimenstrual phases compared to other phases of their cycle. When therapists discussed the menstrual cycle openly, women felt their treatment worked better. Moderate study design 425 women who were currently in therapy ## What they did A mixed-methods study surveyed 425 women in therapy and asked them about the importance of their menstrual cycle to their therapy experience. The survey included both numerical ratings and detailed open-ended questions about their experiences. ## What they found Women reported reduced satisfaction with therapy sessions during their premenstrual and perimenstrual phases. During these phases, they experienced worsening of symptoms, emotional state, therapy participation, and thinking ability, and they doubted whether therapy was helping. When the menstrual cycle was discussed in therapy, treatment outcomes improved. ## What it means for you Therapists may be able to help women more effectively by considering how the menstrual cycle affects mood, thinking, and emotional wellbeing. The study is exploratory and involves women already in therapy, so the results may not apply to everyone or to therapy settings that do not discuss the menstrual cycle. 425 women in therapy surveyed ## About the study Original title The influence of menstrual cycle-related processes on clients’ psychotherapy experience: results from an exploratory mixed-methods study Authors Marie Anderlik, Alexander Karabatsiakis Year 2025 Study design Interview study Participants 425 What was tested Open discussion of the menstrual cycle in therapy Open access Yes Read the paper [doi.org/10.31219/osf.io/eus2y_v1](https://doi.org/10.31219/osf.io/eus2y_v1) 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. The menstrual cycle 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 have been 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, if at all, considered in psychotherapeutic settings. This exploratory study provides initial insight into the impact of MC-related fluctuations on clients’ psychotherapy experiences. Employing a mixed methods approach, this investigation surveyed N=425 female therapy clients for their evaluation of the importance of MC in the context of psychotherapy. Quantitative findings revealed reduced satisfaction with therapy sessions during premenstrual and perimenstrual phases compared to 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. This study highlights the MC as a critical example of how biological and clinical perspectives can enhance psychotherapeutic practices and calls for further research in this underexplored area. Reproduced under CC-BY. ## Topics [Cognition, concentration and memory](https://niyora.com/research/topics/symptom-cognition/)[Psychotherapy, counselling and education](https://niyora.com/research/topics/treatment-psychotherapy/) 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? Review, 2024 What are the most effective treatments for PMDD? Systematic review, 2021 Can cognitive behavioral therapy treat PMS without medication? Systematic review, 2012 How effective are cognitive-behavioral therapy and antidepressants for PMS and PMDD? Systematic review, 2026 What types of talking therapy have been studied for PMS and PMDD? Systematic review, 2026 Do digital tools and apps help reduce PMS and PMDD symptoms? 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