The menstrual cycle has long been associated with physical symptoms—cramps, bloating, fatigue—but its psychological influence often gets sidelined or misunderstood. In truth, hormonal fluctuations throughout the cycle can shape how we think, feel, and process the world. For many, this means mood shifts before a period, anxiety mid-cycle, or foggy thinking during menstruation. Fortunately, a growing number of mental health professionals are beginning to take this seriously.

What is Cycle-Informed Therapy?

Cycle-informed therapy is an emerging approach in which therapists and coaches consider a client’s menstrual cycle when tailoring treatment plans. This doesn’t mean reducing mental health to hormones—it means adding a layer of context. Understanding where someone is in their cycle can help explain emotional resilience, sensitivity, focus, or even motivation changes.

A recent study in Women & Therapy highlighted that more practitioners are recognizing the value of cycle tracking in clinical settings. While confidence in applying this knowledge varies, the shift is underway (Stotz & Brand, 2025). This growing awareness supports a more holistic, personalized kind of care, especially for those who menstruate and feel like their moods don’t follow a one-size-fits-all model.

Hormones and Mental Health: What’s Really Going On?

Three key hormones influence the emotional ebb and flow throughout the menstrual cycle:

• Estrogen rises in the first half of the cycle and tends to boost mood, energy, and even memory.
• Progesterone dominates in the second half, and its calming effects can shift into irritability or anxiety when it drops before menstruation.
• Serotonin, the brain’s “feel-good” chemical, often fluctuates alongside estrogen. Lower levels premenstrually can contribute to mood dips or increased emotional sensitivity.

Understanding these shifts isn't about blaming hormones—it's about being equipped with the full picture. For people who feel like their anxiety intensifies before their period, or they lose mental sharpness during menstruation, there’s now a framework that validates those experiences.

How Therapists Are Adapting

Cycle-informed therapy doesn’t require clients to overhaul their care—it integrates seamlessly with existing modalities like CBT, DBT, or mindfulness-based approaches. Here’s how some professionals are incorporating menstrual awareness into mental health support:

• Tracking cycle patterns alongside mood logs to identify trends and triggers.
• Adjusting session goals based on the cycle phase (e.g., exploring emotions more deeply during the premenstrual phase, focusing on planning or decision-making during the follicular phase).
• Validating emotional shifts as biological, not personal failings—reducing shame or self-blame.
• Timing interventions—like exposure therapy or behavior activation—during phases when resilience is naturally higher.

Practical Tips for Clients and Practitioners

If you're interested in cycle-informed mental health care, whether as a client or a professional, here are some supportive starting points:

• Use a cycle tracking app, like Obie, or journal to note physical and emotional symptoms throughout the month.
• Reflect on patterns: Are there days when you consistently feel more anxious, withdrawn, or overwhelmed?
• Bring this data into therapy sessions—it can open up meaningful conversations and create more tailored care plans.
• Practitioners should seek continuing education on hormonal mental health to build confidence in applying these insights.
• Consider collaborating with healthcare providers if symptoms are severe—sometimes, underlying issues like PMDD (premenstrual dysphoric disorder) are at play.

Why It Matters

Mental health doesn’t happen in a vacuum. It’s shaped by biology, environment, lived experiences—and yes, by hormones. When therapy acknowledges the full complexity of someone’s emotional landscape, including their cycle, it becomes more compassionate and effective. By weaving menstrual awareness into the therapeutic process, we honor a key part of many people’s lived realities.

Source: 
 Stotz, T., & Brand, R. M. (2025). Mental Health and the Menstrual Cycle: Practitioner Attitudes, Confidence, and Practice. Women & Therapy, 1–20. https://doi.org/10.1080/02703149.2025.2459956