Have you ever found yourself wondering, "Why do I feel like a completely different person some weeks than others?"

Maybe your anxiety suddenly ramps up before your period. Maybe your patience disappears, your confidence plummets, or you feel overwhelmed by things you would normally handle with ease. Or perhaps you've entered perimenopause and no longer recognize your emotional reactions at all.

If this sounds familiar, you're not alone.

One of the most common things I hear from women is, "I just don't feel like myself anymore." They often worry that they're becoming more anxious, less resilient, or somehow "losing it."

The reality is that hormones and mental health are deeply connected.

Hormonal changes throughout the menstrual cycle—and especially during the transition into perimenopause and menopause—can influence mood, anxiety, sleep, emotional regulation, and even how we respond to everyday stress. That doesn't mean every emotional struggle is caused by hormones, but it does mean that understanding what's happening in your body can provide an important piece of the puzzle.

Because this is such an important and often overlooked topic, I invited Janet Melo-Thaiss, Registered Psychotherapist (MACP), and Jasmine Melo-Thaiss, Registered Social Worker (MSW), co-founders of Soul Tree Therapy, to share their expertise. Their practice specializes in supporting women through the emotional and psychological challenges associated with hormonal transitions. If you've ever wondered why your emotions seem to change with your cycle, or why you don't quite feel like yourself during perimenopause, the article below will help connect the dots.

Guest Article

Written by Janet Melo-Thaiss, Registered Psychotherapist (MACP), and Jasmine Melo-Thaiss, Registered Social Worker (MSW), Co-Founders of Soul Tree Therapy

Mental Health and Hormonal Health are Deeply Connected

Mental health is often discussed as though it exists independently from the body. We talk about anxiety, depression, emotional regulation, self-esteem, and relationships as psychological experiences, while hormonal health is relegated to a separate category altogether. Yet, for millions of people living with conditions such as PMDD, PMS, PME, PCOS/PMOS, endometriosis, and (peri)-menopause, this separation rarely reflects reality.

For these individuals, emotional well-being is deeply intertwined with hormonal fluctuations, reproductive health, chronic pain, and changing physiological states. Mood symptoms may follow predictable cyclical patterns: anxiety may intensify during certain phases of the menstrual cycle, depression may worsen during hormonal transitions, and emotional resilience can fluctuate in ways that seem confusing, inconsistent, or even alarming when viewed through a purely psychological lens. 

The Limitations of Traditional Psychotherapy

It’s important to note that traditional psychotherapy doesn’t always account for these experiences. Many people spend years wondering why some coping strategies work beautifully one week and seem completely ineffective the next. Others are told that their symptoms are because of stress, personality traits, or relationship problems, without consideration for the biological factors that may be influencing their emotional landscape. This is where cycle-aware psychotherapy offers something profoundly important: context.

What is Cycle-Aware Psychotherapy?

Cycle-aware psychotherapy recognizes that mental health doesn’t occur in isolation from hormonal and reproductive processes. Rather than viewing emotional symptoms as disconnected events, this approach considers how hormonal changes may influence mood, cognition, energy, behaviour, and relationships over time. Furthermore, it invites both therapist and client to look for patterns, not just problems.

Understanding PMDD Through a Cycle-Aware Lens

For someone living with Premenstrual Dysphoric Disorder (PMDD), for example, understanding the cyclical nature of their symptoms can be life-changing. PMDD is far more than “bad PMS,” it’s a severe hormone-sensitive condition that can trigger significant depression, anxiety, irritability, hopelessness, emotional overwhelm, and interpersonal conflict during the luteal phase of the menstrual cycle. Without awareness of these patterns, individuals often blame themselves for emotional reactions that feel uncontrollable. They may question their resilience, relationships, or even their sense of identity. When therapy incorporates cycle awareness, however, those experiences begin to make sense. The goal is not to dismiss emotions as “just part of hormones,” but rather to understand how hormonal sensitivity can amplify emotional experiences and influence mental health.

PME: When Existing Conditions Intensify

The same principle applies to Premenstrual Exacerbation, or PME, in which existing mental health conditions such as anxiety, depression, or ADHD worsen during specific phases of the menstrual cycle. In these cases, the challenge is not simply a recurring premenstrual mood shift; rather, it is that an already existing condition becomes significantly harder to manage due to hormonal influences. Recognizing this distinction can help clients stop interpreting cyclical symptom spikes as personal setbacks or evidence that treatment isn’t working.

Supporting Clients with PCOS/PMOS and Endometriosis

Cycle-aware psychotherapy is equally valuable for those navigating chronic reproductive health conditions. Individuals with Premenstrual Dysphoric Disorder (PMOS; formerly known as PCOS) often experience elevated rates of anxiety, depression, body image concerns, and self-esteem challenges. These emotional struggles may be influenced by hormonal imbalances, metabolic changes, fertility and weight concerns, and years of feeling misunderstood and dismissed by healthcare systems. Similarly, people living with endometriosis frequently carry the emotional burden of chronic pain, fatigue, medical trauma, delayed diagnoses, and disruption to daily life. When physical symptoms are minimized or dismissed, many clients are left feeling gaslit and ignored.

A cycle-aware psychotherapeutic approach understands that emotional suffering in these contexts can’t be separated from the lived experiences of managing a chronic health condition. Rather than treating emotional symptoms as unrelated concerns, therapy can create space to explore grief, frustration, identity changes, relationship challenges, and the impact of living in a body that may feel unpredictable or unsupported.

Navigating Perimenopause and Menopause

The need for this perspective is continually evident during perimenopause and menopause. Many individuals enter this stage of life surprised by the profound emotional changes they experience. Sleep disturbances, heightened anxiety, mood swings, irritability, brain fog, and depressive symptoms can emerge even in people with no significant prior mental health history. And yet, these experiences are often minimized as a normal part of aging, or are overlooked entirely within mental health treatment. 

A cycle-aware approach recognizes that hormonal transitions can affect emotional functioning in meaningful ways. It allows therapists and clients to explore not only symptom management, but also the broader questions that often arise during this stage of life: changes in identity, shifting family roles, evolving relationships, aging, and personal meaning-making. Therapy becomes a space where biological changes are acknowledged, not ignored. 

Reducing Shame Through Self-Understanding

Perhaps one of the greatest benefits of cycle-aware psychotherapy is the reduction of shame. Many clients arrive at therapy believing they’re inconsistent, overly emotional, irrational, or failing to cope effectively. They may feel frustrated by recurring patterns of behaviour they can’t explain. When symptom fluctuations are understood within the context of hormonal and reproductive health, self-blame often gives way to self-understanding and compassion. Clients can anticipate vulnerable periods, develop targeted coping strategies, communicate more effectively with loved ones, and advocate more confidently in healthcare settings.

A More Holistic Approach to Mental Health

Ultimately, cycle-aware psychotherapy reflects a more holistic understanding of mental health. It acknowledges that hormones, chronic illness, nervous system functioning, life stressors, relationships, trauma histories, and psychological processes are all constantly interacting with one another. It also recognizes that effective mental health care requires curiosity about the whole person, not just their symptoms.

For those living with PMDD, PMS, PMOS, PME, endometriosis, (peri)menopause, or other hormone-related conditions, feeling understood can be a transformative experience. When psychotherapy takes the body’s rhythms into account, it offers something many people have been missing for years: a framework that validates their experience, explains their patterns, and supports them in working with their biology rather than constantly fighting against it.

References

1. Anderlik, M., J. Eifert, M. Gander, A. Buchheim, and A. Karabatsiakis. 2026. “Menstrual Cycle Dynamics and Their Impact on Psychotherapy: Insights From a Mixed-Methods Study.” Clinical Psychology & Psychotherapy33, no. 1: e70237. https://doi.org/10.1002/cpp.70237.
2. Nayman S, Niedtfeld I, Lenz B, Karabatsiakis A, Schmahl C, Kuehner C. Menstrual Cycle Dynamics in Mental Health Demand New Approaches in Psychotherapy and Digital Health. Psychother Psychosom. 2026;95(3):250-252. doi: 10.1159/000548508. Epub 2025 Sep 18. PMID: 40966181.

About the Authors:

Soul Tree Therapy is a mother-daughter owned mental health clinic that specializes in supporting women through the unique emotional, psychological, and life challenges associated with hormonal health and ADHD. Founded and co-directed by Janet Melo-Thaiss, Registered Psychotherapist (MACP), and Jasmine Melo-Thaiss, Registered Social Worker (MSW), the clinic offers a compassionate, evidence-informed approach that recognizes the deep connection between mental health, physical health, and lived experience.

With specialized knowledge in conditions such as PMDD, PMS, PME, PCOS/PMOS, endometriosis, perimenopause, menopause, and ADHD, Soul Tree Therapy provides care that is both holistic and individualized. The clinic is particularly passionate about helping clients better understand the impact of hormonal fluctuations, chronic health conditions, neurodivergence, and life transitions on their emotional well-being, relationships, self-esteem, and daily functioning.

At Soul Tree Therapy, clients are met with empathy, validation, and practical support. The team integrates a range of evidence-based therapeutic approaches (i.e. ACT, EFT, IFS) to help individuals develop insight, build resilience, navigate challenges, and create meaningful, lasting change. 

Located in Markham, Ontario, Soul Tree Therapy offers both in-person counselling services and secure virtual/phone therapy for clients across Ontario, making specialized support accessible wherever clients are in their mental health journey

Disclaimer: The information provided on this blog is for educational and informational purposes only and is not intended as medical advice. Always consult with a qualified healthcare professional before making any changes to your health regimen. The content shared here is based on the author’s research and personal experiences, and individual results may vary. The author and blog are not responsible for any adverse effects or consequences resulting from the use of any suggestions, preparations, or procedures discussed on this site.