The CYCLES Training Institute

Your clients' hormones are already shaping their mental health. Most of us were just never taught to see it.

PMS, PMDD (premenstrual dysphoric disorder), PME (premenstrual exacerbation) and perimenopause can all present as depression, anxiety, or emotional difficulties. They are frequently missed, and the cost to clients is real.

It is not a question of attention or care. Across the menstrual cycle and perimenopause, hormones shape mood, anxiety, cognition, and emotional regulation in ways that clinical training has rarely addressed. Lambert, Nolan and Schmalenberger (2026), writing in the British Journal of Clinical Psychology, the BPS's flagship practitioner journal, identify that clinical psychology training programmes generally lack content on cycle-sensitive assessment and treatment.

That is not a clinical failure. It is a training gap.

The CYCLES Institute exists to close it: the first structured clinical programme of its kind in the UK, covering menstrual cycle presentations, PMDD, PME, and perimenopause, developed through research with over 250 people living with PMDD and refined across three programme cohorts and ongoing clinical practice, in partnership with the International Association for Premenstrual Disorders (IAPMD).

Is this for you?

Most therapists are working with half the picture.

Think back to your training. Did anyone teach you about the menstrual cycle? Not briefly, not as a footnote. As something that shapes your clients' mood, anxiety, cognition, and emotional experience week to week, and that should shape how you assess, formulate, and intervene?

If you're like most practitioners, the answer is no. It wasn't in the curriculum. Nobody drew the connection.

Many women spend years in therapy without anyone connecting their emotional experience to their hormones. We can do better.

CYCLES is for psychologists, therapists, counsellors, and CBT practitioners registered with a recognised professional body, ready to close the gap their training left open.

Certified practitioners join the CYCLES Practitioner Directory and receive direct referrals from Helena's clinical network: clients already seeking someone trained specifically in their presentations.

About the CYCLES Framework

The CYCLES Framework was developed through research with over 250 people living with PMDD and refined across three programme cohorts and ongoing clinical practice, in partnership with the International Association for Premenstrual Disorders (IAPMD).

It integrates established psychological approaches, including CBT, DBT, ACT and CFT, which together represent the third wave of evidence-based therapies, alongside psychoeducation specific to hormonal and menstrual cycle presentations. Each brings distinct tools: CBT for thought and behaviour patterns, DBT for emotional regulation and distress tolerance, ACT for values-based living across the cycle, and CFT for addressing the self-blame and shame that so frequently accompany hormonal presentations. CBT is endorsed by NICE, the Royal College of GPs, and the RCOG as a core psychological approach for hormonal mental health difficulties.

In the first cohort, participants moved from the moderate-severe range to minimal on the BDI-II, a 17-point reduction, with improvements across wellbeing and anxiety measures too. A peer-reviewed paper is in progress.

CYCLES is an acronym capturing the six clinical domains at the heart of the framework.