What if counselling for premenstrual dysphoric disorder (PMDD) began not with a treatment plan, but with a question: what do people living with the condition actually need?
New Australian research explores this possibility through a psychotherapy program developed with people experiencing premenstrual distress.
Published on 10 July 2026 in Feminism & Psychology, the study examines how lived experience, self-compassion and creative therapeutic approaches can inform psychological support.
The research offers a promising direction for PMDD counselling, although further studies are needed to establish its effectiveness.
What did the researchers develop?
Researchers Megan Buys, Raquel Peel and Denise Buiten from the University of Notre Dame Australia developed a psychotherapy program through a process called co-design.
Rather than designing treatment solely from a clinical perspective, the researchers gathered people's experiences and preferences to help shape the program.
It addresses three forms of premenstrual distress:
Premenstrual syndrome (PMS): Physical and emotional symptoms occurring before menstruation.
Premenstrual dysphoric disorder (PMDD): A severe cyclical condition involving significant emotional and psychological symptoms.
Premenstrual exacerbation (PME): When symptoms of an existing condition worsen before menstruation.
The program combines person-centred counselling, elements of Internal Family Systems (IFS) therapy and creative activities such as body mapping.
IFS explores different emotional responses, sometimes understood as parts of ourselves, while body mapping uses artwork to express physical and emotional experiences that may be difficult to describe in words.
Participants attended five fortnightly therapy sessions following an introductory appointment.
What did the study find?
The published paper describes the program's development and uses one participant's experience to illustrate the therapeutic process.
The participant, who had previously received a PMDD diagnosis, explored experiences of anxiety, self-criticism and disconnection from her body.
Through counselling and creative activities, she described developing a more compassionate and connected understanding of herself and her menstrual experiences.
These observations are meaningful, but a single case study cannot establish whether the treatment reduces PMDD symptoms or works better than existing therapies.
The paper was primarily intended to explain the program's development and structure, not formally test its effectiveness.
How does this compare with existing PMDD treatments?
Cognitive behavioural therapy (CBT) has a more established research base for premenstrual disorders.
A 2017 Australian randomised controlled trial found that individual and couples-based CBT helped reduce premenstrual symptoms and distress while improving coping.
By comparison, the new program explores approaches that have received less research attention in this context, particularly Internal Family Systems therapy and body mapping.
These approaches may offer additional ways of understanding premenstrual experiences, but they require further evaluation.
Why does this research matter?
PMDD affects far more than mood. Its effects can extend into relationships, work, self-esteem and a person's sense of identity.
For people who have experienced misunderstanding or dismissal when seeking healthcare, feeling heard and respected can be particularly important.
This research highlights a valuable principle: people living with PMDD should have a meaningful role in shaping the care they receive.
Psychological treatment can support emotional wellbeing, relationships and coping alongside appropriate medical care. It should also recognise the individual circumstances, preferences and experiences of each person.
The next step is to determine whether this new program produces measurable improvements across a larger and more diverse group of participants.
For now, the research contributes to a broader conversation about making PMDD care more collaborative, compassionate and responsive to lived experience.
PMDD counselling and support
At Progressive Therapeutic Counselling, we recognise that living with PMDD can affect your emotional wellbeing, relationships and everyday life.
We offer compassionate, gender-affirming counselling that takes your experiences seriously and works collaboratively with you to understand your needs.
Explore PMDD and menstrual health counselling at Progressive Therapeutic Counselling.
Further information and crisis support
If you are experiencing significant distress or suicidal thoughts, support is available.
Lifeline Australia: 13 11 14, available 24 hours.
International Association for Premenstrual Disorders: iapmd.org.
Immediate danger: Call 000.
Original research
Buys, M., Peel, R., & Buiten, D. (2026). Mapping the Body, Meeting the System: The Development of a Codesigned Psychotherapy Programme for Premenstrual Change. Feminism & Psychology.
https://doi.org/10.1177/09593535261464231
Additional research: Ussher, J. M., & Perz, J. (2017). Evaluation of the relative efficacy of a couple cognitive-behaviour therapy (CBT) for Premenstrual Disorders (PMDs), in comparison to one-to-one CBT and a wait list control: A randomized controlled trial. PLOS ONE.
https://doi.org/10.1371/journal.pone.0175068
Disclaimer: This article is for general education and does not replace individual medical advice, diagnosis or treatment. Counselling may complement medical treatment for PMDD, but therapeutic approaches should be tailored to individual needs and supported by appropriate clinical care.