PMS, PMDD & Hormonal Mental Health Care

Specialist Care For Cyclical Hormonal Health

Hormonal health is too often oversimplified.

For many women, cyclical hormonal change is not just “PMS,” nor is perimenopause simply a few hot flushes and irregular periods. Hormonal shifts can profoundly affect mood, cognition, nervous system regulation, sleep, relationships, sexuality, and quality of life.

At Spiced Pear Health, we understand that symptoms do not happen in isolation.

For many women, PMS, PMDD, perimenopause, and menopause intersect with trauma histories, neurodivergence, chronic illness, autonomic dysfunction, hypermobility, mast cell activation, sexuality, and years of not being properly heard.

We offer specialist, evidence-based, trauma-informed care that takes the whole person seriously.

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Pricing

Whole-Person Assessment

Careful, longitudinal review of cyclical patterns, trauma history, neurodivergence, and overlapping physical presentations, not a 10-minute checklist.

Evidence-Based Practice

Following NAPS, RCOG Green-top, BMS and IAPMD frameworks, combined with genuine awareness of lived experience.

Trauma-Informed

Care that takes the whole person seriously, recognising how trauma, sensitivity and masking shape hormonal experience.

Our Clinical Approach

At Spiced Pear Health, we combine lived experience awareness with evidence-based medicine, following recognised guidance including National Association for Premenstrual Syndromes (NAPS), Royal College of Obstetricians and Gynaecologists (RCOG), British Menopause Society (BMS), and International Association for Premenstrual Disorders (IAPMD) frameworks.

This means moving beyond dismissal, fragmentation, or “normal blood tests.”

Because symptoms deserve context — not minimisation.

We focus on:

Careful assessment of cyclical patterns
Accurate diagnosis of PMS, PMDD, PME (Premenstrual Exacerbation), perimenopause, and menopause
Understanding the role of trauma, nervous system sensitivity, and neurodivergence
Recognition of overlapping presentations including ADHD, autism, hypermobility, POTS/autonomic dysfunction, migraine, and MCAS
Sexual and relational wellbeing
Individualised treatment planning

PMS & PMDD: More Than “Bad Periods”

PMDD is a severe cyclical neurohormonal disorder in which normal hormonal fluctuations can trigger significant psychological, emotional, and physical symptoms.

Symptoms may include:

Severe mood changes
Anxiety or panic
Depression or hopelessness
Rage or irritability
Sensory overwhelm
Executive dysfunction
Sleep disruption
Pain, bloating, headaches, or fatigue
Relationship distress

For some women, PMDD can feel like losing themselves every month.

Diagnosis requires careful symptom tracking across at least two cycles to establish cyclical patterning and distinguish PMDD from depression, anxiety, bipolar disorder, or PME.

Neurodivergence, Trauma & Hormonal Sensitivity

We recognise the growing evidence that ADHD and autism may increase vulnerability to cyclical hormonal distress, sensory amplification, and emotional dysregulation.

Many women presenting in midlife may never have had their own neurodivergent diagnosis, but may begin recognising patterns in themselves after their children are diagnosed.

Hormonal transitions can also unmask long-standing trauma adaptations or collapse masking strategies.

This matters.

At Spiced Pear Health, we understand that hormonal care may need to account for:

ADHD / autism traits
Trauma histories
Sensory processing differences
Chronic stress and burnout
Hypermobile syndromes
POTS / autonomic dysfunction
Mast cell activation symptoms

Your body is not fragmented, and your care should not be either.

Our Treatment Options

In line with NAPS and RCOG Green-top guidance

Treatment is always individualised and depends on symptom severity, reproductive stage, medical history, and personal preference.

Lifestyle & Foundational Interventions

Psychoeducation
Symptom and cycle tracking
Sleep optimisation
Exercise and movement strategies
Nutritional support
Stress regulation and nervous system support
CBT-based interventions
Trauma-informed psychological therapies where indicated

Medical Treatments

SSRIs (continuous or luteal phase dosing, depending symptom profile)
Combined hormonal contraception (including ovulation suppression strategies)
Transdermal oestrogen with cyclical or continuous progestogen where clinically appropriate
GnRH analogue therapy for severe or treatment-resistant PMDD (with add-back hormone therapy where indicated)
Specialist menopause hormone therapy for perimenopause/menopause
Vaginal oestrogen and genitourinary support
Non-hormonal alternatives where HRT is contraindicated or not preferred

Specialist & Surgical Pathways (for carefully selected severe cases)

Referral for multidisciplinary specialist care
Complex psychosexual support
Menopause after cancer support
Surgical menopause support
In rare, severe, treatment-resistant PMDD cases: specialist discussion of oophorectomy in accordance with national guidance

What Makes Spiced Pear Health Different?

We believe women deserve:

To be listened to
To be accurately informed
To understand their options
To receive care that respects both science and lived experience

We do not believe in:

“It’s just stress”
“Your bloods are normal”
“Come back when it gets worse”
“You just need to cope”

Begin With Clarity

If you are living with cyclical mood changes, PMDD, worsening perimenopause, hormonal distress after cancer, or complex overlapping symptoms, you deserve specialist care that understands the bigger picture.

Spiced Pear Health offers thoughtful, evidence-based, trauma-informed support for women navigating hormonal change in all its complexity.

Because hormones do not happen in a vacuum.
They happen in bodies, brains, relationships, and lives.

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Our Menopause Consultation Services

Initial Consultation

£ 315

50 minute initial consultation. During the initial consultation...

We will provide you with a personalised care plan which you may share with your GP, if you wish
We may recommend some diagnostic tests are required, which we or your GP can arrange
We decide with you on a course of treatment (eg. HRT) and, if you request, we will provide you with a prescription
We decide together if you would benefit from additional support and refer you to a specialist. These could include pelvic health physios, psychological support or nutritional review

Book Consultations

Review Consultations

£ 200

Ongoing 30-minute review consultations, for those who have received an initial consultation

You have the opportunity to discuss how you are responding to our treatment advice. A chance to discuss any aspect of your health
Any number of further 30-minute review consultations can be booked by you thereafter to discuss any aspects of your health
Patients who wish to recieve ongoing prescriptions from us will be required to attend one review consultation annually