Menstrual Cycle Informed Psychotherapy: Preliminary Findings in Women with Spider Phobia.

Gianna Zorzini, Patricia Patra Ritter, Gianandrea Pallich, Ursula Galli, Ulrike Ehlert, Susanne Fischer

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Article in Psychotherapy and psychosomatics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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Authors and funding

6 authors.

Gianna ZorziniInstitute of Psychology, Clinical Psychology and Psychotherapy, University of Zurich, Zürich, Switzerland, g.zorzini@psychologie.uzh.ch.

Patricia Patra RitterInstitute of Psychology, Clinical Psychology and Psychotherapy, University of Zurich, Zürich, Switzerland.

Gianandrea PallichInstitute of Psychology, Clinical Psychology and Psychotherapy, University of Zurich, Zürich, Switzerland.

Ursula GalliInstitute of Psychology, Clinical Psychology and Psychotherapy, University of Zurich, Zürich, Switzerland.

Ulrike EhlertInstitute of Psychology, Clinical Psychology and Psychotherapy, University of Zurich, Zürich, Switzerland.

Susanne FischerInstitute of Psychology, Clinical Psychology and Psychotherapy, University of Zurich, Zürich, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAnxiety disorders are the most frequent mental disorders worldwide. Although exposure therapy is the gold-standard treatment for anxiety disorders, almost half of patients fail to achieve sufficient improvements. While much has been learned about for whom psychotherapy works and why, far less is understood about when it works. Emerging evidence indicates that estradiol and progesterone may affect fear extinction, yet studies examining the effects of menstrual cycle phase on exposure therapy outcomes remain lacking. This study was the first to investigate to what extent biologically informed menstrual cycle phase affects exposure therapy outcomes in women with spider phobia.

methodN = 45 women with spider phobia in (1) the early to mid-follicular phase, (2) the mid-luteal phase, or (3) using hormonal contraceptives (HC), participated in a group-based exposure therapy. Symptoms were assessed at baseline, 1-week post-therapy, and at 12-14 weeks follow-up, using the Spider Phobia Questionnaire (SPQ), the Fear of Spiders Questionnaire (FSQ), and a behavioral approach test (BAT).

resultsBoth phobic fear and avoidance behavior improved significantly over time. Although improvement did not differ between menstrual cycle groups, higher progesterone levels on the day of exposure therapy were associated with less improvement in behavioral avoidance.

conclusionThe present findings provide preliminary evidence that ovarian hormones on the day of exposure therapy may affect exposure-based outcomes, particularly reductions in behavioral avoidance. More research in larger samples is needed to further investigate menstrual cycle phase effects in exposure-based treatment. If replicated, the findings would attest to the potential of bio-rhythm informed psychotherapy.

Indexed as

EstradiolExposure therapyMenstrual cycleOvarian hormonesPhobiaProgesterone

Identifiers

PMID42700422

DOI10.1159/pps/aemag012

PMCPMC13688526

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Textmetadata

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.