“ I can’t completely run free ”: exploring menstruality for female clients working with male psychotherapists

Little is known about how psychotherapy can support women across their menstrual cycle, as this topic remains largely absent from theory, research, and practice. The existing literature illuminates why, demonstrating how predominantly male-authored knowledge has historically marginalised and psychopathologised menstruation in Western society. To centre female voices, this study uses Interpretative Phenomenological Analysis, to examine how women experience their menstrual cycle during psychotherapy with a male therapist. The study design involved semi-structured interviews with five female participants at four estimated points across participants’ self-identified menstrual cycle phases, providing a holistic perspective on“menstruality”, in contrast to research that focuses only on menstruation. Each participant’s data were analysed individually and then comparatively. Three group experiential themes emerged, each with subthemes: (1) “No shit, Sherlock”; (2) “My religion” (3), “I can’t completely run free”. One integrative theme, “Confronting the Madonna–Whore Complex”, captured latent meaning. Overall, the analysis highlighted how, for the participants, issues of gender, sexuality, and power emerged within psychotherapy with a male therapist. Participants expressed a desire for a more non-psychopathologising narrative that considers menstruality as a potential source of psychological meaning, while recognising that its significance is subjectively experienced. While limited to a small, idiographic sample, the findings suggest the value of therapists phenomenologically engaging with menstruality as part of lived experience within collaborative, non-oppressive psychotherapeutic spaces. The findings also invite greater consideration of menstruality and gendered embodiment within therapist education, supervision, and clinical practice.