The Sirona Health Podcast: PMDD, Hormones & Mental Health

Dr Georgina Standen
  • 5.0 (1)
  • Mental Health

Evidence-based conversations about PMDD, PMS, perimenopause, menopause and women’s mental health, hosted by GP Dr Georgina Standen. Translating the latest research into clear, practical explanations to help you understand how hormones interact with the brain, mood and wellbeing.

  1. 12 hr ago

    Therapy for PMDD: Does CBT, DBT or ACT Actually Help?

    Can therapy help premenstrual dysphoric disorder (PMDD)? In this episode, Dr Georgina Standen, GP and founder of Sirona Health, looks at what the evidence says about CBT, DBT, ACT and self-compassion for PMDD. PMDD is a biological, hormone-sensitive condition, so why would talking therapies help? We start with that question, and why therapy works alongside medical treatment rather than instead of it. In this episode: The evidence for CBT in PMDD, including internet-delivered CBT, and why the RCOG and ACOG both recommend it for severe premenstrual symptomsWhere standard CBT can fall short, and why emotion regulation and relationships matter so much in PMDDHow dialectical behaviour therapy (DBT) skills map onto PMDD symptoms, and why they’re best learned in the follicular phaseWhat acceptance and commitment therapy (ACT) offers, and how early the evidence isWhy self-compassion is one of the strongest protective factors we have evidence for, and what it looks like in practiceTherapy can’t stop your hormones fluctuating. What it can do is change how understandable and manageable that fluctuation feels, month after month. The Sirona Health Podcast is hosted by Dr Georgina Standen, GP and founder of Sirona Health, a specialist women's health practice. Further information: sironahealth.co.uk  This podcast is for general information only and doesn't replace individual medical advice — please speak to your GP or a specialist about your own symptoms. If you're struggling, please reach out for support.

  2. 12 Oct

    How SSRIs, SNRIs and Quetiapine Fit Into PMDD Treatment

    SSRIs can work within days for PMDD, not the weeks it usually takes for depression — and that speed tells us something real about the condition itself. In this episode, Dr Georgina Standen explains how SSRIs and SNRIs actually work for PMDD, why medication doesn't suit everyone the same way, and what happens when none of it is quite enough. In this episode: Why SSRIs can work within days for PMDD, and the luteal-phase-only dosing option that doesn't exist for standard depression treatmentThe real trade-off with cyclical dosing — and why continuous use lets early side effects settle in a way that restarting each month doesn'tWhy SSRIs are non-contraceptive, unlike every hormonal option covered so far — and what that means if you're trying to conceiveChoosing between SSRIs based on the 2025 Lancet data on weight, heart rate and blood pressure — and when an SNRI makes more senseWhy medication doesn't work the same for everyone, and what your genes have to do with itThe stigma that keeps women from accessing the most effective treatment for them — and the real cost of that reluctanceWhat happens when none of this is enough — an honest look at quetiapine for treatment-resistant PMDDThe Sirona Health Podcast is hosted by Dr Georgina Standen, GP and founder of Sirona Health, a specialist women's health practice. Further information: sironahealth.co.uk  This podcast is for general information only and doesn't replace individual medical advice — please speak to your GP or a specialist about your own symptoms. If you're struggling, please reach out for support.

  3. 5 Oct

    PMDD treatment: GnRH analogues

    A landmark study using this exact medication was one of the first to prove PMDD is genuinely hormonal, not psychological. In this episode, Dr Georgina Standen explains GnRH agonists and antagonists — medication that switches off ovulation entirely — how they're used for treatment-resistant PMDD, and why the research on long-term ovarian suppression from other conditions tells us so much about using them safely. In this episode: How GnRH agonists and antagonists actually work — and why the same tool used to treat severe PMDD is also the tool that first proved it's realReal response rates for treatment-resistant PMDD — and an honest look at the roughly 30% who don't respond even to thisWhy endometriosis and fibroid research does so much of the heavy lifting behind how these medications are used for PMDDWhy "add-back" hormone therapy isn't optional — and what the research on primary ovarian insufficiency tells us about the real, long-term stakes of getting this wrongWho this treatment genuinely suits, and why it's not a first-line optionThe Sirona Health Podcast is hosted by Dr Georgina Standen, GP and founder of Sirona Health, a specialist women's health practice. Further information: sironahealth.co.uk  This podcast is for general information only and doesn't replace individual medical advice — please speak to your GP or a specialist about your own symptoms. If you're struggling, please reach out for support.

  4. 28 Sept

    Hormonal treatments for PMDD: Beyond the combined contraceptive pill

    Not every woman can take the combined pill — and not everything that's commonly prescribed for PMDD actually has the evidence behind it. In this episode, Dr Georgina Standen goes beyond the combined pill into transdermal oestrogen, progesterone taken alone, and Slynd — and is honest about which of these genuinely has trial evidence, and which is more contested than it might appear. In this episode: Transdermal oestrogen plus a progestogen — the lesser-known option with real trial evidence behind it, and why it isn't for everyoneWhy this approach can be a particularly good fit for PMDD that worsens in perimenopause, and why it can continue well past age 50 in a way the pill can'tProgesterone taken alone — a genuine, ongoing disagreement in the field, and an honest look at what the trial evidence actually showsSlynd, the progestin-only option — why it's theoretically promising but still unproven for PMDD specificallyA specific combination worth knowing about for perimenopausal women also dealing with menstrual migrainesThe Sirona Health Podcast is hosted by Dr Georgina Standen, GP and founder of Sirona Health, a specialist women's health practice. Further information: sironahealth.co.uk  This podcast is for general information only and doesn't replace individual medical advice — please speak to your GP or a specialist about your own symptoms. If you're struggling, please reach out for support.

  5. 21 Sept

    The Pill for PMDD: What It Actually Is, and Which One Has the Evidence

    Three pills. Three progestins. Three very different reasons a woman ends up on one and not another. In this episode, Dr Georgina Standen properly unpacks "the pill" for PMDD — what actually separates one formulation from the next, which one has the real evidence behind it, and why the way you take it can matter as much as which one you choose. In this episode: What "the pill" actually means — and why the progestin, not the oestrogen, is where most of the real differences liveThe evidence for drospirenone specifically — and the honest admission that it still only works for around half of womenWhy the traditional 21-day, 7-day-break pattern can actively work against you with PMDD, and what running pills continuously changesWhat actually happens to your bleeding on the pill — and the myths circulating online that put women off a treatment that could helpZoely, and why swapping in a natural oestrogen might matter for some womenThe Sirona Health Podcast is hosted by Dr Georgina Standen, GP and founder of Sirona Health, a specialist women's health practice. Further information: sironahealth.co.uk  This podcast is for general information only and doesn't replace individual medical advice — please speak to your GP or a specialist about your own symptoms. If you're struggling, please reach out for support.

  6. 31 Aug

    Brain Fog in Menopause: What's Actually Happening in Your Head

    Walking into a room and forgetting why. Losing a word mid-sentence. Reading the same paragraph three times. In this episode, Dr Georgina Standen properly unpacks brain fog — what it actually is, what's driving it, and answers the question sitting underneath almost every conversation about it: does this mean something worse is coming? In this episode: What brain fog actually clusters around — and why part of it looks more like an attention problem than a memory problemThe honest answer to "is this dementia" — and the reasoning behind it, not just reassuranceThe evidence for a real, causal hormonal mechanism, from studies where memory dipped and recovered as oestrogen was removed and restoredThe three "amplifiers" that actually drive brain fog day to day — hot flushes, sleep, and mood — and why treating those is often where real improvement comes fromWhere HRT does and doesn't fit, and why the evidence on dementia prevention specifically is still genuinely unresolvedThe Sirona Health Podcast is hosted by Dr Georgina Standen, GP and founder of Sirona Health, a specialist women's health practice. Further information: sironahealth.co.uk  This podcast is for general information only and doesn't replace individual medical advice — please speak to your GP or a specialist about your own symptoms. If you're struggling, please reach out for support.

  7. 24 Aug

    Menopause and Your Mental Health

    Why do so many women feel like their mental health suddenly changes in their forties and fifties, often without any obvious trigger? In this episode, Dr Georgina Standen applies everything this series has built so far — hormone sensitivity, DASH-MC, reproductive depression — to perimenopause specifically, and explains why this transition is so often missed, dismissed, or misdiagnosed. In this episode: The clinical pattern that shows up again and again: a history of PMS, PMDD, postnatal depression or a rocky relationship with the pill, now resurfacing in a new formWhy perimenopause isn't simply hormonal decline, but volatility — and why that's what actually destabilises a sensitive brainThe real numbers: a 30% rise in major depressive disorder, a doubling of bipolar incidence, and higher anxiety rates during perimenopause specifically"Diagnostic overshadowing" — why menopausal symptoms so often get treated as a purely psychological problemWhy sleep is so often the hidden driver behind anxiety at this life stageWhy standard HRT isn't a universal fix, and what a properly personalised approach actually looks likeThe Sirona Health Podcast is hosted by Dr Georgina Standen, GP and founder of Sirona Health, a specialist women's health practice. Further information: sironahealth.co.uk  This podcast is for general information only and doesn't replace individual medical advice — please speak to your GP or a specialist about your own symptoms. If you're struggling, please reach out for support.

  8. 17 Aug

    Why Do Some Women Get PMDD and Others Don't? The Genetics Behind It

    If two women have identical hormone levels but completely different experiences of their cycle, what's actually different between them? In this episode, Dr Georgina Standen goes back a step further than hormones themselves, into the genetics and cell biology behind why some brains are wired to be more hormone-sensitive than others. In this episode: The classic hormone-suppression study that proved PMDD isn't about hormone levels at allWhat twin studies tell us about how much of PMDD is inheritedThe specific genes researchers keep finding — ESR1, a serotonin receptor gene, and GABRB2The cellular research showing PMDD cells respond differently to hormones at a genetic level, right down to a mismatch between gene instructions and the protein actually producedWhy understanding the mechanism explains why treatment isn't one-size-fits-allThe Sirona Health Podcast is hosted by Dr Georgina Standen, GP and founder of Sirona Health, a specialist women's health practice. Further information: sironahealth.co.uk  This podcast is for general information only and doesn't replace individual medical advice — please speak to your GP or a specialist about your own symptoms. If you're struggling, please reach out for support.

See All (16)

About

Evidence-based conversations about PMDD, PMS, perimenopause, menopause and women’s mental health, hosted by GP Dr Georgina Standen. Translating the latest research into clear, practical explanations to help you understand how hormones interact with the brain, mood and wellbeing.

Information

You Might Also Like