Therapy for PMDD,
Perimenopause
& Menopause
You’re getting through the day, but it’s taking more out of you.
A small disagreement turns into a conversation you keep replaying. You need quiet, but everyone needs something from you. You’re getting things done, yet your patience, energy, or confidence feels different—and you’re tired of wondering why.
Maybe you notice a pattern around your period. Maybe changes have been building gradually, and you’re wondering whether perimenopause is part of the picture. You may already have a diagnosis and still feel unsure how to manage what’s happening in your everyday life.
I offer therapy for women navigating the emotional and relationship challenges of PMDD, perimenopause, and menopause. We’ll take your concerns seriously, look closely at your experience, and work together on support that fits your life.
Book a free 15-minute consultationYou don’t have to put it all into words before we begin.
PMDD: when part of the month feels especially hard
You may recognize the shift before you have words for it. Your thoughts become more self-critical. Things you could usually let go of feel upsetting or urgent. You want reassurance or closeness, but also need everyone to leave you alone.
Then, when things ease, you may be left feeling guilty about what you said, questioning whether it was “really that bad,” or worrying about the next cycle.
In therapy, we can work on:
- Recognizing your patterns without dismissing every concern as “just PMDD.”
- Planning for difficult days before you’re already overwhelmed.
- Responding to harsh thoughts without getting pulled into every one.
- Explaining what you need to your partner or family.
- Repairing after conflict while also making room for your own feelings.
We’ll look at what becomes harder during those times and what support is missing. The goal is to find more workable ways to respond, rather than expect yourself to handle every day the same way.
Perimenopause and menopause: making sense of what’s changing
You may have spent years being the person who remembers, organizes, and keeps things moving. Now, feeling more anxious, sleeping poorly, or having less patience can leave you questioning yourself.
Changes in your body, sexual wellbeing, confidence, or relationships may be difficult to talk about. You might feel grief about this transition, relief, frustration—or a mix that changes depending on the day.
We can talk about the parts that are affecting you most: feeling less like yourself at work, withdrawing from your partner, worrying about aging, or realizing that the way you’ve been caring for everyone else is no longer sustainable.
Our work may include responding to anxiety, setting limits, communicating about intimacy and support, and making room for what you want from this stage of your life.
Your relationships and responsibilities are part of the conversation
You don’t have to separate these concerns from the rest of your life. Caring for children or aging parents, work demands, cultural expectations, and relationship stress may all shape what you’re carrying.
We can explore where you feel stretched, what you’ve been keeping to yourself, and what needs to change. Sometimes that starts with a sentence you haven’t felt able to say: “I need more help,” “This isn’t working for me,” or “I’m having a harder time than you realize.”
I’m Susan Hea Jin Ko, LMFT. My style is warm and validating, firm yet gentle. I give you space to process, and I’m actively involved in helping you understand what’s happening.
We might slow down a recent argument to notice what you were thinking, feeling, and needing. We might practice how to ask for support, examine a thought you keep treating as fact, or make a realistic plan for an especially difficult week.
I draw from CBT, ACT, DBT-informed skills, mindfulness, and IFS-informed approaches. I’ll explain what we’re working on and why, and we’ll adjust based on your needs and feedback.
Therapy addresses the emotional and relationship side of these experiences. It can work alongside medical care; I don’t prescribe medication or provide hormone treatment.
A few questions you may have.
Do I need a diagnosis to reach out?
No. You can reach out because something feels different or difficult, even if you’re not sure what to call it. We can talk about your concerns and whether therapy with me is a good fit. A medical provider can help evaluate possible physical or hormonal contributors.
Does therapy replace medical treatment?
No. I provide psychotherapy, not hormone treatment or medication management. Therapy can support coping, relationships, and emotional wellbeing alongside care from your medical provider.
Where can I attend online sessions?
Sessions are available to adults physically located in California, Colorado, or Florida. Susan is licensed in California and Colorado and registered as an out-of-state telehealth provider in Florida.
How do I get started?
A free 15-minute phone consultation gives us time to talk about what brings you here and answer practical questions. You can review fees and insurance information before reaching out.
You don’t need to have it all figured out before reaching out.
A free 15-minute phone consultation gives us a chance to talk about what’s been difficult, what you’re looking for, and whether working together feels like a good fit.
Book a free consultation15 minutes · by phone · no pressure