When I first came into contact with phobic patients in my work with Professor Isaac Marks at the Maudsley Hospital, some 20 years ago, I was quickly struck by how many female patients described the worsening of their symptoms in the few days before their periods.
An increase not just in the general pre-menstrual symptoms but in the tendency to panic, to become more anxious and to experience a heightening of the physical symptoms of anxiety.
In some patients the pattern was different with anxiety occurring during menstruation or just after. However, in these patients there was still a predictable, cyclical pattern.
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