In this episode of The Choice Space, Dr Lee David speaks with Dr Sally Doust, GP and women’s health specialist, about premenstrual distress, including premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). The conversation explores how hormonal changes across the menstrual cycle can affect mood, energy, sleep and emotional sensitivity – and why these patterns are often overlooked or misunderstood.

They discuss the wider context of women’s health inequalities, including the lack of research and the ways this can affect recognition and treatment. Sally explains how changes in oestrogen and progesterone interact with the brain and body, and why premenstrual symptoms can look very different from one person to another.

The episode also looks at how to tell when symptoms may be cyclical, why tracking patterns can be so helpful and how recognition itself can reduce self-blame. There is thoughtful discussion of PMDD, including the severity of symptoms some women experience and the importance of feeling believed and supported.

Lee and Sally also explore practical support, from cycle tracking and self-compassion to lifestyle changes, supplements and medical treatment options. This is a grounded conversation about understanding patterns, widening choice and responding with more care and clarity.

Key moments
00:37 Introduction
02:48 Women’s health inequalities
04:27 Hormones across the cycle
08:52 Hormones and the brain
11:16 What PMS can look like
14:22 Cyclical patterns and timing
16:42 Choice Pause – changing mood and energy
25:35 Understanding PMDD
31:35 Supportive choices for PMS
35:29 Treatment options
41:52 Cycle tracking takeaway
42:50 The 30 – 30 – 30 approach

About the guest

Dr Sally Doust is a GP with a specialist interest in women's health and medical educator. She works in the NHS, in private practice, and at Brighton and Sussex Medical School. In her GP work she found many women had adverse experiences of healthcare because of gender biases and lack of research into women's health - this inspired her to specialise in this area and remains the key purpose of her career. She holds diplomas in obstetrics and gynaecology (DRCOG) and sexual and reproductive healthcare (DFSRH). She is a member of the Primary Care Women's Health Society and the British Menopause Society. For the past two years she's been a delegate for the United Nations Commission on the Status of Women.

You can connect with Sally on LinkedIn.

Here is a link to the NAPS PMS guidelines

About the host

Dr Lee David is a GP, CBT therapist and author specialising in mental health and wellbeing. Lee has written many books on CBT, mindfulness and teen wellbeing, and speaks regularly at conferences and in the media. Away from work she enjoys running, hiking, singing in a choir and spending time outdoors with her family. You can find Lee through her website and on Instagram, TikTok (@dr.lee.david), Facebook and LinkedIn. You can find more about her books, wellbeing courses and therapy here: https://linktr.ee/dr.lee.david

In this episode of The Choice Space, Dr Lee David speaks with Nic Malcomson, integrative psychotherapist, about the success trap – the pattern where strengths that once helped us thrive can gradually become rigid and exhausting.

The conversation explores how early success, positive feedback and high standards can shape identity over time. When life becomes more demanding or circumstances change, the same qualities that once worked well can begin to create pressure, self-doubt and a fear of slipping.

Lee and Nic discuss how this can show up in different ways – from ongoing over-striving and perfectionism to a deeper sense of feeling stuck after a setback. They reflect on the link between performance and self-worth, and how difficult it can be when identity becomes tied to always coping, achieving or getting things right.

The episode also explores Nic’s idea of fallible flourishing – a more compassionate and realistic way of thinking about growth, motivation and thriving. Together, they consider the value of naming the pattern, recognising the role of environment and finding space for being human rather than endlessly performing.

This is a thoughtful conversation about pressure, identity and self-worth, offering a kinder and more sustainable way to think about success.

Key moments

00:00 Why naming it matters
00:29 Introducing the success trap
01:30 Nic’s own experience
04:27 How identity develops
06:37 Burnout and breakdown
07:03 Chronic, acute and stuck patterns
11:01 Why setbacks can help
13:37 Ideal lived self and feared self
19:08 The importance of normalising
26:54 Under, over and optimal motivation
31:49 Fallibility and connection
33:18 Environment and supportive change

About the guest

Nic Malcomson is an integrative psychotherapist who has delivered more than 5,000 therapy sessions for doctors through NHS Practitioner Health and in his private practice, Eudemedics: Well-being for Doctors. He developed the Fallible Flourishing Model, which explores how early experiences of success can later create psychological traps around performance, identity and self-worth, and how these patterns can shift towards more sustainable flourishing.

You can connect with Nic on LinkedIn or through his website: www.eudemedics.com

About the host

Dr Lee David is a GP, CBT therapist and author specialising in mental health and wellbeing. Lee has written many books on CBT, mindfulness and teen wellbeing, and speaks regularly at conferences and in the media. Away from work she enjoys running, hiking, singing in a choir and spending time outdoors with her family. You can find Lee through her website and on Instagram, TikTok (@dr.lee.david), Facebook and LinkedIn. You can find more about her books, wellbeing courses and therapy here: https://linktr.ee/dr.lee.david

In this episode of The Choice Space, Dr Lee David speaks with GP and menopause specialist Dr Carys Sonnenberg about the complex ways menopause can affect emotional wellbeing, physical health and everyday life.

Menopause is often described in terms of hormones alone, yet the experience is rarely that simple. In this conversation, Lee and Carys explore how hormonal changes interact with sleep, stress, lifestyle habits and wider life pressures. Many women find themselves navigating fluctuating moods, disrupted sleep and changes in concentration at the same time as managing work, family responsibilities and other demands.

The discussion highlights how menopause is highly individual. Some women experience few symptoms, while others notice significant changes in mood, anxiety or energy. Understanding these differences can help create a more compassionate and personalised approach to care.

They also explore practical ways of supporting wellbeing during this time – including the role of lifestyle medicine, cognitive behavioural strategies, nutrition and hormone treatment where appropriate. Rather than focusing on a single solution, the conversation reflects on how multiple approaches can work together to support women through the menopause transition.

This is a thoughtful conversation about complexity, choice and self-understanding during a significant stage of life.

Key moments

00:00 Emotional symptoms in menopause
02:22 Mood changes and mental health
04:01 The six pillars of lifestyle
09:10 Habits, coping and awareness
12:21 Hormones and brain chemistry
20:27 CBT approaches for menopause
28:35 Hot flushes and thoughts
32:28 Breathing and stress regulation
37:37 Nutrition and neurotransmitters
41:01 A small wellbeing choice

About the guest

Dr Carys Sonnenberg is an NHS GP and British Menopause Society menopause specialist. She founded Rowena Health, an online service providing holistic menopause care for women. She is trained in CBT and nutrigenomics and is co-author of Women’s Health Made Easy, due to be published in 2026. Carys is also a member of the Primary Care Women’s Health Society wider committee and contributes to education through national conferences and webinars.

You can contact her via her website, or on LinkedIn, Facebook and Instagram: @drcaryssonnenberg

About the host

Dr Lee David is a GP, CBT therapist and author specialising in mental health and wellbeing. Lee has written many books on CBT, mindfulness and teen wellbeing, and speaks regularly at conferences and in the media. Away from work she enjoys running, hiking, singing in a choir and spending time outdoors with her family. You can find Lee through her website and on Instagram, TikTok (@dr.lee.david), Facebook and LinkedIn. You can find more about her books, wellbeing courses and therapy here: https://linktr.ee/dr.lee.david