In patriarchal society the menstrual cycle is often sited as a nuisance and associated with shame, resulting in the disavowal of women’s cyclic experience (Severn, 2021). The menstrual cycle is also largely absent from psychotherapy literature and has had little clinical focus (Kolod, 2010). This hermeneutic literature review draws on menstrual cycle awareness (MCA) (Pope & Wurlitzer, 2017) to see how psychotherapy could better support female clients, by asking: What is the relevance of MCA for psychotherapy? The findings identify parallels between conscious menstruality, a branch of MCA, and psychotherapy. Both focus on personal development and meaning making through deep enquiry, and both aim to increase personal agency, empowerment and psychic integration. This research finds that from menarche onwards we form a “menstrual narrative” we carry into our menstrual cycle years (Donmall, 2013, p.207). Understanding the inner seasons of the cycle as experienced by menstruating clients in the context of this narrative provides a rich resource for psychotherapy. Working with the cycle can deepen experiences of sexuality and intimacy. Trauma may also be embodied in the cycle and impact how women experience the inner seasons (Northrup, 2020). Female therapists with cycles can use their own cycle to model self-care, for psychoeducation, or to track changing countertransference. Therapists who have practiced menstruality are well placed to facilitate menstruality work with clients (Severn, 2021). Male therapists are positioned as allies and have a supportive role. Conscious menstruality is also identified as an eco-paradigm that supports clients to feel connected to Earth’s rhythms. This may increase conservation efforts in the face of the climate emergency. As interpretative, this research has limited transferability. However, it addresses a significant gap in clinical knowledge and identifies a new subject area for psychotherapy. This provides a foundation for empirical research.