Hannah, depicted in the video above for the BBC, graduated from medical school in her early 30s with a keen interest in psychiatry and mind-body connection. Exposed to the grim state of mental health services at the time, Hannah then went into general practice with the intention of giving her patients a more holistic overview, and consideration of how mental health can impact physical health, and vice versa. 

She said: “In medicine, there’s a real tendency to separate mental health from physical health, but you can't really do that. If you’re diagnosed with diabetes, that has an emotional and mental health impact as well. A lot of people with any chronic condition would say that. People with rheumatoid arthritis tend to have a higher rate of depression, and it's not just because they’ve got a chronic condition that’s getting them down, but because there’s a physical process that’s affecting the brain, so it’s a real false dichotomy.” 

In psychiatry, Hannah noticed that women’s mental state would fluctuate depending on where they were in their cycle, and this became even more apparent in general practice. She started research to understand how much hormones can impact mind, body, and behaviour – as well as general wellbeing – right across the reproductive lifespan and post-reproductive lifespan.

Her experience as a GP pushed her to branch out into the specialism, and she set up her own private Menopause & Premenstrual Disorders Clinic in Norfolk. Hannah’s comprehensive and holistic approach helps women suffering with severe and complex symptoms of female hormonal health. Hannah’s own journey also contributed to her desire to increase understanding and awareness within the medical profession. 

She said: “I had endometriosis and ended up having a hysterectomy when I was 35, and had my ovaries removed. It brought me into stark reality and highlighted how difficult it was even for me, as a medic, to get the help I needed to manage my own symptoms. I found it difficult enough in a relatively privileged position, and realised there’s a lot more work we needed to do.” 

Severe symptoms of pre-menstural disorders can be triggered by any traumatic hormonal-related event, which includes puberty, childbirth, miscarriage, abortion, menopause, sterilisation, or starting the contraceptive pill. When a woman’s body goes through a period of hormonal change, the brain can have an abnormal response, which can result in severe psychological distress or behavioural change, symptomatic of PMDD. 

Hannah also offers support for women suffering with Premenstrual Exacerbation (PME), which can apply to both physical or mental health conditions. A pre-existing condition can become much worse in the luteal phase of the menstrual cycle. For example, someone suffering with rheumatoid athritis may experience a significant increase in pain during the luteal phase. Equally, someone with a pre-existing psychiatric disorder may suffer worse symptoms in the lead up to their period. 

Hannah said: “PME and PMDD often coexist and I think this can be difficult for women trying to get a clear cut diagnosis, because it often takes many years for women to get their diagnosis recognised. Because of the nature of the condition – something that comes round once a month – you're only just getting over it when you get back into another cycle, so you’re going to get concurrent depression and anxiety. It's a natural reaction to develop a mood disorder, especially if you haven't had the help and support from medical professionals."

Hannah’s work endeavours to shine a light on a problem women may have spent years struggling with before receiving a clear diagnosis, and proper support and treatment. 

Yet this specialised service is not widely accessible through mainstream health services, due to a lack of funding and awareness. 

“I don't remember it being discussed during my training and I think as medical professionals, it would be very good if every time people were admitted to hospital, we could ask where they are in their menstrual cycle or menopause, or are they still having periods, because we’d find with a lot of admissions to A&E – like self-harm – that there could be a relation."

She founded ADHD Girls before she herself was diagnosed with attention deficit hyperactivity disorder, and started interviewing women across the world to find out about their stories.

Her campaign snowballed into the formation of ADHD Girls – an online community which offers education and empowerment. It’s a space where neurodivergent women can ask each other questions about medications, diet, lifestyle and navigating professional and personal relationships. 

Samantha also gives talks and training about neurodiversity in the workplace.

“There was a lot of learning along the way which I share in my community, and now I give a lot of talks on ADHD and women. These sessions are always very impactful and powerful, because it's just nice to be in a room where people feel this sense of community. Most of us find it a bit of a mission to go out and meet other people, so it's nice that when you do, you feel validated in this space.”

From gathering anecdotes from women across the globe, Samantha soon noticed the relationship between neurodiversity and hormonal sensitivity. Her research suggested a link between neurobiological sensitivity present in PMDD and neurodivergent women.

The first study conducted to acknowledge this connection was published in 2021, in the Journal of Psychiatric Research (Volume 133).