Premenstrual Syndrome (PMS) is a collection of recurrent emotional symptoms, with or without physical symptoms, that occurs a few days before a woman’s menstrual cycle. Typical complaints include cyclic irritability, tension and unhappiness. Other emotional changes may include anxiety, stress, anger, mood swings, poor concentration, food cravings and change of sex drive. Some women experience physical symptoms such as sleeping disturbance, headache, abdominal cramps, fatigue, constipation or diarrhea, breast tenderness, acne flare-ups or joint pain. The cyclical symptoms usually subside gradually at the onset of period, regardless of the severity. Although there is no single test that can verify the diagnosis of PMS, it should be severe enough to interfere with a woman’s daily activities.

Interestingly, each woman who suffers from PMS has her own pattern of symptoms, although PMS often runs in the family. These symptoms are predictable, and may vary from slight to intense at each menstrual cycle. Stress can certainly precipitate the condition. PMS can also be aggravated by high caffeine intake, improper diet, insufficient rest, aging and a history of depression. Regular aerobic exercises (e.g. jogging, swimming, cycling) and relaxation exercises (e.g. Qi gong, deep breathing exercise, yoga) are helpful in alleviating PMS symptoms

TCM treats PMS in accordance to syndrome differentiations and different menstrual phases. While PMS is thought to be linked to genetic component or serotonin fluctuations, TCM believes that PMS is primarily caused by stagnation of liver qi, which in turn, lead to a periodic flush of abundant blood in the Conception vessel (Ren mai) and Thoroughfare vessel (Chong mai). Tight-wiry pulse and dark tongue indicate the obstruction of qi and blood. Menstruation is a combination of qi and blood. Liver qi is important to ensure the discharging of menstrual blood in a smooth and unimpeded manner. Other commonly seen TCM Syndrome-classifications of PMS include: — 1. Interior excess of liver fire; 2. Ascending liver yang with blood deficiency; 3. Spleen and kidney vacuity. Complement to syndrome differentiation, TCM also takes into consideration the different phases of menstruation. For example, the time before menstruation (luteal phase) is generally considered a phase of relative repletion, whereas the phase after the menstruation (follicular phase) is a relative vacuity condition.

PMS can be treated with Acupuncture and Chinese herbal medicine. TCM massage (tui na) is also helpful as a complementary therapy to the treatment. The treatment aims to correct the repletion by calming the qi and supporting the flow of qi with the goal of removing stagnation, enhancing the circulation of blood flow.

Depending on the severity of the symptoms, acupuncture & tuina treatment is usually given 2 – 3 times a week. As the condition improves, the frequency can be reduced to once a week. The commonly used acupuncture points for treating PMS include the four gates, GV-20 and SP-6.

The four gates is comprised of the acupuncture points LR-3 and LI-4, which are located on the lower and upper limbs respectively. This combination is commonly used in treating PMS as it promotes qi circulation in general. Specifically, LR-3 is on the back of the foot, between the first and second toes, about two fingers width from the web; LI-4 is located on the back of the hand, between the thumb and index finger, approximately in the middle of the second metacarpal bone on the radial side.

GV-20 is one of the most versatile points, often chosen for its function of raising emotional energy and relieving stress. It is located on the top of the head. Draw an imaginary line upward from the tip of each ear. The center of this imaginary line is where GV-20 is located.

Another main point, SP-6, is the crossing point of Spleen, Kidney and Liver Meridians (three yin meridians). It is widely used to nourish blood and yin. SP-6 is located approximately 4 fingers width upwards from the protruding bone on the inside of the ankle. Other acu-points are selected based on one’s body constitution and syndrome differentiation.

Chinese herbal formulae are usually prescribed on a weekly basis.. Some of the commonly used Chinese herbs are indicated below: Chai hu and Xiang fu are used to sooth liver qi and thus, relieve emotional stress; Dan shen and Hong hua are used to promote blood circulation and prevent the formation of blood clots; Bai zhu, Shan yao and Mu xiang can strengthen spleen and alleviate digestive symptoms; Bai shao and Sheng di nourish the yin and reduce pain related symptoms; Suan zao ren and Wu wei zi can enhance sleeping quality; Ju hua, Zhi zi and Xia ku cao can clear liver fire and toxic; Dang gui nourishes the blood whereas Dang Shen, Huang qi tonify the qi. There are many more Chinese medicines that have been shown to be effective in the treatment of PMS. These herbs also play important roles in treating accompanied menstrual problems, such as irregular menstruation, dysmenorrhoea, menopausal syndrome and etc. However, the combination and dosage of herbal medicine are based on individual condition and should be taken based on prescription from a qualified TCM physician.

Below are some herbal remedies that you can take without a prescription: — 1. Congee using spelt. Add 30g of peeled Fresh Chinese Yam; 2. Rose petal tea with chrysanthemum and wolfberry; 3. Add cinnamon into beverages or food if you have cold hands/feet and abdominal cramps.

Lai Sook Wen
TCM Physician
Aegle Wellness