PMS from a TCM Perspective

While mild breast tenderness and bloating may be normal during the second half of the cycle, severe mood swings, swollen breasts, depression, intense irritability, and even nosebleeds are not. In Traditional Chinese Medicine (TCM), pronounced PMS symptoms indicate an underlying imbalance. Balancing the system takes time, usually around three months, through diet, herbs, acupuncture, and lifestyle adjustments.

In TCM, we recognize that every person has a unique constitution, and PMS can stem from many different underlying imbalances. Treatment is always tailored to the specific pattern presenting in each individual. However, for today, we’ll focus on two of the most common patterns seen in PMS: Liver Qi Stagnation and Blood Deficiency.

Liver Qi Stagnation: The Emotional Rollercoaster

If you experience mood swings, frustration, emotional outbursts, headaches, breast tenderness, bloating, and abdominal pain that start after ovulation, worsen before your period, and resolve once bleeding begins, this is a classic Liver Qi Stagnation pattern.

Why does this happen? Stress, emotional pressure, and a sedentary lifestyle block the free flow of Liver Qi. Since the Liver channel runs through the chest, abdomen, and reproductive organs, stagnation in this meridian can cause pain, swelling, and emotional instability.

If stagnation persists, it can generate Liver Fire, leading to extreme irritability, insomnia, red eyes, migraines, and even behavioral disturbances. A key sign of Liver Fire is a red and tender tongue, especially along the sides.

How to move Liver Qi and reduce stagnation: Movement is key—take daily brisk walks and practice Qi Gong (search “8 Brocades” on YouTube). Massage and acupressure (you can find these online: Liver 3 (LV3) and Large Intestine 4 (LI4) to clear stagnation and relieve tension.

TCM diet for Liver Qi Stagnation includes green leafy vegetables such as dandelion greens, kale, and watercress, cooked beets to move the Blood, chrysanthemum tea to clear Liver heat, lemon water to gently move Qi, and infusions of Bupleurum (Chai Hu) and Mint (Bo He) to move stagnant Liver Qi.

Castor Oil Pack Therapy: Apply a warm castor oil pack over the lower abdomen or liver area three to four times per week to move stagnant Qi, detox the Liver, and reduce cramps.

Vitamins and Supplements for Liver Qi Stagnation: Magnesium Glycinate (300-400mg daily) to relax muscles, ease irritability, and reduce tension. Riboflavin (Vitamin B2, 400mg daily) to help prevent PMS-related headaches and migraines. Vitamin B6 (50-100mg daily) to support neurotransmitter balance and reduce irritability.

Liver & Heart Blood Deficiency: The Sensitive, Fatigued, and Anxious Type

If you feel more sadness, worry, anxiety, fatigue, dry skin, brittle nails, dizziness, or have light or late periods and constipation, your pattern is likely Blood Deficiency, particularly affecting the Liver and Heart.

Why does this happen? Not enough nourishing Blood is available to support the Heart, which governs emotions, and the Liver, which stores Blood. As a result, the Shen (spirit) is disturbed, leading to emotional sensitivity, insomnia, and even palpitations.

How to nourish the Blood and calm the Shen: Massage and acupressure include Spleen 6 (SP6) to tonify Blood, DU20 (Bai Hui) and Yin Tang to calm the mind and relieve anxiety, and Kidney 3 (KD3) to support Kidney Essence, which nourishes Blood over time.

TCM diet for Blood Nourishment includes dark leafy greens such as spinach, nettles, and moringa, beets and goji berries to build Blood, bone broth and red dates (Hong Zao) for deep nourishment, and infusions of Dang Gui (Angelica sinensis) and Rehmannia (Shu Di Huang) to nourish Liver Blood.

Castor Oil Pack Therapy: Apply a warm castor oil pack over the lower abdomen or lower back two to three times per week to improve circulation and support deep nourishment.

Vitamins and Supplements for Blood Deficiency: Vitamin C (500mg daily) to enhance iron absorption. Omega-3s (1000mg daily) to support mood and reduce inflammation. Vitamin B12 (1000mcg daily, methylcobalamin form) to support Blood production and nervous system health.

PMS is your body’s way of showing you where there’s an imbalance. Every person is unique, and in TCM, treatment is always customized to the individual’s specific pattern. The good news is that you can balance your system with acupuncture, herbs, movement, nourishing foods, vitamins, and so many other therapies! Please share this info with any woman you feel might benefit. Knowledge is power! If you would like an appt. with me, please reach out and we can have a Telemedicne session so that we can look at YOUR specific pattern.