PMS - Premenstrual Syndrome

Premenstrual syndrome (PMS) consists of discomfort occurring prior to the onset of the menses, at then end of the monthly cycle. It typically occurs in the week (5-11 days) leading up to the menses. Symptoms include moodiness, irritability, depression, breast tenderness, weight gain, water retention, food cravings, and changes in bowel function, commonly constipation.

Although many women accept this as a "fact of life," it indicates an imbalanced function of the liver and endocrine system, and a healthy menstrual cycle will not produce any significant discomfort. Acupuncture, herbal medicine, and diet changes can eliminate or greatly reduce premenstrual discomfort.

PMS and Liver Function

According to Chinese medicine, the liver regulates the free flow of the menstrual cycle. During the menstrual cycle, large fluctuations in hormone levels increase the burden on the liver for detoxifying the hormones. Stress, emotions, and diet can hinder liver function, contributing to PMS.

Most cases of premenstrual syndrome involve some degree of liver qi (pronounced "chee"=function) stagnation. Signs and symptoms of liver qi stagnation include irritability, frustration, constipation or alternating constipation and loose stools, rib side discomfort, and abdominal bloating.

A study by Qiao et al found that women suffering from such signs in the premenstrual syndrome had continuous low levels and significantly low peak secretions of estrodiol and progesterone during both the follicular (preovulatory) and luteal (postovulatory) phases.

The liver clears excess estrodiol and progesterone that accumulate between ovulation and menstruation. If your hormone levels are excessive, this may congest the liver, leading to symptoms.

The liver also produces and releases bile required for the smooth digestion of fats; impaired flow of bile results in poor fat digestion and consequent abdominal bloating. Bile also stimulates bowel movement for elimination. Depression of liver functions results in bloating and constipation.

PMS and Acupuncture

Acupuncture treatment can relax body tension, induce a parasympathetic response, and stimulate liver, digestion, and endocrine functions, all of which help to relieve PMS.

Yu et al reviewed eight controlled studies involving 807 women (range, 61-225) suffering from premenstrual syndrome. Of these eight studies, seven showed that acupuncture produced therapeutic results superior to other methods (i.e. Western medicine or Chinese herbs).

Click here to see the abstract of this study: Yu et al, Evaluation of clinical therapeutic effects and safety of acupuncture treatment for premenstrual syndrome. Zhongguo Zhen Jiu. 2005 Jun;25(6):377-82.

PMS and Herbal Medicine

Herbal medicine for PMS focuses on improving the liver functions, stimulating digestion and assimilation of foods (particularly fats), and regulating (increasing) female hormone levels. We use herbs like bupleurum root, Chinese angelica root, and peppermint to achieve these goals.

Chou et al reported the results of a study comparing Chinese herbal medicine to a placebo (sugar pill) treat PMS in 61 Australian women. They found "There were significant differences (p < 0.01) in scores after three months of treatment between Chinese herbal medicine and placebo in premenstrual physical and psychological symptoms, depression, anxiety and anger favoring herbal medicine."

See Chou et al, A controlled trial of Chinese herbal medicine for premenstrual syndrome. J Psychosom Obstet Gynaecol. 2008 Sep;29(3):185-92.

Diet for PMS

In the premenstrual phase, your caloric requirements can increase by as much as 500 calories daily. If you fail to increase your food intake appropriately using nutrient-dense foods rich in high quality carbohydrates, such as whole grains, legumes, winter squash, sweet potatoes, carrots, and whole fruits, you will experience food cravings, particularly for sugar and fat (e.g. chocolate).

Barnard and colleagues studied the effect of a whole foods plant-based diet on premenstrual syndrome.  They found that a low-fat whole foods plant-based diet was associated reductions in body weight, dysmenorrhea duration and intensity, and premenstrual symptom duration. 

Return from PMS to Conditions A-Z

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