PMS (premenstrual syndrome)
Premenstrual syndrome (PMS) is a collective term for physical and emotional complaints that return in the period before menstrual periods. The symptoms usually occur several days to about two weeks before menstrual periods and often decrease as soon as menstrual periods begin.
PMS can express itself very differently. One woman mainly suffers from irritability, mood swings or gloomyness, while another person's physical symptoms such as tense breasts, bloating, headache or fatigue are at the forefront. The severity can also vary considerably.
Within regular medicine PMS is associated with sensitivity to normal hormonal changes during the menstrual cycle. Why one woman reacts much more strongly than the other is not fully known.
Common symptoms
PMS can cause both physical and emotional complaints. Common symptoms are:
- irritability and mood changes;
- be emotional or crying faster;
- gloomyness, fear or inner restlessness;
- fatigue and difficulty in concentrating;
- sensitive or tense breasts;
- holding bloating and fluid;
- headache;
- acne or other skin problems;
- altered appetite or appetite in sweet;
- sleep worse;
- changes in bowel movements.
Characteristic is the cyclical character: the symptoms return around the same stage of the menstrual cycle and usually decrease when menstrual periods begin.
Possible causes
The exact cause of PMS is not fully known. Probably PMS comes from a combination of factors. Hormonal changes during the second half of the menstrual cycle play an important role. Some women appear to be more sensitive to changes in oestrogen and progesterone and their impact on neurotransmitters such as serotonin.
Stress, sleep deprivation, hereditary predisposition and lifestyle can also affect the severity of complaints.
Complaints similar to PMS may also occur in, among others, endomatiosis, adenomyosis, thyroid disorders, depression, anxiety disorders and during the perimenopause. Therefore, it is advisable to have these medically assessed in case of new, strongly changing or severe symptoms.
What can acupuncture do?
Acupuncture can be used as an additional treatment in recurrent PMS complaints. Not only does it look at the symptoms just before menstruation, but also at the whole cycle and other physical and emotional symptoms.
The treatment is tailored to the underlying TCM pattern. For one woman, for example, tension and stagnation are at the forefront, while for another fatigue, insufficient recovery or complaints of heat or cold are more important.
Depending on the picture of complaints, treatment may be directed at:
- improve Qi and Blood flow;
- reducing tension around menstrual periods;
- support the menstrual cycle;
- Reduce heat when irritability and heat complaints are at the forefront;
- Support blood, Yin or Yang when there are signs of deficiency;
- Dampness and Phlegm reduce for example with moisture retention and a heavy or bloated feeling.
What can Chinese herbal medicine do?
Chinese herbal medicine is regularly combined with acupuncture at PMS. As herbs can be used daily, they can also support the body between acupuncture treatments.
The composition is tailored to the pattern and can be adjusted during the menstrual cycle. For example, treatment before menstrual periods may be more focused on promoting Qi flow, whereas a clear underlying deficiency over a larger part of the cycle may require nourishing or fortifying herbs.
Depending on the pattern, treatment may be directed at:
- Free flow of Liver-Qi;
- Feeding blood and supporting circulation;
- Reduce heat;
- reduce Dampness and Phlegm;
- Feeding Liver and Kidney-Yin;
- Splenen- and Kidney-Yang support.
Acupuncture and Chinese herbs work from the same TCM diagnosis and can therefore complement each other.
How does Chinese medicine view PMS?
Within Western medicine, the diagnosis PMS is central. Chinese medicine also looks at the underlying imbalance which causes someone to develop symptoms during the premenstrual phase.
The days before menstruation within Chinese medicine form a dynamic phase of the cycle. Qi and Blood prepare for menstruation and must be able to move freely. Especially the Liver and the Chong Mai, a meridian closely connected with menstruation and uterus, play an important role in this.
When the flow of Liver-Qi is less smooth, symptoms such as irritability, tense breasts and bloating may occur. However, PMS does not always recognise stagnation as a main pattern. Blood, Yin or Yang deficiency, Heat, Dampness or Phlegm can also be part of the overall picture of complaints and explain why certain complaints come to the fore just before menstruation.
Therefore, two women with PMS may have very different symptoms and need different treatment.
Besides the Liver, the Spleen, Kidneys and Heart can also play a role. Within TCM, the Spleen is involved in energy and moisture processing, among other things. The Kidneys support the deeper regulation of the menstrual cycle, while the Heart is involved in sleep and emotional rest.
What is a TCM organ system?
A TCM organ system describes a group of related body functions and is wider than just the anatomical organ with the same name. Read more at TCM basics .
What is a TCM pattern?
A TCM pattern is a recognizable combination of complaints and physical characteristics that indicates which imbalance is likely to contribute to the complaints. Read more at TCM basics .
Below are only the most common patterns discussed. Other patterns are possible and multiple patterns can occur at the same time. This allows you to recognize yourself in different descriptions. Also, someone with a certain pattern does not have to have all the symptoms mentioned. The pattern is determined on the basis of the overall picture of complaints.
Most common TCM patterns in PMS
Liver-Qi-stagnation
During the period before menstrual periods, Qi and Blood must be able to move freely. When the regulatory function of the Liver is disturbed, this movement may be less flexible. This is a common pattern in PMS and often becomes clearer during periods of stress or emotional tension.
Common symptoms
- irritability and mood changes;
- tense or painful breasts;
- feeling bloated or tense in the abdomen;
- sigh;
- feeling of chest or flank tension;
- menstrual pain starting before menstruation.
Examples of Western disorders
PMS, functional menstrual complaints and stress-related cycle symptoms.
Liver-Qi-stagnation with Heat
If stagnation remains present for a longer time, according to TCM Heat may occur. The emotional symptoms are often clearer and may be associated with physical heat phenomena.
Common symptoms
- strong irritability or anger;
- inner restlessness;
- headache;
- feeling of warmth;
- thirst;
- acne or pimples before menstruation;
- sometimes a more intense period of menstruation.
Examples of Western disorders
PMS, premenstrual headache and acne that is clearly related to the menstrual cycle.
Liver-Blood deficiency with Liver-Qi-stagnation
Liver-Qi stagnation does not always have to be a pure stagnation pattern. When Blood is insufficient, the Liver can be fed less well and the free movement of Qi may also be disturbed. In this pattern the emotional complaints are often softer in character: rather weepy, bleak or vulnerable than pronounced angry.
Common symptoms
- crying;
- gloomyness or emotional vulnerability;
- mild irritability;
- fatigue;
- slight tension of the breasts;
- dizziness;
- bad sleep;
- a relatively slight period of menstruation.
Examples of Western disorders
PMS, premenstrual mood symptoms and PMS in women with mild or scarce menstrual periods.
Liver-Qi-stagnation with Phlegm
When the processing and distribution of moisture is less effective, TCM Dampness or Phlegm can develop. In combination with stagnation, a strong bloated, heavy or oppressive feeling can occur as well as emotional complaints.
Common symptoms
- well-stressed or swollen breasts;
- bloating;
- chest pressure or short or breath sensation;
- Smell in the throat;
- fatigue;
- heavy feeling;
- Worried a lot.
Examples of Western disorders
PMS with fluid retention, pronounced chest tension or strong bloating.
Liver- and Kidney-Yin-deficiency
Yin stands within Chinese medicine for, among other things, the nourishing and cooling functions of the body. When Yin is insufficient, heat can develop relatively easily. PMS can then combine with dryness, heat and restlessness.
Common symptoms
- irritability;
- feeling of warmth;
- night sweats;
- dry mouth or eyes;
- insomnia;
- low back pain;
- dizziness or ringing in the ears.
Examples of Western disorders
PMS, premenstrual complaints during the perimenopause and cycle-related symptoms with heat phenomena.
Spleen- and Kidney-Yang-deficiency
According to TCM, there is insufficient heating and activating force in this pattern. As a result, not stress and Heat, but fatigue, cold and fluid build-up are at the forefront.
Common symptoms
- clear tiredness prior to menstruation;
- gloomyness or crying;
- cold hands and feet;
- fluid retention;
- bloating;
- loose stools;
- low back pain;
- pee more often.
Examples of Western disorders
PMS where fatigue, fluid retention, bowel discomfort and cold feeling are clearly at the forefront.
Outlook
The course of PMS treatment depends, among other things, on the severity and duration of the complaints, the underlying TCM pattern, the regularity of the cycle and factors such as stress, sleep and other hormonal or gynaecological complaints.
Because PMS occurs cyclicly, the effect of treatment is usually assessed over multiple menstrual cycles. Relatively recent or mild complaints may sometimes occur earlier. Long-term or complex symptoms usually require more time.
In the initial phase, one acupuncture treatment per week is a usual guideline. In case of severe complaints, temporary treatment can be more frequent, for example around the stage in which the symptoms usually occur. When the symptoms become less stable, the frequency can be reduced. Chinese herbs can be used daily between treatments when appropriate.
Contact
Do you regularly suffer from PMS and want to know if acupuncture and/or Chinese herbal medicine can fit your complaints?
During a first consultation, we will discuss your symptoms, menstrual cycle, medical history and other factors that may play a role. Based on the overall picture of complaints, a personal treatment plan will be drawn up.
You can make an appointment directly online or contact us for more information.