PMS from the Oriental medical perspective
by Al Stone L.Ac.

For thousands of years, Chinese medicine has been treating the symptoms of pre-menstrual syndrome. In the modern world, many women have found, especially in the area of gynecology, that conventional modern Western medicine offers few answers, little relief, and no treatments other than harsh chemicals with potentially unpleasant side effects.

PMS is a reasonably simple syndrome to treat with Chinese medicine, however, left untreated, this little problem can become a big one. According to traditional Chinese medical theory, the same condition that gives rise to PMS is also a precursor to lumps, cysts, lesions, and even cancerous tumors in the breasts and uterus.

Acupuncture and herbs can provide enormous relief from PMS, however the underlying cause of PMS is often times due to one's lifestyle, or the way in which one relates with the world. Methods such as meditation, relaxation techniques and exercises that require mental focus, can be employed to treat the root causes of PMS.

According to Chinese medical theory, PMS is mostly indicative of a disharmony in the Liver. Organs in traditional Chinese medicine theory are very different from the organs as we know them according to modern Western science. That's why organs are capitalized in this article, to denote the Chinese concept for the organs, not the Western.

The Liver initiates the menstrual cycle and the Spleen controls the creation of the blood in the body. When there is any disharmony in the Liver, symptoms arise such as the mood swings that we often associate with PMS, including periods of depression, sadness, irritability, crying, and anger. When the Spleen is also involved, a woman can develop symptoms such as a foggy sense of clumsiness, IBS, or anemia.

PMS comes about when the Liver's function is impaired. In Chinese medicine, all of the body's functions are regulated and energized by what the Chinese call "Qi." That's pronounced "chee", sometimes spelled "chi". It could translate to anything from bioelectric energy to cellular metabolism. For our purposes, calling it simply "energy" is probably best.

Among the jobs that the Liver is expected to do in the body, according to Chinese medicine, is maintain the free flow of this Qi energy. When the Qi is moving well, we feel flexible, flowing and graceful within our bodies as well as within life. When there is a problem in the Liver, its function of circulating the Qi is compromised and one manifestation of this Qi stagnation is what we call PMS.

Chinese medicine is based on Taoism. This philosophy teaches that health comes from a balance between the masculine and feminine principles (or "Yin" and "Yang") within everything. For instance, the Yang nature of the Liver makes us want to move forward and succeed, but this must be balanced with the Liver's Yin aspect which represents the ability to move backwards, to be flexible, and to respond to conditions in new and spontaneous ways. Where there is a lack of Liver Yin, we tend to become angry or frustrated. When there is no Liver Yang, we can become overly timid.

When the Yin element of the Liver is deficient we can become violently angry when we encounter barriers to what we want, obstacles to our future, or any shortcoming to our expectations in life. Another typical Liver disharmony that comes from excessive attachments to goals is the lack of free flow of Qi energy within the body.

PMS is what a woman feels when the Qi's free flow is compromised. Disharmonies of the Liver will have two effects on the menstrual cycle. One is Liver Qi stagnation which causes moodiness and unexpectedly intense emotions. The other problem that comes from Liver disharmony is a painful period. It is said that anger makes the Qi rise to the head. That's why our eyes get red, we get headaches, dizziness, and even nosebleeds when we're very angry. However, for the menstrual flow to begin the Qi must be descending. Without the free descending flow of Qi at the onset of the menses, there is pain.

PMS doesn't always have to mean that there is anger at the root of the condition. However, anger is part of the symptomatic picture because of the Liver's involvement.

There can be various other symptoms along with moodiness and pain in PMS. Sometimes, the Liver gets so angry that it lashes out at the Spleen. This causes the Spleen's functions to be compromised. Symptoms associated with this portion of PMS include: cravings (especially for sweets), water retention, fatigue, abdominal bloating, breast tenderness with possible lumps, and of course, pain, especially toward the end of the period.

On a mental or emotional level, this so-called "Liver attacking Spleen" can show up as obsessions in our lives. The Spleen is in charge of the digestive system, but it also controls the digestion of our experiences in life. When we talk about "processing" an old relationship, or a change in our lives, it is the energy of the Spleen that is performing this function. So, when the Liver is attacking the Spleen, not only do we feel angry, but we can't get it out of our heads. We obsessively think about the object of our desire all the time. Nothing is ever really processed, or digested in our minds because the Liver is making it difficult for the Spleen to do its job. Plus, with all this Spleen energy being used in the mental and emotional realms, the physical digestive system suffers, leading to further aggravation of the symptoms mentioned above.

Complications of PMS
When the Liver is angry, the Qi stops flowing smoothly. When there is stagnation of this Qi energy, other things get stopped up behind it. Qi Stagnation can lead to Blood stagnation which can lead to lumps, cysts, lesions, and even cancerous tumors in the breasts and uterus.

Treatments for PMS
Acupuncture will gently break free the stagnation of the Qi in the body. This also has the effect of easing the emotions and pain associated with menstruation. As with many menstrual problems, it may take a few menstrual periods to regulate the cycle completely, although some improvement can often be seen after the first month, or even after the first treatment.

There is a special Chinese herbal formula which is often used for PMS called Xiao Yao Wan (sometimes spelled Hsiao Yao Wan), pronounced "shao yao wan". Confusing, isn't it? Ironic too, since it translates to "Free and Easy Pill." Many know of individual herbs such as Dang Gui that are effective for women's health, but this herb is rarely used alone. Chinese herbal formulas are created with balance and harmony in mind. Xiao Yao Wan has Dang Gui as well as many other ingredients to relieve Qi stagnation, nourish the Blood, strengthen the Spleen, sedate the Liver and relieve pain. They all support each other to increase their various functions. Xiao Yao Wan is widely available at stores that carry Chinese herbs.

Sometimes, an herbal pharmacy will create its own brand of Xiao Yao Wan and call it something else. The K'an Herbals brand "Free & Easy Wanderer" is an example of a domestically produced Xiao Yao Wan.

Tai Chi or Qi Gong (breathing exercises to amplify and invigorate the Qi energy) helps at the root of the problem. Even meditation will have this same effect. Pulling the consciousness into "The Now" makes the Liver less attached to preplanned goals. With this added flexibility, we can become more able to accept obstacles in life which allows us to find appropriate and creative solutions consistent with the needs of the moment.

Also, Qi Gong's breathing exercises stimulate the functions of the Lungs which help to sedate the Liver. In the same way that the Liver can attack the energy of the Spleen, so it is that the Lungs can sedate the Liver. This is all due to the way in which the organs relate to each other within the paradigm of Chinese medicine.

There are also many lifestyle changes that can be incorporated into your life to help control PMS at its root level.

Taoism would suggest that you live in accordance with nature. Many suggest that this includes a vegetarian diet, living off the land, going to bed with the stars, and getting up with the sun, but in the middle of the city in the 20th century, this is very difficult. Instead, it would be wise to become sensitive to the nature within yourself. If you're doing something you don't feel comfortable doing, don't do it anymore.

If you can't live with yourself within traditional female roles, listen to your nature and create the life that is consistent with your heart's stirrings.

If you want to be a mommy instead of a high power account executive, then make that change and watch your health improve. If you must work to survive, then find a job that allows for more of your nurturing side to come out.

These sorts of changes in one's life are not easy, nor is it something that can be adequately addressed in an article about PMS, but it is amazing how our health issues clear up when the internal issues are resolved.

From the Buddhist standpoint, the calming of the Liver might include seeing things As They Are, without any additional meaning. Things that make us mad do so because of the weight that we give to the things that bother us. Buddhism teaches detachment. With detachment comes the ability to see things as they are, because there is no need to make events in your life signify anything other than the random experiences that they ultimately are. Chinese medicine says that the Liver is attached to the eyes. Seeing life clearly with complete acceptance and a lack of interpretation provides the Liver with the freedom to attack life or retreat from it as is appropriate to the moment. With this balance, the free flow of Qi is restored, anger and frustration are calmed.

Islam, Christianity and Judaism and Hindu systems of Bhakti Yoga all have methods to calm the Liver as well. In surrendering your will to Allah, in living your life only to love God, or in offering up your sins to Jesus, we are freed from the past. The neat thing about this is that we're also freed from the future. It is this unhealthy obsession with goals in life that increases the likelihood of the Liver reacting with anger or stagnation of Qi when something stands in our way. Having a direction in life is good, having no flexibility nor acceptance of the midcourse corrections that God makes in your life is what causes pathologies of the Liver such as PMS.

The 20th century brings with it levels of stress and pain that have never been encountered in the past. However, because of the unique multi-cultural interactions available within modern American society, we can also benefit from incredible ancient treatments such as Chinese medicine for these contemporary disorders.