Most people have heard of PMS but may not know that it is actually more than her monthly mood swings and pain. Let’s take a look at the definition and causes of PMS then you’ll know why.
What is PMS?
Premenstrual Syndrome (PMS) is a collection of cyclic symptoms that usually occurs a few days up to two weeks before a woman’s menstrual cycle. In addition, these symptoms are severe enough to interfere with the woman’s daily activities. PMS can affect any woman. Studies show that PMS affects 30% to 40% of the reproductive female population and 20% to 32% of pre-menopausal women.
Signs and Symptoms
Typical complaints of PMS are cyclic irritability, tension and unhappiness. Other emotional changes may include
anxiety, stress, anger, depression;
poor concentration, poor judgement;
change of sex drive.
Some women experience physical symptoms such as
sleeping difficulty or disturbance;
constipation or diarrhea;
the list could go on…
The symptoms can range from mildly annoying to debilitating.
Predictable Patterns of Symptoms
The cyclical symptoms that occur during the luteal phase (the time after you ovulate and before your next period), usually disappear with menstrual flow, regardless of the severity. Although there is no single test that can verify the diagnosis of PMS, the symptoms should be cyclic and 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 during different cycles.
The exact cause of PMS is still unknown.
You may have heard of “hormonal imbalance”, in which fluctuations in sex hormones during the luteal phase every month is deemed to be the biggest contributing factor to PMS. Different etiologies have been suggested. A history of depression, fluctuated serotonin levels, nutritional defects and environmental factors are thought to be related to PMS. Stress can certainly precipitate the symptoms. PMS can also be aggravated by high caffeine intake, alcohol consumption, imbalanced or irregular diet, and insufficient rest. A woman should seek for treatment if she has not been able to manage her PMS with lifestyle changes or when the symptoms of PMS are affecting her daily activities.
TCM holds that PMS is primarily caused by stagnation of liver qi.
From a TCM perspective, menses is a combination of qi and blood. Menstruation is a periodic flush of abundant blood in ren mai (conception vessel) and chong mai (thoroughfare vessel). Maintaining a smooth flow of liver qi is important for ensuring a smooth and unimpeded discharge of menstrual blood. While PMS is thought to be closely linked to cyclic changes in hormones, TCM holds that PMS is primarily caused by stagnation of liver qi. Tight-wiry pulse (弦脉) and a purplish tongue (紫舌) indicate the obstruction of qi and blood in PMS patients.
There are more complex conditions that cause PMS. PMS symptoms can be a result of stagnation and / or deficiency in theKidney, Spleen and Liver.
TCM views the access to the reproductive organs is gained primarily through three ordinary organ systems – kidney, liver and spleen, (these organ systems have a meaning different from the anatomical organs known in the western medicine), and three extraordinary channels – thoroughfare, conception and governing vessels.
- The kidney stores jing (essence), which comprises of both inherited essence and acquired essence. Jing is the material basis for all kinds of functional activities. In other words, it is the source of life force. The inherited essence forms the basis for prenatal growth in the uterus and nourishes the fetus. It also determines the body constitution and characteristics a person will have throughout their life. Acquired essence is obtainable from diet and lifestyle.
- The spleen stores gu qi (food essence). It is the digestion and assimilation organ system, and the primary source and storage place for postnatal essence. The spleen function can be weakened by irregular meals, stimulating food, and constant worrying.
- The liver is the storage organ for blood, and it possesses the function of regulating the movement and activity of qi. This ties it closely to the menstrual cycle and to emotional and hormonal responses. Emotions such as rage, anger, embarrassment, and depression damage the liver and its associated functions.
In the treatment of gynaecological disorders, the extraordinary channels play an important part:
- Chong mai (Thoroughfare vessel, “Sea of Blood “) governs menstruation.
Ren mai (Conception vessel, “Sea of Yin “) has a close relationship to the breasts and genitals.
Du mai (Governing vessel, “Sea of Yang “) connects the uterus and supports the kidney yang.
Syndrome differentiation is a unique TCM way of evaluating and identifying the disharmony patterns of the body.
Stagnation of liver qi can be further sub-divided into more complex disharmony patterns – Interior excess of liver fire; Stasis of blood; ascending liver yang with blood deficiency.
Other commonly seen disharmony patterns of PMS include spleen and kidney vacuity, and yindeficiency with arising fire.
Treatment Options and Lifestyle Changes
Currently, conventional medicine emphasizes treatment of PMS symptoms rather than addressing the underlying causes which is not well understood yet.
A doctor will usually prescribe
NSAIDs such as ibuprofen to ease abdominal cramps and breasts tenderness;
Anti-depressant drugs, for examples, Prozac or Zoloft for controlling emotions in cases of severe PMS or PMDD (Premenstrual dysphoric disorder, a more severe form of PMS showing depression symptoms);
Birth control pills to stop ovulation and disrupt the menstrual cycles;
Diuretics to reduce water retention.
However, holistic treatments and lifestyle that promote overall wellness are helpful in alleviating PMS symptoms naturally. These include but not limited to:
Regular aerobic exercises (e.g. jogging, swimming, cycling)
Qi gong (e.g. Tai chi, Shaolin soft fist)
Relaxation exercises (e.g. deep breathing exercise, meditation)
Low salt, high calcium diet
Restrict caffeine and alchohol
Acupuncture and acupressure
Balanced nutrition and supplements
Last but not least, go to bed when you need to sleep.
Considerations of A TCM Treatment
TCM treats PMS using Chinese herbs, acupuncture, therapeutic tui-na and moxibustion. The treatment principles are set in accordance with your syndrome differentiation and the energetic changes of the four phases of the menstrual cycle, namely the menstrual phase, follicular phase, ovulation phase, and luteal phase.
The time before next menstruation, also called the luteal phase, is generally considered a phase of relative repletion, in terms of qi and blood, therefore sedation is used to clear blockage. On the other side, the time after a menstruation, also called the follicular phase, is a relative vacuity condition, therefore tonifying qi and blood is the main treatment principle during this phase.