Premenstrual Tension

WESTERN MEDICINE: Premenstrual tension is a condition characterized by nervousness, irritability, emotional instability, depression, frequent headaches, generalized edema, and mastalgia, which occurs periodically and cyclically during the 7 to 10 days prior to menstruation but disappears a few hours after the onset of menstrual flow. 

Premenstrual tension occurs most frequently between ages 25 and 40. Its etiology Is unknown. but it may be due to fluid accumulation as a result of sodium ion retention caused by increased steroid hormone activity during the latter half of the menstrual cycle. The greatly increased nervous irritability is thought to be due to edema of nervous tissue generally, as well as to cerebral edema. 

ETIOLOGY AND PATHOLOGY: Premenstrual tension has close relationship with liver, spleen and kidney three organs. Liver plays the most important role in menstruation by its functions of storing blood, regulating and harmonizing. Since the liver is easy to attack spleen, and liver's blood need to supplied by kidney essence, so spleen and kidney are also closely related to menstruation. The common seen etiological factors are the stagnation of liver Qi; the deficiency of spleen and kidney; the deficient liver fire due to its blood deficiency. 


1. Liver Qi Stagnation Type: 

Indications: Before menstruation, there are symptoms of masto-fullness, or distention, or mastalgia, or even can not be torched by clothes, or accompanied with lower abdominal fullness and pain, or referred to chest and hypochondriac regions, restlessness, easy to get irritated. Probably normal tongue, wiry pulse. 

Treatment & Formulas: Regulate and harmonize the liver Qi, promote the blood circulation. 


    • Xiao Yao San (Tang - kuei and Bupleurum Formula, Item No. 2195): It has very good in helping liver's regulating-and harmonizing functions.
    • Jia Wei Xiao Yao San (Bupleurum and Paeonia Formula, Item No. 2068): It treats liver Qi stagnation plus interior heat. 
    • Yi Gan San (Bupleurum Formula, Item No. 2105): It is also a formula which regulate and harmonize the liver Qi. It is often applied for unstable emotions, nervousness, neurosis, insomnia, hysteria. 

2. The Spleen and Kidney Yang Deficiency Type:

Indications: Before menstruation, there show edema on face, eye lids, or four limbs, or diarrhea, poor appetite, abdominal fullness or pain, or sore and weak sensation at lumbar region and knees, lassitude. White and greasy tongue coating, deep and deep weak pulse. 

Treatment & Formulas: Warm and tonify spleen and kidney. 


    • Jia Wei Chang Chun (Ginseng & Codonopsis Combination, Item No. S3101, D3041): It is tonic formula for kidney and spleen, especially kidney. 
    • Shen Ling Bai Zhu San (Ginseng and Atractylodes Formula, Item No. 2173): It is tonic for spleen, so it is used for premenstrual tension with symptoms of edema, diarrhea, and other digestive problems. 

3. Liver Excessive Fire due to the Blood deficiency:

Indications: Restlessness, insomnia, dizziness, headache, especially at the top of head, painful body, symptoms can show before, or during, or after menstruation. Pale or red tongue, thready and wiry pulse, or thready and rapid pulse. 

Treatment & Formulas: Tonify the blood and harmonize the liver. 


    • Ji Ju Di Huang Wan (Lycium, Chrysanthemum and Rehmannia Six Formula, Item No. 2290)
    • Si Wu Tang (Tang- kuei Four Combination, Item No. 2060): This is a blood tonic formula which can combine with Jia Wei Xiao Yao San (Bupleurum and Paeonia Formula, Item No. 2068). The latter can harmonize the liver and promote the circulation of blood and Qi.