Premenstrual syndrome

The regular occurrence about a week before each menstrual period of signs such as vexation, agitation, and irascibility, variously attended by painful distension of the breasts, clouded head and headache or hemilateral headache, fatigue, hypersomnia, oppression in the chest, sore throat and hoarse voice, abdominal distension and aching lumbus, water swelling, diarrhea, pain in the joints, urticaria, or itchy skin. Signs characteristically abate swiftly with the onset of menstruation. Premenstrual syndrome is a term adopted from Western medicine, but in Chinese medicine signs such as irascibility and painful distension of the breasts are classic signs of depressed liver qì. Their regular appearance in the menstrual cycle is understood in terms of the liver’s free coursing function and the thoroughfare (chōng) and controlling (rèn) vessels’ control over menstruation. Other signs are explained by different mechanisms, e.g., aching lumbus and knees by insufficiency of kidney yīn.

Medicinal therapy: For depressed liver qì marked by premenstrual irascibility, painful distension of the breasts, dizzy head or headache, and poor appetite, course the liver and resolve depression with variations of Moutan and Gardenia Free Wanderer Powder (丹栀逍遥散 dān zhī xiāo yáo sǎn). For insufficiency of kidney yīn characterized by limp aching lumbus, dry mouth and red cheeks, and night sweating, treat by enriching yīn and supplementing the kidney with Six-Ingredient Rehmannia Pill (六味地黄丸 liù wèi dì huáng wán).

Acumoxatherapy: For depressed liver qì, base treatment mainly on LR, PC, and SP. Selection PC-6 (Inner Pass, 内关 nèi guān), SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo), LR-3 (Supreme Surge, 太冲 tài chōng), BL-18 (Liver Transport, 肝俞 gān shù), BL-17 (Diaphragm Transport, 膈俞 gé shù), ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ), and LI-4 (Union Valley, 合谷 hé gǔ); needle with even supplementation and drainage and add moxa.

Point selection according to signs: For distending pain in the breasts, add CV-17 (Chest Center, 膻中 shān zhōng), and SI-11 (Celestial Gathering, 天宗 tiān zōng). For dizziness and headache, add GB-20 (Wind Pool, 风池 fēng chí), Greater yáng (tài yáng) (太阳 tài yáng), and GB-43 (Pinched Ravine, 侠溪 xiá xī). For poor stomach intake, add CV-12 (Center Stomach Duct, 中脘 zhōng wǎn) and ST-25 (Celestial Pivot, 天枢 tiān shū). For insufficiency of kidney yīn, base treatment mainly on KI and SP. Select BL-23 (Kidney Transport, 肾俞 shèn shù), KI-3 (Great Ravine, 太溪 tài xī), KI-6 (Shining Sea, 照海 zhào hǎi), KI-2 (Blazing Valley, 然谷 rán gǔ), and SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo); needle with supplementation.

Point selection according to signs: For limp aching lumbus and knees, add GV-3 (Lumbar Yáng Pass, 腰阳关 yāo yáng guān) and BL-40 (Bend Center, 委中 wěi zhōng). For dry mouth, add TB-2 (Humor Gate, 液门 yè mén). For night sweating, add LI-4 (Union Valley, 合谷 hé gǔ) and HT-6 (Yīn Cleft, 阴郄 yīn xī).