Premenstrual syndrome (PMS)
Navigating Through Woman’s Menstrual Cycle: Understanding Premenstrual Syndrome (PMS) and Exploring Treatment with Acupuncture and Herbs
While women undergoes the menstrual cycle, some of us are acutely aware of how it affects our body, and emotional wellbeing while others are not perturbed at all. There are many signs and symptom related to Premenstrual Syndrome (PMS), and treating PMS symptoms with Chinese herbal formula and acupuncture are a safe options, even when combined with western medicine.
PMS is widespread but often underestimated. It affects a high number of women worldwide (Gudipally, 2023) with a pooled prevalence of 47.8% which is nearly half of women of reproductive age. Characterised by physical and psychological symptoms, the complex interaction of hormones especially estrogen and progesterone significantly affects a woman’s quality of life. To grasp the nature of PMS, it is essential to explore its origins and take a look at the mechanism of how the symptoms appear.
The ups and downs of a woman’s menstrual cycle can be described as waves, and in order to navigate it, it is beneficial for everyone to understand why. A particular phase many women complaint about is during the period (no pun intended!) before their period. This stage is commonly known as PMS. The symptoms typically appear at various points of the hormonal cycle which is made up of 2 major phases – Follicular and Luteal and 2 sub-phases, the menstrual cycle and ovulation. The follicular phase (Phase 1) starts at day 1 to 15 with the onset of menstruation. This phase ends with ovulation which may happens on the 14th or 15th day. However, it all varies too depending on the woman’s regular cycle which ranges between 28 to 31 days or maybe more (we will pick up another discussion on this if your cycle is longer than 30 days).
The luteal phase (Phase 2) happens usually one to two weeks before menstruation begins which is day 15th to 28th. Hormonal fluctuations, particularly the fluctuation of estrogen and progesterone levels during this phase, is strongly manisfested, thus grouped as PMS symptoms.
Hormones During The Menstrual Cycle and Its Effects
In the menstrual phase (day 1-7), indicated by the start of menstruation, estrogen and progesterone levels are at their lowest levels. This decline often brings about a sense of relief, but for some, it can also lead to fatigue, mood swings and irritability. As the follicular phase commences, estrogen steadily rises, contributing to increased energy levels, improved mood, and heightened cognitive abilities. During this phase, a woman feels rejuvenated and determined. Ovulation marks the pinnacle of hormonal activity, with a surge in estrogen and a peak in luteinizing hormone (LH). This surge not only triggers ovulation but also brings about heightened physical attractiveness and an elevated sense of well-being. The subsequent luteal phase witnesses rising progesterone levels, contributing to a sense of calm but potentially fostering mood swings, irritability, and physical symptoms such as bloating and breast tenderness. Understanding these intricate hormonal dynamics is essential to comprehend the cyclical nature of the symptoms.
In Chinese Medicine (CM), Yang cycle is associated to the first phase i.e. rising of estrogen level, and Yin phase with the rising of progesterone and the possibility of pregnancy where the kidney essence takes a major role.
Effects on a Woman’s Body
PMS rears its ugly head in diverse ways, affecting different aspects of bodily functions. Symptoms range from back pain, abdominal pain, bloating, breast tenderness, headaches, and fatigue. Emotional and psychological symptoms can include mood swings, irritability, anxiety, and even depression. The intensity and specific symptoms can vary widely among individuals and is also subject to their current mental state. For example, pre-existing stress due to external factors may exacerbate some PMS symptoms and vice versa, according to Alwafa et al. (2021). Some uncommon but often overlooked PMS symptoms are dizziness, fainting, numbing sensations in the fingers, arms or legs and heart palpitations. It is important to monitor severe symptoms and seek help from health professionals to isolate undiagnosed or unrelated conditions.
Statistics on PMS
Statistics reveal that approximately 75% of menstruating women experience at least one symptom of PMS during the week before their period with around 3-8% reporting severe PMS symptoms that come in the way of their daily life (Gao et al., 2021). The prevalence varies, with women in their late 20s to early 40s being more likely to experience pronounced symptoms. PMS can significantly impact daily life, affecting relationships, work performance, and overall well-being.
A common approach to managing PMS with nonpharmacological treatment often involves lifestyle modifications and herbal remedies. Maintaining a balanced diet, regular exercise, and stress management are key components. Herbal supplements, like chasteberry and evening primrose oil (Farag et al., 2023), have been used to address hormonal imbalances and alleviate specific symptoms associated with PMS.
Western Medicine Approach
In Western medicine, various treatments are available to manage PMS symptoms. Hormonal contraceptives, such as birth control pills, are often prescribed to regulate hormonal fluctuations by ensuring hormones are at levels to reduce the severity of symptoms. However, antidepressants particularly selective serotonin reuptake inhibitors (SSRIs), may be recommended for those with severe emotional symptoms or experience a spike in mental health issues (Dilbaz & Aksan, 2021).
Nonsteroidal anti-inflammatory drugs (NSAIDs) can help alleviate pain and discomfort that come in the form of cramps, headaches and dizziness.
Traditional Chinese Medicine (TCM) Approach
Traditional Chinese Medicine offers a different perspective and applies more holistic approach to managing PMS symptoms. Acupuncture, a key component of TCM, has shown efficacy in regulating hormonal imbalances, reducing physical discomfort, and alleviating emotional symptoms. By inserting thin needles into specific acupuncture points related to reproductive organs and hormonal regulation, TCM aims to restore balance and harmony within the body. Herbal remedies, such as Dong Quai and White Peony Root, further enhance the personalized approach to symptom management.
The diagnostic procedure is to identify patterns based on findings of sleep, diet, fluid intake, bowel movements, energy level, menstrual flow, and emotions are among the many factors to determine where stagnation and disharmony are presented. The idea is to determined the Ben and Biao (root and branch) manisfestations of signs and symptoms.
Comparison of Treatments
The intricate nature of PMS and its varying impact on women necessitate a multifaceted approach to treatment. In a nutshell, there is no one set route that can be used to treat these symptoms. Instead a more personal and holistic route has to be taken, as every woman experiences PMS in her own way and severity. Western medicine interventions, such as hormonal contraceptives and antidepressants, provide targeted relief for specific symptoms.
Traditional Chinese Medicine (TCM) offers women a harmonious approach to managing and controlling PMS from getting worse. By targetting the root cause of hormonal imbalances, treatment by acupuncture aims at restoring the flow of Qi and promoting overall well-being. Acupuncture points related to reproductive organs and hormonal regulation are strategically stimulated, providing relief from physical discomfort and emotional distress (Zhang et al., 2019).
The use of herbal remedies in TCM further enriches the treatment plan and highly recommended. Herbal remedies, unlike western medicine are formulated based on the same principle as acupuncture formula. There is not one herb being use but a combination of herbs which addresses the root cause and relieve the associated symptoms identified.
Therefore if you choose Traditional Chinese Medicine as your go-to remedies for PMS, begin by consulting your TCM practitioner to get more information and prepare a treatment plan. It is highly recommended to prepare a feedback mechanism to measure treatment results and report any adverse effects.
Western medicine can always be combined with TCM treatments, however both your doctor and TCM practitioner need to be informed and transparent with every aspect of the treatment plan and prescription of medications or herbal remedies.
If you or a loved one is experiencing monthly turmoil due to the complications of PMS, contact us by phone or book us online for a 15 mins free consultation. We are always here to listen and assist in harnessing your capacity to manage PMS.
Alwafa, R. A., Badrasawi, M., & Hamad, R. H. (2021). Prevalence of premenstrual syndrome and its association with psychosocial and lifestyle variables: a cross-sectional study from Palestine. BMC Women’s Health, 21(1). https://doi.org/10.1186/s12905-021-01374-6
Dilbaz, B., & Aksan, A. (2021). Premenstrual syndrome, a common but underrated entity: review of the clinical literature. Journal of the Turkish German Gynecological Association, 22(2), 139–148. https://doi.org/10.4274/jtgga.galenos.2021.2020.0133
Farag, M. A., Reda, A., Nabil, M., Elimam, D. M., & Zayed, A. (2023). Evening primrose oil: a comprehensive review of its bioactives, extraction, analysis, oil quality, therapeutic merits, and safety. Food & function, 14(18), 8049–8070. https://doi.org/10.1039/d3fo01949g
Gao, M., Gao, D., Sun, H., Cheng, X., An, L., & Qiao, M. (2021). Trends in research related to premenstrual syndrome and Premenstrual dysphoric Disorder from 1945 to 2018: A bibliometric analysis. Frontiers in Public Health, 9. https://doi.org/10.3389/fpubh.2021.596128
Gudipally, P. R. (2023, July 17). Premenstrual syndrome. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK560698/
Zhang, J., Cao, L., Wang, Y., Jin, Y., Xiao, X., & Zhang, Q. (2019). Acupuncture for Premenstrual Syndrome at Different Intervention Time: A Systemic Review and Meta-Analysis. Evidence-based complementary and alternative medicine : eCAM, 2019, 6246285. https://doi.org/10.1155/2019/6246285