Conditions · Women’s health
Acupuncture for PMS
PMS is the irritability, low mood, bloating, breast tenderness and cravings that come in the week or two before your period and ease once it starts. Chinese medicine sees it as a pattern that builds through the cycle, and treats that pattern.
Common symptoms
- Irritability, mood swings or feeling low in the days before your period
- Breast tenderness or swelling
- Bloating and fluid retention
- Food cravings, tiredness or poor sleep
- Headaches before your period
- Symptoms that ease within a few days of bleeding starting
Common causes
- Sensitivity to the normal rise and fall of estrogen and progesterone after ovulation
- Changes in brain chemicals such as serotonin across the cycle
- Stress and poor sleep, which can make symptoms stronger
- A severe form, premenstrual dysphoric disorder (PMDD), in some people
How Chinese medicine understands PMS
PMS is different from a painful period. If cramping pain with the bleeding is your main problem, see period cramps. This page is about the week or two before: the short temper, the tears, the tender breasts, the bloating and the cravings.
In Chinese medicine, the second half of the cycle is when Qi and Blood gather in preparation for the period. If they cannot move freely, the pressure shows up as PMS. The patterns most often described are:
- Liver Qi stagnation. The most common one. Irritability, snapping at people, breast tenderness, a feeling of tightness under the ribs, sighing, and bloating. Symptoms are worse with stress and ease once the period starts.
- Liver Qi stagnation with heat. The same picture, but hotter: anger that flares, headaches, a red face, poor sleep and thirst.
- Spleen Qi deficiency with dampness. Bloating, puffiness, sugar cravings, loose stools and heavy tiredness before the period.
- Blood deficiency. A weepy, anxious low mood, poor sleep, dizziness and a light period. In Chinese medicine the Blood is thought to anchor the mind, so when it runs short before a period, mood suffers.
- Kidney deficiency. Low back ache, tiredness and low mood, often in the later reproductive years.
Most people have a mix. Someone who is tense and stuck is treated by moving Qi; someone who is run down is treated by building Blood. That is why the diagnosis comes first.
What treatment involves
Your first visit includes a lot of questions about your cycle: which symptoms come, on which days, how strong they are and when they lift. We also cover sleep, digestion, energy and stress. I look at your tongue and take your pulse. If you have tracked your symptoms for a few cycles, bring the record. The first visit is 75 minutes, including the diagnosis and the first treatment, and follow-ups are 60 minutes.
Acupuncture for PMS commonly uses points on the legs, arms, belly and head, chosen for your pattern. Treatment aims to ease tension, settle mood and sleep, and reduce bloating and breast tenderness. It is usually spread across the whole cycle, with the second half as the focus.
Chinese herbal medicine is often part of the plan: a formula written for your pattern and dispensed at the clinic in Keswick. Herbs are extra to the treatment fee. The formula may change at different points in your cycle.
Plan on 5–10 treatments to judge progress. Because PMS comes once a month, it takes a few cycles to see whether things are shifting, so keep tracking while you are in treatment.
Between visits
- Track your symptoms daily for at least two cycles. Note mood, breasts, bloating, sleep and the day bleeding starts. It helps your doctor and it shows your pattern.
- Move most days. Walking, swimming or yoga are low-risk and can help mood and bloating.
- Cut back on caffeine, alcohol and salty food in the second half of your cycle.
- Eat regular meals. Long gaps can make cravings and mood swings worse.
- Protect your sleep, especially in the week before your period.
When to see your doctor first
PMS is common, but other problems can look like it. See your doctor if:
- Your mood before your period is severe enough to affect work, school or relationships. This may be PMDD, which has specific medical treatments.
- Your low mood or anxiety does not lift after your period starts. That points to something other than PMS.
- You have heavy bleeding, bleeding between periods, or new pelvic pain.
- Your cycle has become irregular, or your periods have stopped.
- You are in your forties and your symptoms have changed. Perimenopause can look like PMS.
If you ever have thoughts of harming yourself, call or text 9-8-8 (Canada’s suicide crisis helpline) any time, or call 911.
What the research says
Across five small trials (277 women), the limited evidence suggested acupuncture and acupressure may improve both physical and psychological PMS symptoms compared with a sham control. The evidence was low to very low quality, no trials compared acupuncture with recommended treatments such as SSRIs, and the authors called for better research.
Acupuncture and acupressure for premenstrual syndrome. Cochrane Database of Systematic Reviews, 2018.
Research findings describe groups of people in studies. How you respond depends on your own diagnosis.
Questions about pms
How is PMS different from period cramps?
PMS is about the days before your period: mood, bloating, breast tenderness, cravings. Period cramps are pain in the lower belly that starts with the bleeding. Many people have both, and Chinese medicine often finds a shared pattern, but the treatment focus is different.
When in my cycle should I come in?
You can start at any point. In Chinese medicine the pattern behind PMS builds in the second half of the cycle, so treatment is usually spread across the month rather than booked only for the bad week.
Can I keep taking the pill or an antidepressant my doctor prescribed?
Yes. Do not stop or change a prescribed medicine without talking to your doctor. Tell me everything you take at your first visit, because it affects what your cycle shows and what a herbal formula should contain.