PMS and menstrual pain from the perspective of TCM (Traditional Chinese Medicine)
First of all, what does the term TCM mean? TCM = “Traditional Chinese Medicine”
TCM is a medical science that developed in China more than 3000 years ago. The medical approach at that time was already preventive – that is, the prevention of disease. A Chinese doctor at that time only received money from his patients as long as they were healthy. The basic idea of TCM is to keep Yin and Yang in balance. You surely have heard of these two terms before.
Yang (white) stands for the male part, for warmth, dynamics, movement, the day. This also includes all male hormones. The time of Yang is from midnight to noon. Qi is also assigned to yang, which can be described as life energy or very superficially as our metabolism. Qi should always flow freely.
Yin (black) corresponds to the female part, substances such as blood, saliva, sweat, breast milk, lymph and bone marrow. This is commonly referred to as bodily fluids. This includes all female hormones. Yin is inward-facing, it represents purification, rest, protection and preservation. The time of Yin begins in the early afternoon and ends around midnight.
The basic principle of TCM is always to keep Yin and Yang in balance.
The female cycle from the point of view of TCM
TCM accredits much more importance to the female cycle than Western medicine. Is your cycle irregular, longer or shorter than before, has the amount or color of blood changed, is your period a painful experience? TCM interprets all of these symptoms as an imbalance in your body that needs to be regulated. According to TCM, a “healthy” cycle should always be regular and pain-free.
PMS from the TCM point of view
PMS usually arises from a blockage in the liver meridian. A meridian is an energy pathway that flows through the body – and there are several of them. They support each other. But they also hinder each other. You can think of these meridians as different highways in your body, running from the bottom up and crossing each other. If there are problems (=congestion) on one stretch of the highway, it will inevitably affect the other highways at some point.
Good to know: TCM often speaks of the organs liver, kidney, spleen, heart, and so on. However, this does not refer to the Western anatomical organ, but to a functional circuit associated with that organ.
A blockage or congestion in the liver meridian is called liver qi stagnation in TCM terminology and can cause a wide variety of PMS complaints. According to TCM, this meridian is very important for a symptom-free cycle. For one thing, it stores the blood and distributes it in the body – and this is extremely important for pain-free menstruation. So if a blockage or stagnation arises in this meridian (= congestion on the highway), Qi and blood cannot be distributed. You perceive this blockage as pain or discomfort.
What is PMS from the TCM point of view?
Possible physical symptoms can be:
Headaches, migraine, acne, sleep disturbances, hot flashes, circulation problems, pulling in the chest or sensitive breast, ovulation pain, food cravings, cravings for sweets, pulling in the legs and groin, weight gain, edema, indigestion, abdominal pain, tightness in the abdomen, nausea.
Psychological symptoms may include:
Lack of concentration, lethargy, exhaustion, irritability, tearfulness, hypersensitivity and mood swings. There are no limits in terms of emotions during this time. For some women, PMS begins as early as ovulation or in the luteal phase about 5 days before the onset of menstruation. Usually, all symptoms disappear with the onset of menstruation or shortly thereafter.
What are the causes of PMS or Liver-Qi stagnation?
Often, stagnation arises from a prolonged emotionally stressful situation. For example, due to dissatisfaction, pressure and stress – especially relationship stress, anger or rage. In today’s age, where many women have a job as well as a family, have to assert themselves and are often unable to show any weakness. The result? Their Yin – the female part – is more and more out of balance. And this is also noticeable in the cycle. Doggedness, high demands on oneself, comparing oneself with others, and wanting to do everything – all of that leads to an inner tension, which often shows itself in the liver meridian. There is a lack of relaxation, joy and time for oneself.
What can you do about PMS?
Realize that it can be quite useful to change your inner attitude towards yourself and your demands. I know – it’s easier said than done. Every woman is unique and the energy level of every woman is different. Therefore, please never compare yourself with others! Everything that frees you internally, such as gentle exercise – without performance thoughts – a walk in nature, relaxed jogging, dancing, being creative, journaling, living in tune with your sexuality, singing, yoga, massages or wellness, is good for you. With the “right” diet, the days before the days can be less stressful. Yang increases from ovulation onward because it’s supposed to get the blood moving – and for this, it needs movement and warmth. That means: The body temperature increases – and therefore also the temperament.
So to avoid too much dynamics/heat, everything in food is valuable that refreshes and moves. In TCM, each food is assigned to a certain temperature and a certain effect. For example, radish is cool and moves, rice cools, nourishes and relaxes. You can use foods as medicine.
Depending on the severity of your PMS, you can start eating easily digestible foods as early as ovulation. Vegetable soups, stews or steamed foods are especially recommended. Flowers such as rose blossom or orange blossom tea, also marigold tea and lady’s mantle tea relax and move the liver meridian. Drink 1 – 2 cups per day from ovulation or 1 week before menstruation. Do so over several months. To move the Qi – without overheating – fresh herbs, cress, chives and sprouts are also helpful.
What is counterproductive for PMS?
Avoid – especially during the time after ovulation – anything acidic such as tomatoes, yogurt, tropical fruits – because acid contracts and hinders the movement of Qi and blood. Anything fried, fatty, as well as lavish food in general, creates heat in the body and puts too much strain on the body. So do alcohol, coffee, yogi tea, nicotine, and hot spices. Tampons have a blood stagnant effect and therefore I would advise you to go without tampons if you suffer from PMS. Exercise is also a very important aspect to get your liver meridian going again. Special yoga and Qi-Gong exercises, which especially loosen up the liver energy pathway, will help you. But of course, a walk in nature and the types of exercise described above are also valuable aspects to get your Qi flowing again and to relax.
Can acupuncture help with PMS?
Do you have very severe pain or discomfort that has been present for a long time? Then it is always helpful and useful to support yourself with acupuncture. The main focus is to get the liver meridian going again. Make sure you find an experienced TCM therapist to get acupuncture. Don’t forget, however, that nutrition is always the foundation of all treatments.
Menstrual pain from a TCM perspective
Pain can arise from the imbalance of Yin & Yang. This can be menstrual pain like classic abdominal pain, but this can also be the PMS complaints listed. Any pain – no matter where in your body indicates that something is out of balance. If the pain is intense and you can describe the area with your hand, it is usually a Qi (=energy) blockage. If you can point directly to the pain point with your finger, it is usually a blood blockage.
Acupuncture for menstrual pain
Acupuncture can support you very well if you experience period pain. The corresponding energy channels (=meridians) are specifically triggered and activated to get Qi and blood moving again. This works best if you eat healthy food. Because Qi and blood are formed from food. So the healthier the food, the more Qi and blood you have available.

This article was written by Beate Birkel
Beate Birkel is a TCM nutritionist and a yoga teacher. Her mission is to break the taboo of menstrual cycles and women’s health and to educate about many nutritional misconceptions. Her approach is individual – her credo: Every woman has the right to experience a symptom-free cycle!