PMS - Liver-Qi Stagnation Pattern

Dr. Li Wei, DACM

PMS · Liver-Qi Stagnation Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Pelvis

Pattern Overview

Liver-Qi Stagnation is the most common pattern in PMS, characterized by luteal phase estrogen-progesterone imbalance, irritability, breast tenderness, bloating, and mood swings. The core pathogenesis is luteal phase hormonal fluctuations causing Liver-Qi stagnation, leading to emotional symptoms, breast tenderness, and fluid retention.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Irritability, breast tenderness, bloating, mood swings |

| Associated Symptoms | Chest tightness, frequent sighing, depression, premenstrual headache |

| Tongue and Pulse | Pale red tongue with thin white coating, wiry pulse |

| Pathogenesis | Luteal phase hormonal fluctuations causing Liver-Qi stagnation |

| Etiology | Hormonal changes, chronic stress, emotional distress |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

| Ganshu (BL18) | Lower back, 1.5 cun lateral to T9 | Back-Shu point of Liver meridian; soothes Liver-Qi |

| Taichong (LR3) | Dorsum of the foot, between the 1st and 2nd metatarsals | Source point of Liver meridian; soothes Liver-Qi |

| Qimen (LR14) | On the chest, 4 cun lateral to the midline, below the nipple | Front-Mu point of Liver meridian; regulates Liver-Qi |

| Neiguan (PC6) | 2 cun above the wrist crease, between the tendons | Relieves chest tightness and calms the spirit |

| Sanyinjiao (SP6) | 3 cun above the medial malleolus | Regulates menstruation and harmonizes Liver and Spleen |

Clinical Recommendation: Filament needle, reducing method; combine with stress reduction techniques. Treatment is most effective when started 1-2 weeks before menstruation.

Herbal Formula

Base Formula: Xiao Yao San (逍遥散) or Chai Hu Shu Gan San (柴胡疏肝散)

Composition:

Bupleurum (Chai Hu), White Peony (Bai Shao), Angelica (Dang Gui), Atractylodes (Bai Zhu), Poria (Fu Ling), Cyperus (Xiang Fu), Mint (Bo He), Licorice (Gan Cao)

Action: Soothes Liver-Qi, nourishes Blood, and regulates menstruation.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Severe breast tenderness | Add Ju He, Zhe Bei Mu to regulate breast Qi |

| Bloating | Add Mu Xiang, Sha Ren to regulate Qi and relieve distension |

| Depression | Add Yu Jin, He Huan Pi to relieve depression |

| Insomnia | Add Suan Zao Ren, Yuan Zhi to calm the spirit |

Western Mechanism Reference

Luteal phase estrogen-progesterone imbalance with abnormal E2/P ratio, aldosterone elevation causing water and sodium retention. Liver-Qi Stagnation corresponds to PMS with prominent emotional and physical symptoms, where hormonal fluctuations and aldosterone elevation contribute to mood changes and fluid retention.

References

  1. Gynecology of TCM - PMS with Liver Depression.

  2. Xiong Jibai: Liver Depression uses Chai Hu Shu Gan San.

  3. WHO. (2023). Women’s health. World Health Organization.

Explore More

  • Find your solution at MendGod.com – Personalized herbal protocols and acupressure tools for women’s health.

  • Deepen your knowledge at TcmCIO.com – Full research papers and clinical case studies on TCM gynecology.