PMS - Spleen Deficiency with Phlegm-Dampness Pattern

Dr. Li Wei, DACM

PMS · Spleen Deficiency with Phlegm-Dampness Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Pelvis

Pattern Overview

Spleen Deficiency with Phlegm-Dampness is a common pattern in PMS, characterized by water retention, weight gain, bloating, heavy sensation, and sticky mouth. The core pathogenesis is Spleen deficiency with Phlegm-Dampness accumulation, leading to fluid retention, weight gain, and bloating.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Water retention, weight gain, bloating, heavy sensation |

| Associated Symptoms | Sticky mouth, fatigue, loose stools, poor appetite |

| Tongue and Pulse | Pale and swollen tongue with white greasy coating, soft and weak pulse |

| Pathogenesis | Spleen deficiency with Phlegm-Dampness accumulation |

| Etiology | Hormonal changes, poor diet, sedentary lifestyle, constitutional Spleen deficiency |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

| Pishu (BL20) | Lower back, 1.5 cun lateral to T11 | Back-Shu point of Spleen meridian; strengthens Spleen-Qi |

| Zusanli (ST36) | 3 cun below the patella, 1 finger-width lateral to the tibial crest | Strengthens Spleen and Stomach; tonifies Qi |

| Fenglong (ST40) | 8 cun above the lateral malleolus, 2 cun lateral to the tibial crest | Transforms Phlegm and Dampness |

| Zhongwan (RN12) | 4 cun above the umbilicus | Front-Mu point of Stomach; harmonizes the Stomach |

| Yinlingquan (SP9) | Below the medial condyle of the tibia | Transforms Dampness and promotes diuresis |

Clinical Recommendation: Filament needle, even method; moxibustion may be applied to Pishu and Zusanli to strengthen Spleen and transform Dampness.

Herbal Formula

Base Formula: Shen Ling Bai Zhu San (参苓白术散) + Er Chen Tang (二陈汤)

Composition:

Ginseng (Ren Shen), Atractylodes (Bai Zhu), Poria (Fu Ling), Dioscorea (Shan Yao), Hyacinth Bean (Bian Dou), Coix Seed (Yi Yi Ren), Tangerine Peel (Chen Pi), Pinellia (Ban Xia), Licorice (Gan Cao)

Action: Strengthens Spleen, transforms Phlegm, and drains Dampness.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Severe water retention | Add Ze Xie, Che Qian Zi to promote diuresis |

| Weight gain | Add Cang Zhu, Hou Po to dry Dampness |

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

| Sticky mouth | Add Huo Xiang, Pei Lan to transform Dampness |

Western Mechanism Reference

Water retention with elevated aldosterone, abnormal antidiuretic hormone secretion, and weight gain. Spleen Deficiency with Phlegm-Dampness corresponds to PMS with fluid retention, where elevated aldosterone levels and abnormal ADH secretion contribute to water retention and weight gain.

References

  1. Gynecology of TCM - PMS with Spleen Deficiency and Phlegm-Dampness.

  2. Xiong Jibai: Spleen Deficiency with Dampness uses Shen Ling Bai Zhu San.

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

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