PMS - Liver Depression Transforming into Fire Pattern
TCM differentiation and treatment for PMS with Liver
PMS · Liver Depression Transforming into Fire Pattern
Updated: June 23, 2026
Reviewed by: Dr. Li Wei, DACM
Reading Time: 7 min
Body Area: Pelvis
Pattern Overview
Liver Depression Transforming into Fire is a common pattern in PMS,
characterized by **luteal phase neurotransmitter fluctuation,
irritability, headache, insomnia, acne, and premenstrual migraine**. The
core pathogenesis is Liver-Qi stagnation transforming into Fire,
leading to neurotransmitter imbalance, elevated prolactin, and emotional
and physical symptoms.
Key Symptoms and Differentiation Points
| Differentiation Dimension | Manifestations |
|---|
| Primary Symptoms |
|---|
premenstrual migraine |
| Associated Symptoms |
|---|
flashes, restlessness |
| Tongue and Pulse |
|---|
pulse |
| Pathogenesis | Liver-Qi stagnation transforming into Fire |
|---|
| Etiology |
|---|
emotional distress |
Acupuncture Point Prescription
| Point | Location | Function |
|---|
| Ganshu (BL18) | Lower back, 1.5 cun lateral to T9 |
|---|
of Liver meridian; soothes Liver-Qi |
| Taichong (LR3) |
|---|
metatarsals | Source point of Liver meridian; clears Liver Fire |
| Xingjian (LR2) |
|---|
metatarsals, proximal to the web margin | Spring point of Liver
meridian; drains Liver Fire |
| Dadun (LR1) |
|---|
corner | Well point of Liver meridian; clears Liver Heat |
| Neiguan (PC6) |
|---|
| Relieves chest tightness and calms the spirit |
Clinical Recommendation: Filament needle, reducing method; Xingjian
may be pricked to bleed to enhance Liver Fire drainage.
Herbal Formula
Base Formula: Dan Zhi Xiao Yao San (丹栀逍遥散) or Hua Gan Jian
(化肝煎)
Composition:
Moutan (Dan Pi), Gardenia (Zhi Zi), Bupleurum (Chai Hu), White Peony
(Bai Shao), Angelica (Dang Gui), Green Tangerine Peel (Qing Pi), Alisma
(Ze Xie), Fritillaria (Bei Mu), Licorice (Gan Cao)
Action: Soothes Liver-Qi, clears Fire, and regulates menstruation.
Modifications
| Associated Symptoms | Additions/Subtractions |
|---|
| Premenstrual migraine | Add Ju Hua, Xia Ku Cao to clear Liver Fire |
|---|
| Acne | Add Jin Yin Hua, Lian Qiao to clear Heat and detoxify |
|---|
| Insomnia | Add Suan Zao Ren, Yuan Zhi to calm the spirit |
|---|
| Constipation | Add Da Huang to drain heat |
|---|
Western Mechanism Reference
Luteal phase neurotransmitter fluctuation with decreased 5-HT, GABA
dysfunction, and elevated PRL. Liver Depression Transforming into Fire
corresponds to PMS with prominent irritability and physical symptoms,
where decreased serotonin and GABA dysfunction contribute to mood
changes, while elevated prolactin contributes to breast tenderness and
other physical symptoms.
References
1. Gynecology of TCM - PMS with Liver Fire.
2. Zang-Fu Pattern Differentiation: Liver Fire → Clearing Pathway.
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.
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Last reviewed: June 2026 | Lead author: Dr. Li Wei, DACM | Content updated: Monthly
Disclaimer: This guide is for educational purposes only and does not constitute medical advice. Consult a licensed healthcare provider before starting any treatment.