PMS - Liver-Qi Stagnation Pattern

TCM differentiation and treatment for PMS with Liver-Qi

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

swings |

Associated Symptoms

depression, premenstrual headache |

Tongue and Pulse

pulse |

Pathogenesis

stagnation |

Etiology Hormonal changes, chronic stress, 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; soothes Liver-Qi |

Qimen (LR14)

the nipple | Front-Mu point of Liver meridian; regulates Liver-Qi |

Neiguan (PC6)
Relieves chest tightness and calms the spirit
Sanyinjiao (SP6) 3 cun above the medial malleolus

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

|

Bloating

|

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

Personalized herbal protocols and acupressure tools for women's health.

research papers and clinical case studies on TCM gynecology.


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.