The Real Reason Behind Your PMS- A TCM & Functional Medicine Guide to Relief
I will never forget the first time I went in for an acupuncture treatment and the practitioner asked me about my menstrual cycle. I was completely caught off guard. No healthcare provider had ever asked if my periods were painful, and definitely not what my blood looked like, or whether I experienced PMS.
When I casually mentioned that I had "normal PMS," she looked at me and explained that PMS actually isn't normal. Common? Absolutely. But normal? No. She went on to tell me that in Traditional Chinese Medicine, a healthy menstrual cycle should ebb and flow with ease, much like the rhythms of nature and the cycles of the moon. Umm... what?!
Like so many women, I had grown up thinking that bloating, mood swings, cramps, cravings, fatigue, headaches, and feeling unlike myself for one to two weeks every month were simply part of being a woman. Just something to dread and deal with each month. But as it turns out, she was right.
After beginning my own healing journey, becoming a Traditional Chinese Medicine Practitioner, and dedicating years to studying, practicing, and supporting women's health through both Traditional Chinese Medicine and Functional Medicine, I now understand that PMS is simply a symptom of disharmony. It isn't something you have to expect every month or learn to live with. Instead, it's your body's way of communicating something deeper it wants you to address.
In this post, I'll walk you through how I approach PMS from both a Traditional Chinese Medicine and Functional Medicine perspective, along with the foundational protocol I often recommend to support hormone balance and address the root causes, not just the symptoms. You will find lifestyle recommendations along with the supplements I often suggest.
If you experience PMS or even PMDD, and feel like you have tried everything without improvement, I encourage you to reach out for support. There may be some deeper and more complex conditions that need to be addressed as well. In my practice I incorporate functional lab testing alongside foundational TCM principles. That is where I have found all the magic and healing happens.
The TCM View: Your Liver Is Talking to You
In Traditional Chinese Medicine, our diagnostics look and sound a little different. We look at the body through organ systems and patterns. One of the most common patterns of PMS is called Liver Qi Stagnation. The liver in TCM isn't just the organ that filters your blood. It's also in charge of the smooth, free flow of qi (energy) and emotions throughout the body. Think of qi like a river. When the river is flowing freely, everything moves as it should. But when something blocks the flow, the water begins to build up and create pressure. When that flow gets "stuck," and liver qi becomes stagnant, you may feel more emotionally reactive, tense, or irritable. You may notice that small things suddenly feel much more frustrating than usual. You may feel like you need to scream, cry, or get away from everyone, or you may simply feel like you have a lot of emotion and energy building inside of you with nowhere for it to go.
Physically, this stagnation can show up as symptoms in the week or two leading up to your period, including:
Irritability and mood swings
Breast tenderness or swelling
Bloating, digestive upset, nausea
Constipation or loose stools
Tension headaches, especially around the temples or eyes
A feeling of being "wound up" or emotionally stuck, with nowhere for that energy to go
Frequent sighing
Distention or a feeling of fullness in the ribcage
These symptoms occur when the body is having trouble moving and processing what needs to move and be processed. This can include physical energy, digestion, emotions, and even the natural transitions of the menstrual cycle. From a TCM perspective, the goal is not to suppress these symptoms. It is to help restore the smooth flow of qi and support the underlying patterns contributing to the stagnation.
The Functional Medicine View: A Hormone-Gut-Liver Connection
Estrogen Metabolism
Estrogen is produced, metabolized, and eliminated through a process that involves multiple organs and systems throughout the body.
Your liver helps metabolize hormones, while your digestive tract plays an important role in eliminating them from the body. Once estrogen has been processed by the liver, it needs to be properly excreted through the stool. If bowel movements are infrequent or the gut microbiome is not functioning optimally, some estrogen metabolites may be reactivated and reabsorbed into circulation. For some women, this may contribute to symptoms such as breast tenderness, bloating, heavy periods, mood changes, headaches, and irritability. This is one reason why regular bowel movements and a healthy gut are so important for hormone health.
Blood Sugar Balance
Blood sugar is another major piece of the PMS puzzle. When blood sugar rises and falls dramatically throughout the day, it can create additional stress on the body and activate stress hormones such as cortisol and adrenaline. Over time, blood sugar dysregulation can influence ovulation, insulin sensitivity, inflammation, and reproductive hormone production. This is why some women notice that their PMS comes with intense sugar cravings, feeling shakiness or irritable when they haven’t eaten, afternoon energy crashes, anxiety, and difficulty concentrating. For some women, what feels like a hormonal problem may also be a blood sugar problem. And because insulin and reproductive hormones are closely connected, supporting blood sugar balance can be an important part of supporting a healthy menstrual cycle and luteal phase.
Progesterone and Ovulation
PMS symptoms are also influenced by what happens during ovulation. After ovulation, the body produces progesterone, a hormone that helps support the second half of the menstrual cycle. Progesterone also has a calming effect on the nervous system. If ovulation is irregular, impaired, or not occurring consistently, progesterone production may also be affected. This can contribute to symptoms such as anxiety, irritability, sleep disturbances, breast tenderness, and changes in mood during the luteal phase. This is why supporting healthy ovulation is an important part of long-term PMS support.
The Stress Connection
And then there is stress, which, let's be honest, is a major factor for most of us. Your reproductive hormones do not exist in isolation from your nervous system. When your body is constantly receiving signals that it is under stress, it prioritizes immediate survival over things like reproduction and optimal hormonal balance. Chronic stress can influence ovulation, progesterone production, blood sugar regulation, thyroid function, sleep, inflammation, and digestion. This is why you can eat perfectly, take every supplement, and still struggle with PMS if your body never has the opportunity to feel safe, rested, and supported.
The Gut-Hormone Connection
The gut microbiome helps influence estrogen metabolism, inflammation, immune function, and blood sugar regulation. Digestive symptoms such as constipation, diarrhea, bloating, or changes in bowel movements around your period may provide important clues about what is happening beneath the surface. Your gut and your hormones are constantly communicating with one another. This is why I don't believe in approaching PMS by simply trying to "balance your hormones." Instead, we need to look at the systems that influence those hormones. Your PMS may be telling you that your body needs more support with hormone metabolism, nutrient status, and inflammation levels.
And this is where the Functional Medicine and TCM approaches come together beautifully.
Bringing It Together: A Root-Cause PMS Approach
When we combine the wisdom of Traditional Chinese Medicine with the Functional Medicine approach, we can begin to look at PMS from a much bigger perspective.
From a TCM lens, we may ask: Is qi stuck? Is there a deficiency of blood? Is there too much heat? Is the spleen struggling to properly transform and transport fluids and nutrients? From a Functional Medicine lens, we may ask: Are blood sugar fluctuations contributing to symptoms? Are there nutrient deficiencies? Is inflammation elevated? Are hormones being properly metabolized and eliminated? Is the gut supporting healthy hormone clearance?
These two systems may use different language, but they often point us toward similar areas of the body that need support. This is why I love combining both approaches in my practice. One of the ways I do this is though using both functional lab testing and TCM pattern recognition. For labs, I often utilize hormone testing and stool testing to get a full picture of your health, in addition to bloodwork that looks beyond the standard markers typically tested. Using those values, along with foundational TCM lifestyle and herbal treatments, we can create a more individualized approach to supporting lasting results.
Liftstyle Recommendations:
Before we talk about supplements, I want to emphasize that supplements are just one piece of the puzzle. The foundation of hormone health is built through the everyday habits that support your nervous system, blood sugar, digestion, and overall health.
Some of the most important foundational practices include:
Eating enough protein and pairing carbohydrates with protein, fat, or fiber to support healthy blood sugar
Prioritizing regular meals instead of chronically under-eating or skipping meals
Getting consistent, quality sleep, and aiming to go to bed before 11 p.m.
Moving your body regularly and incorporating activities that support circulation and sweating
Supporting regular bowel movements (1-2 per day), which are important for healthy hormone elimination
Limiting alcohol
Creating space for stress management and nervous system regulation
Eating more warming, nourishing, and cooked foods during the luteal phase
From a TCM perspective, the luteal phase is also a time to begin turning inward. Your body is naturally preparing for menstruation, and many women benefit from honoring this shift instead of trying to maintain the same energy and output they had during ovulation.
Before we talk about supplements, I want to emphasize that supplements are only one piece of the puzzle. You cannot out-supplement a lifestyle that is constantly working against your body. From a Functional Medicine perspective, we want to support the foundations that influence your hormones: blood sugar, sleep, digestion, inflammation, movement, and the nervous system. From a Traditional Chinese Medicine perspective, we also want to consider your relationship with your energy and body. Your body is constantly communicating with you. The goal is to start listening before it has to start shouting.
Eat Enough and Support Blood Sugar
One of the most important things you can do for your hormones is to eat enough food. I know this sounds incredibly basic, but chronic under-eating, skipping meals, or trying to survive on coffee until lunch can place additional stress on the body and make blood sugar regulation more difficult. Stable blood sugar helps support healthy insulin levels, cortisol regulation, ovulation, and reproductive hormone production. I always say that anxiety is blood sugar dysregulation until proven otherwise.
A non-negotiable is protein with breakfast. This helps support stable blood sugar and may reduce the intense cravings and energy crashes that many women experience before their period. If you have a hard time eating breakfast or don’t feel hungry in the mornings, that is a sign of imbalance. Try working in easy-to-digest foods like oatmeal, congee, and broths.
Prioritize Warm, Nourishing Foods
In Traditional Chinese Medicine, digestion is considered the foundation of qi and blood production. The spleen also plays an important roll transforming food into qi and blood. When digestion is supported, the body has the resources it needs to create energy and nourish the rest of the body.
One of the ways to support digestion and spleen qi, especially for women, is to emphasize more warm, cooked, and nourishing foods, particularly during the luteal phase. This one seems like it wouldn’t make a big difference but it really does!
This may look like:
soups, stews and congee instead of frozen smoothies
bone broths
roasted vegetables instead of raw
cooked grains
warming spices like ginger
Support Regular Bowel Movements
Your digestive system plays an important role in hormone metabolism and elimination. Regular bowel movements are important for eliminating hormone metabolites, including estrogen metabolites, from the body. From a TCM perspective, constipation can be a sign that qi is not moving smoothly. This is especially relevant when we are talking about liver qi stagnation. Your body needs a way to move things out.
Support regular bowel movements with:
adequate hydration
sufficient fiber (30 grams per day)
regular movement and sweating
enough food and avoiding chronic under-eating
addressing underlying digestive issues (getting testing done)
Ideally, you should be having regular, comfortable bowel movements. If constipation, diarrhea, or significant digestive changes occur regularly around your cycle, this may be an important clue worth investigating.
Move Your Body
Movement is one of the best ways to support the smooth flow of liver qi. In TCM, physical movement can help move stagnant qi and blood. This is particularly relevant for women who feel tense, frustrated, irritable, or physically stuck before their period. Regular movement also help with insulin sensitivity, mood (one of the best treatments for depression), stress regulation, and metabolic health.
Finding the right movement routine can be challenging, especially if you are experiencing intense PMS. However, building muscle is one of the best things we can do for our health as women so figuring out ways to exercise each week is so important for your longevity. As a functional fitness trainer, this is one of the things I work with women on in my 1:1 coaching.
Prioritize Sleep
Sleep is not a luxury when it comes to hormone health. Nighttime is an important time for the body to restore and replenish yin and blood. When we consistently sacrifice sleep, we are asking the body to keep producing energy without allowing adequate time for restoration. Try to create a consistent sleep and wake schedule, reduce stimulating activities before bed, eliminate doom scrolling at night, and turn off artificial light when it is dark outside. And, according to TCM, going to bed before 11 p.m. is especially important.
Create Space for Stress Regulation
This is one of the most important recommendations for women with PMS and liver qi stagnation. Emotional stress contributes to the stagnation of qi and dysfunction in the body. When we are constantly suppressing emotions, rushing, overworking, or living in a state of chronic tension, the body can begin to feel stuck. Chronic stress influences the HPA axis, cortisol, blood sugar, digestion, sleep, and reproductive hormones. Finding your favorite ways to work through stress can be life-changing. For me, I love to take a walk without my phone, spend as much time outside and in nature as possible, get acupuncture, create (new recipes, embroidery, gardens), journal, and read fiction books.
Honor the Shift Into Your Luteal Phase
Your energy is not meant to remain exactly the same throughout your entire menstrual cycle. The follicular phase and ovulation are generally more outward-facing phases of the cycle. You may naturally feel more social, energetic, creative, and motivated. After ovulation, the energy of the cycle begins to shift inward. If you continue trying to operate at the same pace and intensity as you did during ovulation, your body may eventually begin to push back. This does not mean you need to cancel your life for two weeks every month. It just means you may benefit from creating more space for rest, reflection, nourishment, and boundaries during the luteal phase. This is part of learning to move with the natural rhythm of your body rather than constantly fighting against it.
My Foundational PMS Protocol Supplements:
*Disclaimer: These recommendations are general education, not a substitute for individualized care. If you want a protocol tailored to your specific pattern and history, book an information call and we'll build one together.
I also recommend purchasing supplements through a trusted professional dispensary to ensure quality and purity. I've linked my professional-grade dispensary through Fullscript, where you can find all of the supplements mentioned below at a discounted price.
Magnesium Glycinate
WHY?
Magnesium is front-line treatment for so many hormone challenges (PMS, PMOS, period pain, etc.). Examples of food sources of magnesium include nuts, seeds and leafy greens, but food supply is often not enough. If you are stressed (umm hello that’s almost all of us in modern world), your body is going to excrete magnesium. This happens because your nervous system gets activated to help you deal with whatever stressor you have going on. Magnesium calms and soothes your nervous system, aids in sleep, regulates your HPA axis and improves insulin and thyroid hormone. It also is anti-inflammatory and helps with estrogen metabolism. All of these wonderful for healthy periods!
I recommend around 300mg of magnesium daily. If you experience painful periods, you can increase this dose a few days before your period.
Xiao Yao san
WHY?
This is a classic TCM formula, translating to “Free and Easy Wanderer,” is used to treat PMS. In TCM language, it pacifies the liver, moves qi, eliminates stagnation, nourishes liver blood and tonifies the spleen. In other words, it will help with mood, bloating, irritability, headaches, and distention before your period.
It works to gently move stagnant Liver Qi while also supporting the Spleen, which is the organ system responsible for digestion and the production of qi and blood in TCM. Because it addresses both the root imbalance and the resulting symptoms, it has remained a cornerstone of women's health for hundreds of years. It is a staple in my supplement cabinet for tough months of PMS!
Vitamin D
WHY?
Vitamin D is actually a hormone that regulates more than 200 genes in your body. It is important for insulin sensitivity, ovulation, calcium absorption, immune function and hormone optimization.
I recommend 2,000 IU after food that contains healthy fats, although your ideal dosage should be based on blood work.
zinc
WHY?
Zinc is anti-inflammatory and regulates our HPA axis and stress responses. It support healthy ovulation, decreases histamine, and increases progesterone and GABA. Zinc is especially important for thyroid hormone, skin healthy and healthy androgen levels. The best sources of zinc is red meat, oysters and shellfish.
I recommend 30mg daily with food. If you take it on an empty stomach it can cause nausea.
Omega-3 Fatty Acids
WHY?
Omega-3 fats help regulate inflammation throughout the body and are one of the most well-researched nutrients for menstrual health.
They help with reducing menstrual cramps, anxiety, inflammation, insulin sensitivity and brain health.
I recommend a high-quality fish oil that provides 1,000–2,000 mg of combined EPA and DHA daily. Do not get a poor quality fish oil!
beef liver capsules
WHY?
Beef liver is one of the most nutrient-dense foods available and is an excellent source of nutrients that support hormone production.
It naturally contains vitamin A, B vitamins, iron, copper, choline and selenium. Think of it as natures multi-vitamin. These nutrients help with energy production, thyroid function and healthy blood building. I love capsules because they are a food source and easy for the body to absorb.
Choose a high-quality, grass-fed beef liver supplement and follow the serving recommendations on the label.
inositol
WHY?
Inositol is one of my favorite supplements for women with insulin resistance, PCOS, irregular ovulation, or blood sugar-related hormone imbalances related to PMS. It can help with healthy ovulation, improve egg quality, reduce cravings and support mood. Because blood sugar has such a significant impact on our hormones, improving insulin sensitivity can dramatically improve PMS for many women.
Find a combined myo-inositol and d-chiro-inositol in about a 40:1 ratio. The standard dose is 2000-4000 mg daily.
I have all of these supplements and which brands I recommend on my trusted online pharmacy through Fullscript
Final Thoughts:
After working with so many women who have struggled with PMS each month, I am here to tell you that you do not have to settle for feeling this way forever. If you find yourself in a constant battle during each luteal phase, choose a few of these suggestions and implement them consistently for at least three months. Then, pay attention to whether you notice any changes.
Track your cycle, symptoms, and patterns to help you gain a better understanding of your body. When you begin to notice patterns, your symptoms become information, and that information can help guide your healing.
You are absolutely capable of feeling better and experiencing significantly fewer PMS symptoms. With the right tools, support, and individualized treatment plan, you can begin to work with your body instead of feeling like you are constantly fighting against it. Your PMS is not a character flaw, a lack of willpower, or something you simply have to endure every month. It is your body communicating with you. The more you learn to listen, the more empowered you become to support what your body actually needs.
Other posts that might be helpful:
Make this Luteal Phase Tea Blend prior to menstruation for added cyclical liver support.
These Protein Sesame & Date Balls are perfect for the luteal phase.
Do you struggle with PMS or PMDD? Your symptoms are not random, and you do not have to just “push through” them every month. If you are ready to better understand your hormones and feel more supported throughout your cycle, I invite you to book an information call to learn more about working together.
Let’s Connect!
