PMS: cramps, cravings, tears… and, according to Chinese Medicine, a whole lot of blocked qi. Dr Vivian Tam breaks down what your symptoms are really saying, and how tuning into your body’s energy can make each phase a little smoother.

Guest Post by Dr Vivian Tam

In Chinese Medicine, the menstrual cycle isn’t just about hormones. It’s a rhythm of yin, yang, qi and blood. Women’s cycles are also understood in seven-year phases - at seven, a girl gets her first teeth, at fourteen, menstruation begins, and at twenty-one and twenty-eight, fertility is at its peak. By thirty-five, fertility begins to decline, and around forty-nine, menopause occurs.

When I’m assessing hormone imbalance, I don’t just look at lab results. I ask detailed questions about cycle length, flow, whether bleeding is heavy or light, the colour and consistency of the blood, and whether there are clots. PMS symptoms tell us a lot, too - mood changes, energy dips, breast tenderness, bloating or fluid retention. Pain and cramps give more clues, as do the tongue and pulse. Because hormones affect the whole body, I also ask about digestion, sleep and overall wellbeing.

PMS is a sign that the body is imbalanced. Sometimes it’s stagnation - qi and energy blocked. Sometimes it’s a deficiency - the body doesn’t have enough energy to drive the hormone system. It can also be excess - inflammation, heat or dampness. Emotional shifts before bleeding are often due to liver qi stagnation. In TCM, the liver is tied to mood, so when its qi is blocked, emotions can feel heightened.

Supporting yourself in the luteal phase is about calming and moving qi. Breathing exercises, gentle movement, warm foods, good sleep and reducing stress all help. Stress is one of the biggest contributors to stagnation and makes PMS worse.

Digestive symptoms like bloating are another big pre-period complaint. Progesterone naturally slows digestion, but in TCM, it’s also a sign of stagnation. My go-tos are adaptogens, warming foods like ginger and cinnamon, and avoiding cold drinks or raw foods. Sometimes it’s also about listening to your body - swapping an intense workout for a walk can make all the difference.

Even “cortisol face” - puffiness in the luteal phase - fits here. To us, it reflects the body holding fluid because of stagnation. Acupuncture points like Spleen 6 (above the inner ankle) and Large Intestine 4 (between the thumb and index finger) are excellent for calming stress and balancing hormones, and adaptogenic herbs help support adrenal fatigue.

For me, the cycle isn’t a monthly inconvenience to fix. It’s a rhythm to work with - how your body speaks to you. The key is listening.”