Today, I’m excited to take you inside a real case from my clinic! We’re discussing the case of a 29-year-old female patient struggling with PMS and tension headaches—a combination we see all too often in practice.

In this video, I’ll guide you through my step-by-step diagnosis process, how I built the treatment plan, and what results we achieved with acupuncture, diet, and herbs. By the end, you’ll feel more confident recognizing and treating similar Liver Qi-related patterns in your own clinical work.

Let’s get to it!

Clara
TCM Geek

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She Was Suffering from PMS & Headaches – Here’s How TCM Fixed It!

Understanding the Patient’s Symptoms

My patient, age 29, came in with premenstrual syndrome (PMS) as her main complaint. She described breast tenderness, irritability, and frequent tension headaches that worsened just before her period.

Other important details included:

• Emotional sensitivity and mood swings before menstruation

• Headaches in the temporal and orbital regions, aggravated by stress

• Sighing and rib-side tightness

• Sensitivity to light and sound during episodes

• Normal appetite, but a tendency toward mild bloating after meals

From a TCM perspective, these symptoms immediately point toward Liver Qi stagnation affecting the head and digestive system—but we’ll break it down in more detail below.

Diagnosis Using TCM Principles

Let’s analyze the case through multiple TCM frameworks to build a clear diagnosis:

Eight Principles

• Internal pattern (not caused by external pathogens)

• Excess rather than deficiency—stagnation and heat are dominant

• Yang in nature, due to heat and upward movement of Qi

Four Vital Substances

• Qi stagnation of the Liver leading to emotional tension and PMS

• Blood deficiency secondary to stagnation (causing tenderness and headaches)

• Mild Body Fluid deficiency from heat affecting the Stomach

Zang Fu Diagnosis

• Liver Qi stagnation with Liver heat rising

• Stomach heat and rebellious Qi (hence the headaches and irritability)

Five Element Theory

• The Liver (Wood) is overacting on the Stomach (Earth)—a classic “Wood attacking Earth” pattern.
  This imbalance causes digestive symptoms, emotional frustration, and headaches, especially around menstruation when Liver Qi becomes most active.

TCM Treatment Plan

The focus of treatment was to soothe Liver Qi, clear heat, harmonize the Stomach, and calm the Shen (mind).

1. Move and Pacify Liver Qi

• LV3 + LI4 – “The Four Gates” combination to move Qi and Blood.

• SJ6– for hypochondriac tension and constipation.

2. Clear Stomach Heat & Rebellious Qi

• PC6  + Ren17 – to descend Qi, release chest tension, and harmonize digestion.

• ST36 – supports Qi flow and relieves Stomach heat through regulation.

3. Calm the Mind & Relieve Stress

• Yin Tang – relaxes the nervous system and soothes emotional agitation.

• HT7 – nourishes the Heart and quiets the mind.

• KD6 – balances Yin, calms anxiety, and supports hormonal regulation.

4. Diet & Lifestyle Guidance

• Avoid spicy, greasy, and fried foods that generate heat and stagnation.

• Encourage cooked greens, peppermint tea, and warm, balanced meals.

• Suggest deep breathing, journaling, and gentle exercise (like yoga or tai chi) to keep Liver Qi moving.

5. Herbal Formula Options

Depending on the presentation, several formulas can help:

• Chai Hu Shu Gan San – to smooth Liver Qi and relieve PMS.

• Qing Wei San – for stomach heat symptoms like irritability or red tongue.

• Zuo Jin Wan – if acid reflux or digestive discomfort are present.

For many patients, acupuncture and diet alone bring powerful relief, but herbs can enhance and sustain results.

Results and Reflection

After two months of weekly acupuncture sessions, plus dietary adjustments and mindfulness practices, the patient reported:
✅ Headaches completely resolved
✅ PMS symptoms significantly reduced
✅ Menstrual cycle became regular and more balanced
✅ Energy, mood, and sleep improved

This case beautifully illustrates how TCM sees and treats the whole person, not just the symptom.

When we identify the root cause—like Liver Qi stagnation and heat affecting the Stomach and Heart—we can create targeted, effective, and lasting change.

TCM truly ROCKS!