When Less Is the Problem: Rethinking PMS in Modern Women
By Winston Lee, L.Ac., Ph.D., KMD
About six months ago, a 24-year-old woman and her mother visited my clinic. Her chief complaint was irregular menstruation and severe menstrual cramps. While the average menstrual cycle is around 28 days, she only had a period once every three months. When it did come, the pain was so intense that she couldn’t function in daily life—she had to stay home for several days, relying heavily on painkillers. An ultrasound had revealed no significant abnormalities.
At the time, she was in her final year of college, juggling graduate school applications and a part-time job. Physically and mentally, she was under a great deal of stress.
My diagnosis was “Blood Deficiency.” Her body wasn’t producing enough menstrual blood, leading to delayed cycles and intense pain during menstruation. I prescribed an herbal formula centered around blood-tonifying herbs, including Bai Shao (White Peony Root), Bai Zhu (Atractylodes), Fu Ling (Poria), and Shu Di Huang (Rehmannia).
After just two weeks of taking the herbs, her period came—this time, without the usual pain. Recently, she returned to my clinic for a different issue and happily shared that since taking the herbs six months ago, her periods have become regular and pain-free. She said her quality of life has improved so much that it feels like she’s living a completely different life.
Although people today consume far more calories than when classical Chinese and Korean medicine texts were written, this doesn’t prevent Blood Deficiency. Modern diets are often high in carbohydrates and fats, yet still leave many people lacking in the nourishing elements needed to support blood health, especially during times of stress.
In my clinical experience, most cases of menstrual cramps and irregular cycles in young women today stem from deficiency patterns rather than excess. Common lifestyle factors—such as chronic stress, poor sleep, dehydration, excessive caffeine consumption, and overexertion—gradually deplete the body’s blood supply. In such cases, herbal formulas that focus on tonifying the blood can lead to remarkable improvements.
It’s essential to remember that being young or having a normal (or even above-normal) body weight does not mean a person is not blood deficient. In Eastern Medicine, physical and emotional stress can rapidly consume the body’s blood, just like water evaporates in a boiling pot. Replenishing the blood is essential to restoring balance, and that’s where herbs like Bai Shao, Bai Zhu, Fu Ling, and Shu Di Huang play a vital role.
