Integrative Management of Premenstrual Dysphoric Disorder: The Role of Traditional Chinese Medicine

Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS), affecting 3%-8% of women of reproductive age. It is characterized by emotional, behavioral, and physical symptoms during the luteal phase, primarily driven by neuroendocrine sensitivity to hormonal fluctuations and dysregulation of central neurotransmitter systems. Genetic predisposition and environmental stressors contribute to its onset. Although conventional treatments such as selective serotonin reuptake inhibitors (SSRIs) and hormonal therapies offer symptom relief, they are often accompanied by adverse effects and limited long-term efficacy. Traditional Chinese medicine (TCM) posits that the core pathogenesis of PMDD lies in the dysfunction of liver's conveyance and dispersion, which may consistent with modern biological research evidence. TCM approaches, represented by Chinese herbal medicine and acupuncture, may alleviate symptoms of PMDD by targeting and modulating its core modern pathogenic mechanisms. With its few side effects and the unique advantage of individualized treatment based on syndrome differentiation, TCM holds the potential to become a mainstream therapeutic option for PMDD. This narrative review synthesizes evidence from clinical trials, animal and pharmacological studies to explore the efficacy and underlying mechanisms of TCM in the treatment of PMDD and compares these approaches with conventional therapies. Nonetheless, the integration of TCM into mainstream practice for PMDD is still hampered by challenges such as insufficient evidence-based medical data. Research in TCM focusing on biomarker identification, establishment of standardized treatment protocols, and refinement of efficacy evaluation systems is expected to drive its evolution into a mainstream treatment option for PMDD.