From a TCM viewpoint, PMS is not complicated.

Every month, a woman's essence (acquired and congenital) will gradually be enriched to a particular level by the kidneys; the kidneys will then produce a substance called tian gui. Under the action of this substance and guided by the liver, the Conception Vessel becomes exuberant and flushed with abundant qi (vital energy) and blood. When the excessive qi and blood in the vessels become overflowing, they drift into the uterus and become menses. This is considered a normal healthy process.

Emotional strain, improper diet and overwork are common incidences of modern life. TCM believes that these unhealthy lifestyle habits will eventually produce functional disorders of organs. Anger, frustration and anxiety can easily interfere with the flow of blood and qi, which gives rise to a state called "stagnation of liver-qi." This becomes the most important factor for developing PMS. Excessive consumption of cold and greasy foods damages the spleen and leads to the formation of phlegm and dampness evils. Overwork not only exhausts kidney essence, but also flares up the fire inside the heart and liver. In general, these factors also contribute to the stagnation of liver-qi and kidney-yin deficiency, which are the predisposing conditions necessary for PMS to occur.