How Acupuncture Supports PMS

If you get a period or spend time with anyone who has a period, you’ve probably heard the term PMS tossed around. “I’m so PMS-y this week”, “Wow she must be PMS-ing”, or my personal favourite: “Are you PMS-ing or something?” (rude lol).

Many people that use the term or know of its truthful (or slightly derogatory) meaning, might not actually know what it stands for.

PMS = Premenstrual Syndrome. That’s what it stands for.

When does it happen? Typically, PMS symptoms are experienced the week or two prior to the start of menstruation and can continue until bleeding ceases (yes, it’s still apparently called PRE-menstrual syndrome even though it can occur during).

What happens? PMS can be different for everyone who experiences it, and can also vary month-to-month.
Some of the common symptoms include:
- mood changes: feeling irritable, angry, anxious depressed, and unstable mood or mood swings
- cognitive changes: sleep disturbances, difficulty focusing, forgetfulness, and confusion
- physical changes: headaches, bloating, water retention, constipation, nausea, low back pain, acne, constipation, cramping or heaviness in low abdomen, breast tenderness, fatigue

Why does it happen? (Theories from a Western Medicine Lens): Estrogen, progesterone, pregnenolone, prolactin, and cortisol (among others) are key hormones in the body that communicate with the ovaries and uterus and play a role in the monthly cycle that female bodies follow. They are at higher or lower levels throughout the month and the fluctuation of these hormones are thought to play a role in PMS. Genetics are also thought to be a factor from a Western standpoint - there may be individual sensitivity to hormonal fluctuations that cause these symptoms.

How does Chinese Medicine conceptualize PMS?

The phases of the menstrual cycle and how to support at each phase. PMS occurs during the Luteal phase, roughly days 17-28 (varies person to person).

It is helpful to conceptualize all of the phases of the menstrual cycle in full to understand what is going on from this perspective and how and acupuncturist would support at each phase of the cycle.

In Chinese Medicine Theory (on which Acupuncture practice is based), PMS is a disease that has an underlying “pattern” or combination of patterns.

The pattern that most of the common symptoms of PMS fall under is known as “Liver Qi Stagnation”. *

The phase at which PMS occurs is known as the Luteal phase, seen above in the diagram. This phase occurs directly after ovulation.

Here the body moves from a very yang state (high energy & intense burst needed for ovulation), into the most yin part of the cycle.

The Liver in Chinese Medicine is responsible for the free flow of qi and blood and when it gets stagnated it causes a disruption in the flow - conceptualized as if there is a kink in a garden hose causing a blockage of proper flow. Part of the preparation for menstruation is to ensure that the channels that carry the blood into the uterus and out of the body are flowing smoothly, and ensuring that our emotions are flowing smoothly as well… if there is stagnation we can experience pain, emotional dysregulation, breast tenderness, bloating, mental confusion, and sleep disturbances (among other symptoms).

*there are often other patterns at play as no one fits into a perfect box, but this is a standard place to start :)

What is the BEST time to come for Acupuncture to support PMS symptoms?

The best time to book acupuncture for PMS is after ovulation, when you’re expecting that the symptoms of PMS are are on the horizon. There is no “perfect day”. Aiming for booking during the timeframe of your luteal phase will be helpful for ensuring things are flowing smoothly in your body as it prepares for your menstruation, and hopefully help you feel better during this time!

(Not always, but commonly supporting the pattern of Liver Qi Stagnation in this part of your cycle can reduce downstream symptoms during menstruation as well!)

References:

Maciocia, G. (2011). Obstetrics and gynecology in Chinese medicine (2nd ed.). Churchill Livingstone.

Modzelewski, S., Oracz, A., Żukow, X., Iłendo, K., Śledzikowka, Z., & Waszkiewicz, N. (2024). Premenstrual syndrome: New insights into etiology and review of treatment methods. Frontiers in Psychiatry, 15, Article 1363875. https://doi.org/10.3389/fpsyt.2024.1363875

The Merck Manual Editorial Staff. (2025, October). Quick facts: Premenstrual syndrome (PMS). Merck Manual Consumer Version. https://www.merckmanuals.com/en-ca/home/quick-facts-women-s-health-issues/menstrual-disorders-and-abnormal-vaginal-bleeding/premenstrual-syndrome-pms

The 5 Point Ear Protocol (aka NADA) & The Many Benefits

Let’s talk about a standardized auricular (ear) acupuncture protocol known as NADA (National Acupuncture Detox Association).

Firstly, how did it come about? Why is it called NADA?

The protocol was created in response to the opioid epidemic in the 1970’s with the guidance of emerging research being done in China with Auricular acupuncture for pain relief. The 5 needle protocol was created and standardized in 1979, and by 1985 the National Acupuncture Detox Association was established to support the treatment of mental health and addiction and streamline care for an overwhelming public health problem affecting a large number of people.

The research on its effectiveness is extensive for addictions/substance use, mental health, behavioural issues, sleep, PTSD, chronic stress and trauma.

I prefer to call this the 5 Point Protocol instead of NADA because while this protocol is highly effective for addiction and related symptoms, truly these points together do SO much more than treat addiction. The term 5-Point Protocol (not coined by me) opens the door for this treatment to be used to support a wider range of conditions!

What are the points used?

There are 5 points used in the protocol, as the colloquial name I prefer (5 Point Protocol) suggests ;). Sometimes they are done on only 1 ear, and sometimes on both. The length of time can vary person to person and treatment to treatment.

The 5 Point Ear Protocol

The points are:

• The Lung Point

• The Liver Point

• The Kidney Point

• Shen Men (Heart)

• Sympathetic Point

What are the functions of each point?

To explain how this protocol can be used to support a wide range of conditions, it’s useful to dive into what each point does. In auricular acupuncture, the ear is looked at as a microsystem of the body. Mapped onto the ear is a fetus, similar to how the homunculus of the nervous system is mapped onto the motor cortex and sensory cortex of the brain, and each area relates to a part of the body.

The picture of this microsystem is depicted on the image to the right (Oleson, 2002).

The Lung Point

This was the first point studied in the creation of this protocol for withdrawal symptoms. It functions as an analgesic, or pain management point.

As its name suggests, it is linked to the Lung. The Lung in the theory underlying acupuncture (namely Chinese Medicine) has functions that resemble what the Lung does in Western anatomy/physiology, but also a few more functions.

Relevant Aspects of The Lung in Acupuncture Theory:

• Associated with the emotion of grief

• Breathing in Air qi

• Moves qi and blood as part of our circulation

• Associated with the skin

The Lung Point of the ear can treat:

• cough

• issues of the skin and sweating

• hoarseness

• pain

The Liver Point

This point is crucial as a part of the protocol as the Liver in acupuncture theory has many functions related to overall wellbeing, and is especially relevant here to emotional health.

Relevant Aspects of The Liver in Acupuncture Theory:

• Associated with the emotion of anger

• Responsible for the smooth flow of qi and blood throughout the body

• Regulates emotions

• Supports decision making

The Liver Point of the ear can treat:

• Chest tightness

• Pain in tendons/muscles

• Liver qi stagnation pattern: mood swings, frequent sighing, irritability, pain

The Kidney Point

There is no organ in acupuncture theory that is unimportant of course, but the Kidney might take the cake as really being the Origin of our wellbeing. Much of our constitutional wellbeing originates here, and it governs much to do with our health and wellness. It is also associated with fear, a common emotion that is associated with the many things that the 5 Point Protocol has been proven to support.

Relevant Aspects of The Kidney in Acupuncture Theory:

• Associated with the emotion of fear (and also wisdom)

• Responsible for ageing, reproduction, and is the root of our Essence, Yin & Yang - our vitality

• Stores our Will Power (Zhi)

• Associated with our long term memory & our marrow (in Chinese Medicine this term is linked to bones, but also is more linked to the brain than we would say in Western Medicine)

The Kidney Point of the ear can treat:

• Headaches

• Insomnia

• Dizziness

• Supporting the brain/marrow

• Hormonal support

• Chronic health conditions

Shen Men (of the Ear)

This point is widely used in a lot of different approaches to ear acupuncture. Its direct translation is “Spirit Gate”. The term “shen” refers to the Spirit in Chinese Medicine that resides in the heart. This spirit is most closely associated with our consciousness in western thought. It houses so much of who we are, and is related to our memory. The Shen of the heart is important for our sense of identity and our ability to connect.

Relevant Aspects of The Shen:

• Associated with the Heart & housed in the Heart

• Closely associated to our consciousness and sense of self

• Related to our memory

• Fosters connection

• Important to have a rooted “shen” for sleep

The Shen Men (Spirit Gate) of the ear can treat:

• Insomnia

• Panic

• Anxiety

• Forgetfulness/memory issues

• Stress

The Sympathetic Point

As its name suggests, this point is supportive to regulation of the Sympathetic (and Parasympathetic) nervous systems.

Relevant Aspects of The Sympathetic Nervous System:

• Regulates our breathing

• Governs our stress response

• Parasympathetic/sympathetic balance allows us to respond to stressors OR rest and relax

• An overactive sympathetic nervous system that does not downregulate and allow for a parasympathetic state can lead to chronic stress responses in the body

The Sympathetic Point and relevant things it treats:

• Appropriate stress response

• Sleep disturbances

• Muscle relaxation

• Panic disorders

• Regulating the nervous system (typically downregulation into parasympathetic states)

If any of the actions of the above 5 points speak to you, this protocol may support you in feeling better in your body and finding balance in your emotional, physical, and spiritual wellbeing.

REFERENCES:

Carter, K., & Olshan-Perlmutter, M. (2014). NADA protocol: Integrative acupuncture in addictions. Journal of Addictions Nursing, 25(4), 182–187. https://doi.org/10.1097/JAN.0000000000000045

Cheng, X. (Ed.). (1999). Chinese acupuncture and moxibustion. Foreign Languages Press.

Oleson, Terry. (2002). Auriculotherapy stimulation for neuro-rehabilitation. NeuroRehabilitation. 17. 49-62. 10.3233/NRE-2002-17107.

Acupuncture: more than needles & pain

Acupuncturist Toolkit

Most hear the term “acupuncture” and think of needles… and of course they would not be wrong! BUT it is not the whole picture of how Acupuncturists can support people. Acupuncture has a rich and complicated history - as does anything with over 2000 years of history. What we think of as Acupuncture in the West falls typically under the umbrella of Traditional Chinese Medicine (TCM). In BC, Acupuncturists are regulated by a College that outlines our scope of practice based on TCM principles (College of Complementary Health Professionals of British Columbia, 2026).

Some of the therapies that Registered Acupuncturists can use to support people include:

• Acupuncture - the thin needles you think of :)

• Moxibustion - burning of a herb known as mugwort to warm up acupuncture points

• Cupping - the practitioner creates a vacuum inside of cups made of glass (fire cupping) or silicone to form a strong suction onto the skin and tissues beneath releasing tension and stagnation

• Electrical Stimulation - applying a small current through two adjacent acupuncture needles

• Tuina - an umbrella of specific massage techniques that support moving qi and blood (promote healthy circulation) throughout the body

• Diet therapy & lifestyle advice - self explanatory, but from a TCM view rather than from a Western lens

Therapies and modalities that Registered Acupuncturists in BC are able to use to support people based on their individual needs.

Acupuncture is NOT Dry Needling/IMS, but it CAN treat Orthopedic Injuries! That’s just not ALL it does…

Something I have noticed when I have mentioned that I am an Acupuncturist is that the response is often along the lines of: “Oh, I have had acupuncture when I got tennis elbow, I’ll keep you in mind for if I get injured again!" or “Oh my Physiotherapist gave me Acupuncture when I hurt my hip and it was so painful”.

It is totally true that acupuncture can treat injuries from sport, repetitive strain, accidents, or the like…. it simply is not the whole picture.

Acupuncture can treat a variety of ailments that are more external - in TCM (very simply put) we talk about injuries to the 12 meridians or channels as being more external, and that would apply to what we refer to as Orthopedic Pain conditions in our Western Culture. Some of these include joint sprains, muscle strains or “pulls”, muscle “knots”, pinched nerves, or tendonitis (HealthLink BC, n.d; Maciocia, 2015).

It’s also true that many other practitioners are licensed to administer needles for pain relief… it’s just not Acupuncture. What people are typically referring to when they’ve received a treatment involving needles from a Physiotherapist is called “Dry Needling” or Intramuscular Stimulation (IMS). This involves the insertion of needles into an affected muscle tissue typically at a local “trigger point” (colloquially a muscle “knot”) to release the tissue and promote healing (Medical News Today, 2024). This treatment has been really effective for many people - BUT BUT BUT it is not Acupuncture. I am not here to slam this modality nor the practitioners that administer it, I have talked to many people for which it has been life changing, I simply think it is worth further differentiation.

As mentioned previously, Acupuncture theory is rooted in 2000+ years of history and the points chosen are based on a series of channels and treatments are most often planned based on a comprehensive diagnostic process for which the practitioner attended years of schooling to learn. An Acupuncturist may needle a trigger point and elicit the same release that an IMS therapy is aiming for, only it won’t be their standalone plan and most won’t be manipulating the needle as harshly - so in most cases it will hurt A LOT LESS. Acupuncturists are trained to look at the entire body as system wherein nothing can be separated from the whole. Every injury or ailment is assessed as a part of a whole system, and an injury on your arm is treated as a channel pathology that by TCM theory may stem from a broader issue somewhere entirely different!

This is where Acupuncture becomes more than just needles and pain. It treats systems - channels that have inextricable links to internal organs. In this view the body is not just a machine with sometimes faulty mechanics or a broken engine, but rather an ecosystem that can sometimes find itself out of balance for one reason or another. We look locally and we zoom out. (Maciocia, 2015)

Acupuncturists Can Treat Internal Medicine Dis-eases

When we zoom out and look at the body from a TCM lens, we see patterns and propensities. Everyone’s unique ecosystem that is constantly changing - a system that can innately find its own balance when we are in good health, but may need support in other times.

Symptoms become apparent when we shift out of the healthy and normal ebbing and flowing, we acquire stagnation or we become deficient (to put it as simply as possible). Every dis-ease has symptoms and the collection of these that varies case to case becomes a pattern. The acupuncture points along the channels, each linked to specific organs, help us to direct the ebbs and flows where they might need redirecting. They help us to impart innate wisdom into a system that needs a reminder of its nature.

From a framework that looks very different to Western Medicine, an Acupuncturist can help to support the treatment of a variety of ailments that may be surprising if you are unfamiliar.

A few of the most common ailments that Acupuncture is great at supporting are:

• Chronic pain conditions

• Acute pain and associated injuries

• Digestive concerns (IBS symptoms, constipation, diarrhea, bloating, nausea)

• Headaches (migraines, hormonal headaches, tension headaches, etc.)

• Mental health conditions (anxiety, depression, addiction, stress)

• Sleep issues (insomnia, parasomnia)

• Fertility & pregnancy

• Hormonal disturbances (menopause, menstrual disorders, menstrual pain, infertility, ovulation issues, breast pain, erectile dysfunction)

This list (CTCMCPANL, n.d.; Healthlink BC, n.d.) is far from exhaustive so if you have any questions about whether Acupuncture might be able to support you with whatever affliction you are dealing with, please feel free to reach out and we can explore that together!

Some common ailments for which Acupuncture can support symptom relief.

References:

College of Traditional Chinese Medicine Practitioners and Acupuncturists of Newfoundland and Labrador. (n.d.). What health conditions can acupuncture treat?https://ctcmpanl.ca/what-health-conditions-can-acupuncture-treat/

College of Complementary Health Professionals of British Columbia. (2026, May). Scope of practice explanatory statement: Traditional Chinese medicine and acupuncture (TCMA). https://cchpbc.ca/wp-content/uploads/2026/05/SoP.ExplanatoryStatement-TCMA.V8FINAL.pdf

Giovanni Maciocia. (2015). The foundations of Chinese medicine: A comprehensive text (3rd ed.). Elsevier.

HealthLink BC. (n.d.). Acupuncture. https://www.healthlinkbc.ca/healthwise/acupuncture

Medical News Today. (2024, October 16). Dry needling vs. acupuncture: What the research says. https://www.medicalnewstoday.com/articles/321989