Feature Formula: Xiao Yao San for PMS

Xiao Yao San, or “Free and Easy Wanderer” as it is often translated in English, is a widely prescribed Chinese formula for treating menstrual disorders, depression, and digestive difficulties. Xiao Yao San has been in use for over 1000 years and includes a number of well-known Chinese herbs, including dang gui, or Angelica root. This versatile formula is extremely clinically effective in addressing a variety of menstrual difficulties, including PMS.

PMS, or pre-menstrual syndrome, is a cluster of symptoms that usually occur in the week leading up to a woman’s menstrual cycle. These symptoms can include: bloating, breast tension, irritability, depression, anxiety, constipation, loose stools, insomnia, cramps, and headaches.

For some women PMS symptoms appear right after ovulation, while other women don’t experience PMS until a day or two before the start of their period. There are also some women who don’t have PMS at all. (Yes, I swear those women exist!)

Let’s take a look at what creates PMS from a Chinese medicine perspective and how Xiao Yao San can help.

PMS in Chinese Medicine

The “ideal” menstrual period should come and go with no pain, no breast tenderness, no unholy desire to eat chocolate cake, and no “nothing fights” with your partner. But since we live in the real world, with its endless stressors, both physical and mental, many women brace themselves for PMS each month. Like clockwork, it seems we go haywire.

In reality, we do not go haywire.

Our bodies are beautifully attuned to the external world and are primed to carry life. What a miracle! But anyone who suffers through cramps, pre-menstrual depression, and loose stools every month might not exactly think a period is a miracle.

In Chinese medicine PMS symptoms have a physiological origin, meaning there are bodily explanations for why you don’t feel well. This should be a great relief to women who wonder if their pre-menstrual anxiety and agitation are all in their heads. While it’s true that PMS can create some really nasty mental states, Chinese medicine, and specifically Xiao Yao San, addresses the underlying physical imbalances that make us feel so uncomfortable.

Qi and Blood Stagnation

The natural outcome of PMS is that you eventually start to menstruate. Your period has an energy that must be released. Whether your pre-menstrual days are easy-going, like the Free and Easy Wanderer, or excruciating, is determined by how freely your qi and blood are flowing. When qi and blood are bound up, they wreck havoc.

Here’s an image I use to think of qi stagnation: imagine leaning your palms against a wall and pressing with all your body weight. The energy you’re expending leaning into this wall is magnificent, and yet, no matter how hard you try, you can’t move that wall. Instead, you become tired, agitated, and frustrated. That’s qi stagnation. It’s annoying, and somewhat painful, both to the body and the mind (not to mention the ego).

Now, imagine pounding your fists on that immovable wall. Really think about it! There you are, a vibrating ball of energy trying to get through a wall that will not yield, unless you smash into it with all your might. Smashing through that wall will hurt, but you’re totally determined to do it because you have to. That is blood stagnation, the cause of cramps, menstrual back pain, and clots.

Behind every cramp and clot are qi and blood stagnation, and the origin of this stagnation is lack of free flow. When our lives feel bound, we constrict. The same thing happens in our bodies. The same thing happens in our minds, too.

Ever notice how when someone tells you to chill out, or relax, or take it easy when you have PMS you want to scream? This is normal. PMS creates an uncomfortable tension between constriction and release that is ultimately relieved through starting your period, but before that happens, you’re still pressing and pounding on that wall. If you could relax, you would. But the truth is, you can’t, because until your body shifts from preparing for the period to actually having a period, your body is under pressure.

This is where Xiao Yao San comes in.

Xiao Yao San’s primary functions, in Chinese medicine terms, are to move qi and blood, support the Spleen (aka, your digestion), and build the blood. Let’s take a look at how Xiao Yao San supports the Spleen.  

Spleen Deficiency in Chinese Medicine

The term “spleen deficiency” is used a lot in Chinese medicine. The Spleen is the primary organ of digestion and has a similar function to the pancreas in Western medicine.

The Spleen is responsible for absorbing and distributing the nutritional aspects of our food and sending the waste materials on for elimination. When the Spleen is weak, our digestive function suffers. This can lead to gas, bloating, loose stools, constipation, weight gain, and a feeling of heaviness or lethargy. Sound familiar? Many women have irregular digestion around their periods, which is why you can’t really treat PMS if you don’t support the Spleen.

Especially as it relates to menstruation, a healthy Spleen is critical for making sufficient blood. When the Spleen is impaired, either through undernourishment (such as in crash dieting or eating disorders), or bogged down by low-quality food (think junk food, greasy meals, sugar, alcohol, and processed food) it cannot make high quality blood. For women who are menstruating, this is a problem.

High quality blood moves easily, doesn’t clot unnecessarily, and provides the proper nourishment for pregnancy. We have a good idea of the quality of our blood by seeing how it is shed in menstruation. This is a critical tool for determining our fertility, should we decide to become pregnant.

Blood Deficiency in Chinese Medicine

Chronic Spleen deficiency leads to internal blood deficiency. Blood deficiency can cause women to feel cold, experience headaches, dizziness, and brain fog, feel depressed or anxious, and have scant periods. This lack of sufficient blood can also add to menstrual cramping. Light, and especially erratic, periods are often a sign of fertility issues as well.

Moving backward from these symptoms, we can assume a woman has Spleen deficiency if she has blood deficiency. Similarly, if a woman loses a lot of blood, either through a heavy period or childbirth, it is imperative that she replenishes that blood by eating healthy food. This is one of the reasons why nutritional counseling is so important in cases of infertility. We want to be making the best blood possible for sustaining a pregnancy.

How to Use Xiao Yao San for PMS

Xiao Yao San can address PMS at any point in the menstrual cycle after the time of ovulation.

For most women ovulation occurs around 14 days after the first day of their last period. The onset of PMS symptoms can happen any time after ovulation. Sometimes it can be hard to pinpoint exactly when ovulation occurs, especially if your cycle is erratic. The average monthly cycle between periods is 28 days, but your period could fall anywhere from twenty-one to who-knows-how-long between menstrual cycle. Xiao Yao San can still help.

I advise women to start taking Xiao Yao San as soon as they have their first symptom of PMS. For many women, breast tenderness comes first. Other women notice digestive issues early. Some women become depressed, anxious, or can’t sleep. Pay attention to the symptoms you experience and see if there is a pattern. Each month you’ll become better at knowing when to start taking Xiao Yao San for PMS.

If your period runs like clockwork, and you know you’ll begin feeling lousy three days before you start menstruating, plan on starting Xiao Yao San a couple of days before those symptoms come on. Every woman is different, and this formula is safe and effective for many different types of PMS.

Xiao Yao San can also be modified to make it more cooling, more blood building, etc. Pills are an easy way to take this formula, but some women need a more specialized formula, which requires a customization of raw herbs or herbal powders. Ask your acupuncturist or Chinese herbalist what the best form of Xiao Yao San is for your particular type of PMS.

This versatile formula is one of my favorites. I’ve seen many women go from having PMS every month to barely noticing when their period is on the horizon. I love how gentle it is at working with a very complex (and irritating!) set of symptoms. If you have PMS, definitely talk with your practitioner about trying Xiao Yao San.

For additional information on using this formula in a clinical setting, see Memorial Sloan Kettering Cancer Center’s About Herbs listing for Xiao Yao San

5 Chinese Herbs in Your Grocery Store

Some Chinese herbs are easy to integrate into your diet. You don’t even need to visit a health food store to find watermelon, walnuts, spring onions, mint, and ginger. If you love the idea of using Chinese herbs as part of your healthcare plan, visit Herbs.

Five Chinese Herbs for High Summer

girl eating watermelon

Mother Nature is in full bloom in high summer, and these five Chinese herbs are the perfect antidotes for the heat.

Watermelon: Considered by many to be the fruit of summer, watermelon is naturally full of the nutrients, electrolytes, and liquid we need to stay hydrated in extremely hot weather. This wonderful, sweet fruit also offers a kick of sugar, which can revive us when we’ve overworked in the yard, taken a long hike, or danced in the sun at a summer music festival. I recommend buying, cleaning, and cutting up a watermelon once a week and leaving it in the refrigerator to use as a preventative medicine as well as a quick-recovery herb if you become overheated.

Mint: Mint is energetically cool and grows like a weed in the summertime. In fact, some gardeners consider anything in the mint family to be a major pest because it is so prolific. Take advantage of the availability of fresh mint by using it in your cooking or making a tea out of the leaves. Steep a large, crushed amount of mint in hot water for ten minutes, then transfer that to a pitcher filled with ice for instant iced tea. Mint is also particular helpful for stomachaches and intestinal upsets after ingesting oily, heavy foods. The light and cool nature of this herb make it the perfect accompaniment to hot weather.

Mung bean: Many Americans are unfamiliar with the lovely green mung bean, but this ingredient is actually quite common in some Asian cuisines. Mung beans are energetically cool and help the body drain excess water. As a very mild diuretic, you may think mung bean would be the wrong choice for summer. As with all herbs though, its efficacy depends on your personal constitution, as well as where you are living. Mung bean is useful in hot, damp environments, like the American south and the Midwest, where high levels of humidity can leave our insides feeling like a swamp. Incorporate mung beans in summer salads or soups, or make a tea from the rehydrated beans. You may find you develop a taste for this little green herb.

Barley tea: Barley, or Job’s tears, is another common ingredient in Asian cooking and is often found in teas designed to cool the digestive system. Like mung bean, barley helps the body drain excess water, which can improve digestion and cool the stomach. Many Americans don’t think of drinking teas made from grains, but barley is an excellent place to start. Simply boil the herb in hot water and simmer for twenty minutes. Next, drain the liquid from the herb, allow it to cool, and enjoy. Of course, if you are celiac, or gluten-sensitive, skip the barley tea and consider one of the other herbs on this list.

Chrysanthemum: Chrysanthemum tea is an excellent choice if your eyes become red and irritated in hot weather. This could be due to environmental irritants—like pollen or dust—or you may simply express heat through your eyes. If red eyes are a problem, chrysanthemum tea can bring great benefits. Considered a powerful herb for eye health, this flower has a delicate flavor that lends well to hot or cold infusions. Just remember that chrysanthemum does not need to be steeped for longer than five minutes. Also, if you have allergies to any plants in the aster family, it’s best to avoid chrysanthemum. Try mint instead.

This summer stock your pantry with these easy-to-find Chinese herbs and use them to prevent and treat mild cases of dehydration, upset stomach, and heat exhaustion. If you find one of these treasures really works for you, consider nurturing and growing them in your garden next year.

Just be sure to put the mint in its own pot!

Feature Formula: Gan Mai Da Zao Tang

Dried red jujube
Dried red dates

Gan Mai Da Zao Tang—or Licorice, Wheat and Date Decoction—is a 2,000-year-old formula created by the Chinese master herbalist Zhang Zhong Jing and recorded in the classic text Jin Gui Yao Lue. Although this blend of three herbs may look simple, its effects on body, heart and mind can be profound, if it is matched with the right patient.

Gan Mai Da Zao Tang is used in cases of “Zang Zao”, or what the Chinese call “Restless Organ Syndrome”. This state of agitation is associated with frequent crying and mood swings, poor sleep, irritating bodily sensations, fatigue and feeling emotionally low.

Each herb in the formula serves a unique role. Licorice gently boosts energy by helping the digestive system. Wheat berries calm the spirit and anchor the mind. And those beautiful red dates? They soothe rattled nerves and moisten dryness.

I like to think of Gan Mai Da Zao Tang as the hug you offer a friend who is going through a difficult transition. Its sweet taste and gentle nature make this formula easy to digest, and its simplicity works well with other herbs.

If you are suffering through an emotional storm, ask us if Licorice, Wheat and Date Decoction is right for you.

Are You Making this One Immunity Mistake with Every Cold?

frozen branchAutumn is the start of the dreaded cold and flu season, which means coughs, sniffles, body aches, and missed days of work. In fact, you may already be impulsively buying immune-boosting supplements to stave off catching the latest bug living on your office door handles. But are you making this one immunity mistake every time you catch a cold?

This year, before you spend any more money on immunity herbs and supplements, remember this: taking immune-boosting herbs at the beginning of an illness may actually make you sicker.

Believe me, I know the allure of those immunity herbs. Before I became a trained herbalist, every time I came down with something, I took tonic herbs, which never seemed to help me recover quickly. It wasn’t until I visited an acupuncturist during the first few days of a cold that I learned how counterproductive this self-help remedy actually is.

Herbs like ginseng, astragalus, and medicinal mushrooms, such as Reishi, are immune super-herbs. These plants have powerful stimulating characteristics that are ideal for jump-starting a weakened immune system. But these herbs also become super foods for invading viruses and bacteria.

It’s kind of like giving your cold or flu the spa treatment, complete with a smoothie, a pedicure, and a massage.

In Chinese medicine, the herbs used at the beginning of a cold address the surface of the body. After all, cold and flu bugs are superficial illnesses, meaning they are not lodged too deeply inside. We call this a surface invasion and use medicinals that gently open the pores, releasing the pathogen through the skin. Many Chinese formulas for colds and flus actually induce a light sweat.

If a cold or flu bug has decided to call your body home get an acupuncture treatment and a custom Chinese herbal formula right away. If I could train patients to do one thing when they feel “a little something coming on,” it would be to call me within the first 24-48 hours of getting sick.

Chinese medicine has been effectively treating the common cold for over 2,000 years. Acupuncture and the appropriate herbs can significantly reduce the amount of time you spend on the couch, and in some cases, keep you from developing a full-fledged illness, like pneumonia.

If chronically low immunity is always a factor for you during the colder months, visit our clinic before you catch that first cold. We create customized acupuncture and herbal treatments meant to support your immunity, optimize your digestion, and keep you sleeping so that you’re prepared for winter weather.

When it comes to protecting your immunity, start now, and start early. Stay warm, eat cooked healthy food, exercise, sleep, and monitor your mood. If you encourage your body to naturally repel cold and flu bugs, those immune super-pills won’t be necessary.

Just think of how much time and money you’ll save!