Introduction
Premenstrual syndrome refers to emotional changes occurring regularly before menstruation. The clinical manifestations are restlessness, sorrow and sweeping, or mental depression, murmuring and insomnia which disappear when menstruation is over. This syndrome is called “abnormal emotional changes during menstruation” usually caused by stagnant liver qi attacking the spleen and failure of the spleen to produce blood to nourish the cardiac spirit due to asthenia; or by transformation of mental depression into fire that heats fluid into phlegm and disturbs the mind.

Syndrome Differentiation
1. Stagnation of Liver Qi
Mental depression and irritability, oppression and distension in the chest, no appetite, thin and greasy tongue coating as well as taut and thin pulse.

2. Phlegm-fire Attacking the Upper
Mania, headache, insomnia, flushed complexion and red eyes, oppression in the chest and dysphoria, reddish or deep red tongue, yellowish thick or greasy tongue coating as well as taut and rapid pulse.

Treatment
Prescription:
Shenmen (HT 7), Neiguan (PC 6) and Taichong (LR 3).

Modification:
For stagnation of liver qi, Qimen (LR 14), Zhongwan (CV 12) and Zusanli (ST 36) are added; for phlegm-fire attacking the upper, Daling (PC 7), Fenglong (ST 40) and Neiting (ST 44) are added.

Performance:
Filiform needle is used with reducing needling technique. Shenmen (HT 7), Taichong (LR 3), Daling (PC 7) and Neiting (ST 44) are needled vertically 0.3 - 0.5 cun with rotating manipulation for reducing purpose; Qimen (LR 14) is needled obliquely inward with twirling manipulation for reducing purpose; the rest acupoints are needled with reducing manipulation.