Normal sleep is usually maintained, but insomnia occurs before menstruation, sometimes even lasting all night, and returns to normal after menstruation. This condition is known as premenstrual insomnia.

bubble_chart Pattern Analysis

1. Yin Deficiency︰Premenstrual irritability and insomnia, dizziness and blurred vision, dry mouth and throat, soreness and weakness of the waist and knees, advanced menstruation, scanty and red flow. The tongue tip is reddish with thin coating, and the pulse is thready and rapid. Premenstrual insomnia caused by deficiency of yin-blood and heart-fire disturbing the heart is characterized by irritability and insomnia, dry mouth and throat, and a thready rapid pulse. The treatment should focus on nourishing yin, clearing the heart, and tranquilizing the spirit. The recommended formulas are Coptis Rhizome Ass Hide Glue and Egg Yolk Decoction with modifications, or Celestial Emperor Heart-Tonifying Pill.
2. Blazing of Heart-liver Fire︰Pre-menstrual insomnia, even all-night insomnia, irritability, bitter taste in the mouth, dry throat, headache, dizziness, breast headache and itching, advanced menstruation, heavy and dark-colored flow. Red and prickly tongue tip, thin yellow coating, wiry and slippery pulse. Pre-menstrual insomnia caused by liver depression transforming into fire and blazing of heart-liver fire is characterized by all-night insomnia, irritability, nipple pain, and wiry-slippery pulse, belonging to an excess pattern. For blazing of heart-liver fire, treatment should focus on clearing the liver and draining fire to calm the spirit. The recommended formula is Gentian Liver-Draining Decoction with modifications.
3. Deficiency of Both Heart and Spleen︰Premenstrual insomnia, restless dreams at night, severe palpitation, dull complexion, or facial and limb swelling, mental fatigue and lack of strength, advanced menstruation with heavy and pale flow. The tongue texture is pale and swollen, with thin and greasy coating, and the pulse is thin and soft. The cause is excessive blood loss during menstruation or excessive premenstrual overthinking, which damages the heart and spleen. The clinical manifestations include: premenstrual insomnia, restless dreams at night, severe palpitation, and dull complexion. The treatment should focus on strengthening the spleen, nourishing blood, and tranquilizing the spirit. The recommended formula is Returning to Spleen Decoction.

bubble_chart Documentation

1. "Liu Fengwu's Gynecology Experience: Five Cases of Premenstrual Tension Syndrome" "Before menstruation, the Chong and Ren meridians are exuberant, with abundant qi and rapid blood flow, which often leads to Jingmai stagnation and obstruction, easily inducing the aforementioned symptoms and signs. However, once menstrual blood arrives, the qi and blood of the Chong and Ren meridians are regulated, and the symptoms naturally disappear."