Traditional Chinese medicine holds that excessive liver fire in women can lead to liver stagnation, which is the primary cause of premenstrual breast tenderness.
Breast Structure
Modern medicine primarily understands breasts from physiological and anatomical perspectives. The internal structure of breasts closely resembles that of an autumn orange, primarily consisting of milk ducts, lobules, and alveoli.Adults possess 15 to 20 milk ducts, each forming an independent duct system. This resembles how an orange functions as a unified whole while internally dividing into over a dozen segments, each maintaining its distinct integrity.Traditional Chinese medicine holds that a person's mental state significantly influences the onset and progression of disease. It categorizes emotional expressions into seven types—such as joy, anger, fear, and others—referred to as the Seven Emotions. These emotions primarily affect the internal organs, disrupting their functions, most commonly affecting the heart, liver, and spleen. Among these, anger harms the liver. Those unfamiliar with traditional Chinese medicine may find this concept difficult to grasp.In everyday language, however, we describe someone prone to anger as having "excessive liver fire," making the concept much more accessible. Life presents numerous frustrations, and women, due to societal expectations and upbringing, often suppress anger or displeasure rather than expressing it openly. This internalized resentment is termed "liver qi stagnation" in TCM, which is the primary pathogenesis of premenstrual breast distension.
Premenstrual breast swelling is rarely documented in historical gynecological texts. Yet in daily clinical practice, it affects many patients—though they typically seek treatment for irregular menstruation or infertility.
However, few patients seek treatment solely for breast distension and pain. Two possible reasons may explain this:
1. Breasts have long been considered a private part of the female body. Even when experiencing distension or pain, many women avoid seeking medical help due to embarrassment;
2. This condition typically occurs before menstruation and resolves naturally once menstruation begins, leading many women to overlook it.
Premenstrual breast swelling, as the name suggests, occurs before menstruation. It typically appears 3–7 days before the period starts, though some experience it as early as two weeks before menstruation. The swelling usually subsides 1–2 days after menstruation begins, or may persist until the period ends, only to recur before the next cycle. This pattern exhibits distinct regularity and cyclicality.Symptoms include breast fullness and pain, sometimes accompanied by lumps or a burning sensation. Characteristic sensations involve chest and rib discomfort, breast distension, and abdominal bloating. Patients often feel gas distending the chest and abdomen, causing significant discomfort that may intensify into pain.
During treatment, patients with breast distension should begin medication when premenstrual symptoms like chest tightness and breast distension appear, continuing until the distension and pain resolve with menstruation. This constitutes one treatment cycle. Consistent completion of 3–4 cycles yields reliable results.However, some patients mistakenly believe they are cured after one menstrual cycle without experiencing premenstrual distension or pain, and thus discontinue medication. Symptoms often recur before the next menstrual cycle, rendering previous efforts futile.