What does the Korean medicine concept of liver qi stagnation mean in terms of modern medicine when explaining the premenstrual emotional roller coaster? In fact, this phenomenon can be explained by complex hormonal fluctuations occurring in a woman's body and their close interactions with brain neurotransmitters.
Estrogen and progesterone levels fluctuate continuously across the menstrual cycle. In particular, the process where progesterone levels rise sharply after ovulation and then drop again before menstruation directly affects our brain. Progesterone binds to specific brain receptors and increases the activity of the neurotransmitter called gamma-aminobutyric acid (GABA), which calms the nerves and reduces anxiety. The problem, however, is that research shows a metabolite of progesterone called allopregnanolone can abnormally affect brain GABA receptors at specific times, causing confusion in emotional regulation.
Furthermore, changes in the sensitivity of the serotonergic system, often referred to as the happiness hormone system, also play a major role. In the premenstrual period, observations often show relatively lower serotonin levels in the brain or desensitized serotonin receptors. Because serotonin is involved in diverse physiological functions including mood, appetite, sleep, and pain regulation, an imbalance in this system can lead to major PMS symptoms such as depressive feelings, irritability, anxiety, excessive appetite, and sleep disorders. It is as if the brain's internal mood regulation device temporarily malfunctions.
In addition, hyperactivation of the hypothalamic-pituitary-adrenal axis (HPA axis), which regulates stress responses, cannot be overlooked. If the stagnant qi in liver qi stagnation is a concept similar to stress, modern medicine explains that chronic stress stimulates the hypothalamic-pituitary-adrenal axis to increase the secretion of stress hormones like cortisol, which in turn affects the brain's emotional centers, amplifying mood swings and irritability. This is not simply an emotional issue, but a complex neuroendocrine system reaction.
Chest tightness or flank pain can also be viewed in relation to autonomic nervous system imbalance. When the sympathetic nerve is excessively activated by stress and hormonal shifts, blood vessels constrict and muscles tense, which may be accompanied by physical symptoms such as palpitations, shortness of breath, and digestive hypofunction. In particular, tension in the intercostal nerves or thoracic cage muscles can lead to sharp tingling in the flanks.
Ultimately, the stagnation of qi described in liver qi stagnation aligns from a modern medical perspective with complex physiological shifts: brain neurotransmitter imbalances driven by hormonal changes, an overloaded stress response system, and autonomic nervous system disruption. Our body is truly a collection of delicate biochemical reactions, and understanding all these links is the first step toward grasping the true nature of the distress we experience.
