The concepts of a cold uterus and blocked qi found in Donguibogam align with multifaceted physiological mechanisms in modern medicine. Premenstrual syndrome is not merely an emotional struggle. It involves subtle ovarian hormone fluctuations, corresponding brain neurotransmitter responses, and systemic inflammatory activity.
During the luteal phase between ovulation and menstruation, estrogen and progesterone levels change rapidly. In particular, shifts in progesterone affect serotonin levels in the brain. As a primary neurotransmitter regulating mood, appetite, and sleep, fluctuating serotonin can lead to low mood, restlessness, irritability, and sudden cravings for sweets. Meanwhile, breast fullness, chest pain, and edema stem from mammary gland tissue sensitivity and fluid retention driven by estrogen.
The traditional concept of a cold uterus corresponds closely with reduced pelvic blood circulation and impaired thermoregulation. When local blood flow declines, the delivery of oxygen and nutrients to the uterus and adjacent tissues drops, while metabolic waste accumulates, promoting inflammatory responses. This manifests as lower abdominal heaviness, discomfort, and premenstrual abdominal distension. Altered autonomic regulation also slows intestinal motility and increases gas production, worsening abdominal distension.
Chronic stress further strains autonomic nervous system balance. Excessive sympathetic hyperactivity constricts blood vessels, limits blood circulation, elevates cortisol levels, and interferes with progesterone metabolism—a modern parallel to liver qi stagnation. Additionally, inflammatory mediators known as prostaglandins play a central role; elevated prostaglandins trigger uterine contraction and pain, intensifying dysmenorrhea and abdominal cramps.
PMS represents an interplay between neurotransmitter changes, inflammatory pathways, and autonomic tone rather than a simple hormonal variation. The classical notions of uterine coldness and qi stagnation reflect pelvic circulatory insufficiency, neuroendocrine-immune imbalances, and stress responses. These symptoms are meaningful physiological signals sent by the body.
