Premenstrual syndrome: An integrative review of unani principles and therapeutic approache

Introduction: Premenstrual Syndrome (PMS) is a prevalent cyclical gynecological condition characterized by recurrent physical, psychological, and behavioral symptoms that occur during the luteal phase of the menstrual cycle and subside with the onset of menstruation. Although PMS is not described as a distinct disease entity in Unani medicine, its symptom complex closely corresponds to conditions such as Ihtebās-e-Ṭams (retention of menses), Sudāʿ Qabl al-Ḥayḍ (premenstrual headache), and Tashannuj al-Raḥim (uterine spasm). These conditions are attributed to sūʾ-e-mizāj (deranged temperament), imtilāʾ (congestion), and fasād-e-dam (impurity of blood), resulting in humoral imbalance and altered uterine function. Meterial and Method s: This narrative review examines the Unani conceptualization of PMS through classical medical texts such as Al-Qānūn fī al-Ṭibb, Al-Ḥāwī, Kulliyāt-e-Nafīsī, and Zakhīra Khwārazm Shāhī, along with contemporary scientific literature. The Unani framework is critically compared with modern biomedical explanations emphasizing hormonal and neurochemical mechanisms. Results and Discussion: Unani management of PMS focuses on restoring humoral balance and normalizing temperament through Ilāj bil-Tadbīr (regimenal therapy), Ilāj bil-Ghizā (dietotherapy), and Ilāj bil-Dawā (pharmacotherapy). Medicinal plants such as Asgandh (Withania somnifera), Bābūna (Matricaria chamomilla), and Saunf (Foeniculum vulgare) exhibit musakkin, mudirr-e-ṭams, and muḥallil-e-waram properties, providing symptomatic relief and hormonal regulation. Conclusion: The Unani system offers a holistic and individualized approach to PMS by addressing both physiological and psychological dimensions. Integration of classical Unani therapeutics with contemporary scientific research may lead to safe, effective, and patient-centered strategies for managing PMS.