Premenstrual syndrome (PMS) is a common disorder of some women during their reproductive years, characterized by a range of cyclical physical and/or mood symptoms experienced during the last few days of each menstrual cycle. Several treatment approaches have been applied, but have shown limited success, as the exact cause and pathophysiology of PMS is still not fully identified. In this paper, the etiology and pathogenesis of PMS is compared from both a Traditional Chinese Medicine (TCM) perspective and the Western biomedicine paradigm. TCM has used herbal medicines to treat the symptoms of the premenstrual and menstrual phases for centuries. To date, very few studies on the application of TCM to PMS have applied rigorous research methods. We examine the case of PMS from each paradigm: The biomedical view and that of TCM. Similarities and differences are identified and explored, and possible treatment approaches are considered and discussed in the light of these two models.