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Danggui Shaoyao San (DSS) is a traditional Chinese medicine (TCM) formula, also known as Toki-shakuyaku-san in Japanese Kampo medicine. It is composed of six herbal ingredients: *Angelica sinensis* (Danggui), *Paeonia lactiflora* (Shaoyao), *Alisma orientale* (Zexie), *Poria cocos* (Fuling), *Atractylodes macrocephala* (Baizhu), and *Ligusticum chuanxiong* (Chuanxiong). Historically used to treat gynecological disorders, DSS is primarily indicated for conditions involving blood deficiency and liver-spleen disharmony in TCM theory, such as primary dysmenorrhea, irregular menstruation, and infertility. Its pharmacological effects are attributed to anti-inflammatory, analgesic, and sedative properties, as well as the modulation of the endocrine and immune systems. Recent clinical research evaluates its efficacy in alleviating menstrual pain and associated physical and emotional symptoms, potentially through the inhibition of prostaglandin synthesis and regulation of the hypothalamic-pituitary-ovarian axis.
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