Montanoa tomentosa, commonly known as "zoapatle," has a long history of traditional use in Mexican herbal medicine, primarily for women's reproductive health. Traditional healers have employed its extracts for purposes such as inducing menstruation, facilitating childbirth, and managing various menstrual disorders. Its use for symptoms resembling PMS Type D (characterized by depressive symptoms, mood swings, and emotional disturbances) is based on its broader application in regulating menstrual cycles and addressing women's emotional health during their cycles. However, there is a lack of documented, specific traditional use explicitly targeting "PMS Type D" as defined in modern clinical terms; most traditional references relate generally to menstrual or reproductive support.

Scientifically, there is minimal evidence to support the efficacy of Montanoa tomentosa for PMS Type D. A handful of animal studies have explored its effects on uterine contractility and hormonal modulation, but none have directly examined its impact on mood or depressive symptoms associated with PMS. No clinical trials in humans have evaluated its safety or efficacy for PMS or mood disorders. As such, its use for PMS Type D remains rooted in traditional practice, with a very low evidence base and no modern scientific validation specific to this indication.