European peony (Paeonia officinalis) has a long history of use in traditional medicine, including European herbalism and traditional Chinese medicine (where the related species Paeonia lactiflora is more common). The herb is traditionally used for gynecological conditions, such as menstrual irregularities and pain. The term "PMS Type P" generally refers to a premenstrual syndrome subtype characterized by predominant pain symptoms, such as cramps and headaches.

Scientific evidence for European peony specifically in the management of PMS pain is limited but emerging. Research has focused more extensively on Paeonia lactiflora (white peony) and its use in combination with other herbs (notably in the traditional Chinese formula Shao Yao Gan Cao Tang) for menstrual pain and dysmenorrhea, which shares some features with PMS Type P. Some clinical studies and animal experiments suggest that peony root extracts may have antispasmodic, anti-inflammatory, and analgesic effects, possibly due to constituents like paeoniflorin. These properties could theoretically benefit women experiencing PMS-related pain.

However, direct clinical trials examining Paeonia officinalis alone for PMS Type P are scarce, and much of the evidence is extrapolated from studies on related species or on broader menstrual pain rather than PMS specifically. Thus, while there is some scientific rationale and preliminary evidence, robust clinical data are lacking, which is reflected in the moderate evidence rating.