Squaw Vine (Mitchella repens) has a long history of use in traditional herbal medicine, particularly among Native American and early American herbalists. It has been used as a general tonic for women’s reproductive health, including supporting menstruation and easing symptoms associated with the menstrual cycle. Traditional use often included combining Squaw Vine with other herbs to promote uterine health, reduce cramping, and soothe nervous tension, which aligns with some symptoms of PMS, particularly PMS Type P (characterized by pain and cramping). However, while these uses are well-documented in 19th and early 20th century herbal texts, there is scant modern scientific evidence to support the efficacy of Squaw Vine for PMS or its subtypes. No well-controlled clinical trials have evaluated its effects on PMS symptoms. Its inclusion in formulas for PMS is largely based on ethnobotanical tradition and empirical use rather than on pharmacological or clinical validation. Therefore, while it is used traditionally for menstrual discomfort, its use for PMS Type P should be viewed in the context of historical herbalism rather than evidence-based medicine.