Tokito is a Kampo prescription to treat abdominal bloating and abdominal cramping which radiate to the back associated with deficiency pattern and cold pattern. There are few reports on the use of tokito in gynecology, especially for menstrual-related symptoms. Here, we present a case in which tokito was successful in treating armpit back pain, abdominal bloating, diarrhea and anxiety, which are recognized as symptoms of premenstrual syndrome and endometriosis. The patient was a 34-year-old woman with endometriotic cysts on both ovaries. She started taking hormone treatment for dysmenorrhea and endometriosis, but the treatment was discontinued because of depression caused by drug side effects. While Western medical treatment options were limited due to multiple complications, her various symptoms improved after taking tokito. In addition, the edema, which had remained unchanged despite seven years of treatment with goreisan alone prescribed by her previous physician, rapidly improved with the combined use of tokito. Thus, we report a case in which traditional Japanese medicine was effective when Western medical treatment was not an option or was difficult.