The main metabolites in KXN, including astragaloside IV, icariin and baohuoside I increased estradiol levels by enhancing the activity of CYP19A1, the representative enzyme in hormone biosynthesis pathway.<h4>Discussion</h4>This study shows that KXN could relieve anxiety, depression, and osteoporosis in PMS. Here, CYP19A1 is linked to depressive symptom measurement.