Abstract
Endometriosis, in today’s women’s health scenario, is becoming a focus of great concern. Endometriosis is defined as the abnormal proliferation of endometrial cells outside of the uterus. It is a difficult and painful condition that primarily affects women throughout their reproductive years. The term “endometrium” refers to the tissue that borders the interior of the uterus and is built up and shed each month throughout the menstrual cycle. The various causes and theories related to endometriosis are intriguing as well as thought-provoking. The aim of the treatment plan in this case study for endometriosis is to reduce the severity of symptoms, improve the quality of life and lessen the severe nature of pain during menstruation using Ayurvedic formulations and Panchakarma therapy sessions. The Ayurvedic treatment focuses on rebalancing the person’s imbalances rather than treating the sickness or its symptoms.
Case Description
A woman who was trying to conceive complained of severe painful cramping periods (dysmenorrhoea), in the lower abdomen, with heavy bleeding patterns accompanied with nausea, vomiting and high-grade fever (++), particularly during the cycle. The severe pain that the condition led to her taking two or three days off every month as she was unable to get up from the bed for the first three days.
Past treatment history revealed two laparoscopic surgeries done with endometrial cystectomy and adhesiolysis in 2017 and 2020, followed by 6 lupride injections.
Investigations
- 14/06/2021: USG Findings – Right ovarian endo cyst of size 4.8 * 4.2 cm and left cyst 3.6 *4 cm
- H/o Laparoscopic surgery with endometrial cystectomy and adhesiolysis (2017 & 2020)
Diagnosis
A complication of Udavartini yonivyapad (Pitta dosha dominance) / Yoni Kanda of Pitta origin / Endometriosis
The closest diagnosis as per Madhav nidana and symptoms of the patient was Yoni kand of Pitta origin or it can also be correlated with a complication sign of Udavartini yonivyapad.
Treatment plan
- Nidana Parivarajana
- Restrictions in dietary menu with avoiding all heavy-to-digest food items particularly during and prior to menstrual cycle and consuming home-cooked food.
- A diet that is abundant in nutrients and easy to digest, including plenty of digestive herbs.
- Drink lukewarm water throughout the day.
- Ayurvedic medication
- Vasaguluchyadi kashayam
- Trayantyadi kashayam
- Praval panchamrit ras ( mukta yukta)
- Sukumar erandam
- Trailokya Vijaya vati (to be taken during periods)
- Panchakarma Therapy
- Uttar Basti cycles
- Advised for Yog vasti in the next cycle along with the oral medicines.
Observation
The expected outcome of the treatment plan was to primarily relieve her of the pain, inflammation and to have a sound sleep pattern. The efforts were primarily emphasized in providing permanent relief with the Ayurveda healing power of herbs and Panchkarma as preventing or managing this condition early on can result in healthier and more successful aspects of this case.
Since the disease is caused by toxin buildup, poor nutrition, poor digestion, and mental and neurological system imbalances, therapy must involve actions to address the imbalances and reverse the disease process.
The patient was treated for a period of 4 months initially and noticed a 60% less painless period in July with normal bleeding, no fever and vomiting. In her repeat USG, only one small-sized cyst of 2.1* 1.5 cm is left.
Discussion
Endometriosis is described as the development of endometrial-like tissue outside of the uterus. It mostly affects women of reproductive age and, while the precise origin is unknown, it is an oestrogen-dependent disorder related to menstruation. It is commonly connected with symptoms such as pelvic discomfort, painful periods, and exhaustion, and it can have serious medical, sexual, psychological, and social consequences. Endometriosis can occur in women without symptoms, making it difficult to determine the disease’s prevalence in the general population.
Most modern drug treatments for endometriosis work by suppressing ovarian function and are contraceptives. Endometriotic lesions are removed or destroyed during surgery. The therapy chosen is determined by the symptoms and priorities in terms of pain management and fertility.
Ayurveda illustrates symptoms of endometriosis as an ama/ toxins accumulation disorder; therefore, the treatment should focus on detoxification or Shodhana therapy to eliminate the ama and return the doshas to their rightful positions. As a result, Panchakarma is recommended in addition to Agni treatment. Most crucially, because it is involved in menstruation and hormone production, the liver should be cleaned or detoxified.
The use of Trailokya Vijaya Vati, a herbal formulation with the remarkable advantages of a medical variation of cannabis and vansh lochan, successfully relieves the state of chronic pain. Cannabinoids have analgesic properties. They interact with a wide range of receptors throughout the body, including those involved in pain sensation.
Conclusion
Normal menstruation denotes a healthy state of the female reproductive system. Menstruation can cause discomfort, but when it becomes severe, it is inconvenient for a woman. Endometriosis is the most prevalent cause of secondary dysmenorrhoea, especially among married women. Endometriosis has increased in both real and perceived incidence during the previous few decades, and it now accounts for around 10% of all cases. Udavartini yonivyapad can be equated to any sort of dysmenorrhoea in Ayurveda. Udavartini is primarily a vata dosha pradhana vyadhi, in which vata leads raja to go higher. Our Acharyas have defined gulma and vandhaytawa as yonivyapad problems. As a result, endometriosis caused by retrograde menstrual flow might be linked to Udavartini therefore.
Trailokya Vijaya Vati is a superb painkiller in menstrual pain management instances since it acts as a supportive pain management herbal treatment while also assisting in regulating the digestive fire and aiding in liver functions according to the person’s body constitution.
Case Study by Dr. Rani Gupta
Published By Hempstreet
