Ayurveda management of large endometrioma - A case report

Endometriosis is an unusual feature of retrograde menstruation that affects nearly every woman of reproductive age. Endometrioma, a severe form of endometriosis, is a common cause of infertility. Surgery is the recommended treatment for large endometrioma, which most women prefer to avoid. A 23-year-old unmarried patient had right side rapidly enlarging endometrioma measuring 6.9 × 5 cm with acute intermittent abdominal pain diagnosed as udavarta yonivyapada. Yoga basti (eight medicated enemas) and Kuberaksha vati were the primary treatments. Yoga basti is the treatment of choice for pain, inflammation and all the pelvic diseases related to fertility caused by vata aggravation. Alleviation of pain avoided the surgery. After discontinuation of medicines, the endometrioma size increased to 10.3 × 5.5 cm The second Yoga basti was administered before wedding. The patient conceived within four months after the marriage and had a full-term normal delivery with no acute pain episodes. The endometrioma size was reduced by 2 cm within one year and further reduced to 7.6 × 5.2 cm in the first trimester. Ayurvedic conservative treatment for endometriosis can manage pain and may also prevent retrograde menstruation. It can be a minimally invasive alternative prior to surgical removal, that has long-term beneficiary effects. As a seasonal regimen, yoga basti can also help fertile women with primary and secondary dysmenorrhea enhance the quality of life.