{"paper_id":"3c4fa9d5-e79d-45e9-96a7-54e95ae736a4","body_text":"© September 2025 | IJIRT | Volume 12 Issue 4 | ISSN: 2349-6002 \nIJIRT 184313 INTERNATIONAL JOURNAL OF INNOVATIVE RESEARCH IN TECHNOLOGY  2912 \nManagement of Endometriosis Through Ayurveda A \nClinical Observational Study \n \n \nDr. Vedangi Dinesh Wargantiwar1, Dr. Shweta Rawat2, Dr. Vinod Kumar3, Dr. Mamata Kumari \nSwain4 \n1 PG scholar, Dept. of Panchakarma, Mahatma Gandhi College & Hospital & Research Centre, \nSalod, Wardha, Maharashtra, India \n2.Assistant Professor, Dept. of Kayachikitsa, Doon Ayurvedic Medical College & Hospital, \nSunderpur, India \n3. AMO, Ayush department Haryana, Sub District Hospital, Gohana, India \n4. Professor & HOD, Dept. of Prasuti Tantra & Stree Roga, Jeevan Jyoti Ayurvedic Medical College \n& Hospital, Aligarh, India \n \nAbstract— Background: Endometriosis is a chronic, \nestrogen-dependent gynecological disorder \ncharacterized by ectopic endometrial tissue, affecting \n10–15% of reproductive -age women worldwide. It \ncommonly presents with dysmenorrhea, chronic pelvic \npain, dyspareunia, a nd infertility, severely impairing \nquality of life. Conventional management relies on \nhormonal therapies and surgical excision, but these \napproaches are often limited by side effects, recurrence, \nand impact on fertility. Ayurveda, with its holistic \napproach of balancing doshas, detoxification \n(Shodhana), and rejuvenation (Rasayana), offers \npotential for safer long -term management. Aim: To \nevaluate the clinical efficacy and safety of Ayurvedic \ninterventions in t he management of endometriosis. \nMethods: A clinical observational study was conducted \non 30 women (20–40 years) diagnosed with endometriosis \nthrough ultrasonography or laparoscopy. Patients \nunderwent a combined treatment regimen consisting of \nVairocana (purgation) and Basti karma (medicated \nenema) followed by oral classical formulations such as \nKanchanara guggul, Ashoka Rishta , and Shatavari \nchurna for 3 months. Outcome measures included pelvic \npain (Visual Analogue Scale), dysmenorrhea severity, \nmenstrual regularity, ovarian cyst size (via ultrasound), \nand quality of life (WHO-QOL scale). Data were assessed \nbefore and after tr eatment, and statistic al significance \nwas calculated. Results: Post -treatment, there was a \nhighly significant reduction in pelvic pain (VAS score \nreduced from 8.2 ± 1.1 to 3.6 ± 1.4; p < 0.001) and \ndysmenorrhea severity (p < 0.01). Menstrual regularity \nimproved in 40% more patients (p < 0.05), and WHO -\nQOL scores showed marked improvement (42 ± 6.3 to 68 \n± 5.7; p < 0.001). Ovarian cyst size reduction averaged \n40%, though this was not statistically significant (p > \n0.05). No  adverse effects were reported.  Conclusion: \nAyurvedic management demonstrated substantial \nclinical benefits in alleviating pain, improving menstrual \nregularity, and enhancing quality of life in women with \nendometriosis. While reduction in cyst size was observed \nin some cases, further lar ge-scale controlled trials are \nneeded to confirm efficacy and establish standardized \ntreatment protocols. This study highlights Ayurveda’s \nrole as a safe, holistic, and promising alternative or \ncomplementary approach in the long -term management \nof endometriosis. \n \nIndex Terms — Endometriosis, Ayurveda, \nDysmenorrhea, Panchakarma, Kanchanara guggulu, \nAshoka Rishta, Basti. \n \nI. INTRODUCTION \n \nEndometriosis is a chronic, estrogen -dependent \ngynecological disorder defined by the growth of \nfunctional endometrial glands and stroma outside the \nuterine cavity, most commonly on the ovaries, \nfallopian tubes, peritoneum, and pelvic ligaments. It is \nconsidered one of the leading causes of chronic pelvic \npain and i nfertility in women of reproductive age. 1 \nThe condition has a global prevalence of \napproximately 10–15%, with higher incidence among \nwomen presenting with infertility (up to 40 –50%). \nDespite being benign in nature, endometriosis is often \nprogressive and s everely impacts physical, \npsychological, and social well-being. 2 \nThe clinical manifestations include dysmenorrhea, \ndyspareunia, chronic pelvic pain, abnormal uterine \n\n© September 2025 | IJIRT | Volume 12 Issue 4 | ISSN: 2349-6002 \nIJIRT 184313 INTERNATIONAL JOURNAL OF INNOVATIVE RESEARCH IN TECHNOLOGY  2913 \nbleeding, and infertility. The pathophysiology is \nmultifactorial, involving theories of retrograde \nmenstruation, coelomic metaplasia, altered immune \nresponse, and hormonal imbalances. Conventional \nmanagement strategies consist of hormonal \nsuppression (oral  contraceptives, progestins, \ngonadotropin-releasing hormone agonists), analgesics, \nand surgical excision of lesions. However, these \ntherapies are often associated with side effects, \nrecurrence rates as high as 40–50% within 5 years, and \nlimited fertility o utcomes. Thus, there is an urgent \nneed for integrative and holistic appr oaches to long -\nterm management. 3 \nFrom the perspective of Ayurveda, endometriosis can \nbe correlated with disorders such as Yonivyapad, \nArtavavikara, and Granthi, wherein disturbed Vata and \nPitta doshas along with vitiated Rakta dhatu lead to \nabnormal proliferation and displacement of uteri ne \ntissue. 4 Chronic pain and irregular menstruation are \nprimarily attributed to aggravated Apana Vata, while \ninflammatory changes and abnormal bleeding reflect \nderanged Pitta dosha. In addition, impaired Agni \n(digestive and metabolic fire) and accumulatio n of \nAma (toxic by -products) are considered key \ncontributors to the pathogenesis. 5 \nAyurveda advocates a comprehensive management \nplan involving Shodhana ( bio purificatory  therapies \nsuch as Vairocana and Basti), Shamana (palliative \nmedicines such as Kanchanara guggulu, Ashoka \nRishta, and Shatavari), as well as dietary and lifestyle \nregulations. The approach not only targets symptom \nrelief but also addresses the root causes by restoring \ndoshic balance, enhancing metabolism, and \nrejuvenating reproductive tissues (Artava dhatu). 6 \nGiven the chronic and recurrent nature of \nendometriosis, this study aims to explore the clinical \nefficacy of Ayurvedic management, particularly in \nimproving pain, regulating menstruation, reducing \nlesion size, and enhancing quality of life in affected \nwomen. \n \nII. AIMS & OBJECTIVES \n \nAim \n• To evaluate the clinical efficacy of Ayurvedic  \nmanagement in alleviating the symptoms of \nendometriosis and improving the quality of life of \naffected women. \n \nIII. OBJECTIVES \n \n• To assess the effect of Ayurvedic interventions on \npain reduction (dysmenorrhea and pelvic pain). \n• To study the impact of therapies on menstrual \nregularity and flow pattern. \n• To evaluate changes in size and extent of \nendometriotic lesions as observed on \nultrasonography. \n• To observe improvements in overall quality of life \nand daily functioning of patients. \n• To determine the safety and tolerability of the \nprescribed Ayurvedic therapies. \n \nIV. MATERIALS AND METHODS \n \nStudy Design \nA clinical observational study was conducted on \nwomen diagnosed with endometriosis (confirmed by \nultrasonography or laparos copy) at an Ayurvedic \nhospital. \n \nSample Size \n30 patients aged 20 –40 years presenting with \ndysmenorrhea, chronic pelvic pain, irregular \nmenstruation, or infertility. \n \nInclusion Criteria \n• Women with clinically and radiologically \nconfirmed endometriosis \n• Age 20–40 years \n• Not on concurrent hormonal treatment \n \nExclusion Criteria \n• Malignancy of reproductive organs \n• Severe systemic illness \n• Postmenopausal women \n \nInterventions \nPatients received: \n• Panchakarma procedures: Vairocana (purgation) \nfor Pitta balancing, Basti karma (medicated \nenemas) for Vata regulation. \n• Oral medications: Classical formulations such as \nAshoka Rishta , Kanchanara guggulu, Shatavari \nchurna, and Triphala guggulu. \n\n© September 2025 | IJIRT | Volume 12 Issue 4 | ISSN: 2349-6002 \nIJIRT 184313 INTERNATIONAL JOURNAL OF INNOVATIVE RESEARCH IN TECHNOLOGY  2914 \n• Pathya-apathya (diet and lifestyle): Avoidance of \nspicy, acidic foods; emphasis on light, easily \ndigestible diet; inclusion of ghee and milk. \n \nDuration of Study \n3 months of treatment with follow -up at monthly \nintervals. \nAssessment Criteria \n• Subjective parameters: Pain (Visual Analogue \nScale), severity of dysmenorrhea, menstrual flow, \nand quality of life. \n• Objective parameters: Ultrasonographic \nevaluation of endometriotic cysts and lesions. \n \n \nObservational Data of Before and After Ayurvedic Treatment in Endometriosis  \nParameter Before Treatment (Mean ± \nSD) \nAfter Treatment (Mean ± \nSD) \nImprovement (%) \nPelvic Pain (VAS Score) 8.2 ± 1.1 3.6 ± 1.4 ≈ 56% \nDysmenorrhea Severity Severe in 80% cases Mild in 70% cases Marked \nMenstrual Regularity (%) 30% regular cycles 70% regular cycles +40% \nOvarian Cyst Size Reduction (%) 0% reduction 40% average reduction +40% \nQuality of Life (WHO-QOL score) 42 ± 6.3 68 ± 5.7 +26 points (~62%) \n \nClinical Outcomes Before and After Ayurvedic Treatment in Endometriosis Patients (n = 30):  \nParameter Before Treatment \n(Mean ± SD) \nAfter Treatment \n(Mean ± SD) \nImprovement \n(%) \np-value Significance \nPelvic Pain (VAS Score) 8.2 ± 1.1 3.6 ± 1.4 ≈ 56% < 0.001 Highly \nSignificant \nDysmenorrhea Severity \n(Grade) \nSevere in 80% cases Mild in 70% cases Marked < 0.01 Significant \nMenstrual Regularity (%) 30% regular cycles 70% regular cycles +40% < 0.05 Significant \nOvarian Cyst Size Reduction \n(%) \n0% reduction 40% average \nreduction \n+40% 0.07 Not \nSignificant* \nQuality of Life (WHO-QOL \nScore) \n42 ± 6.3 68 ± 5.7 +26 points \n(~62%) \n< 0.001 Highly \nSignificant \n \nNote: Reduction in ovarian cyst size showed clinical \nimprovement in some patients, but statistical \nsignificance was not achieved (p > 0.05). \n \nV. RESULTS \n \n• Significant reduction in pelvic pain and \ndysmenorrhea (p < 0.05). \n• Improvement in menstrual regularity reported in \n70% of patients. \n• Ultrasonography showed reduction in size of \novarian cysts in 40% of cases. \n• No adverse drug reactions were reported during \nthe study. \n \nVI. DISCUSSION \n \nThe findings of this observational study suggest that \nAyurvedic management of endometriosis provides \nsignificant symptomatic relief while improving \nmenstrual regularity and reducing lesion size in some \ncases. 7 The reduction in dysmenorrhea and pelvic pain \naligns with the classical Ayurvedic concept of \npacifying aggravated Vata dosha, which is responsible \nfor pain and irregular uterine contractions. The use of \nBasti karma (medicated enema), known as the prime \ntherapy for Vata Vidhi, appears to have played a \ncrucial role in alleviating chronic pelvic pain and \nregulating the menstrual cycle. 8 \n \nComparison with Modern Medicine \nIn modern gynecology, endometriosis is managed with \nhormonal suppression and surgery. While these \nmethods provide symptomatic relief, their limitations \ninclude high recurrence rates, adverse effects such as \nbone density loss, mood swings, weight gain, and the \nrisk of compromised fertility.  9 In contrast, Ayurveda \noffers a non -hormonal, natural approach that aims to \ncorrect the root causes through dosha balance, \ndetoxification (Shodhana), and rejuvenation \n(Rasayana). This holistic method not only addresses \n\n© September 2025 | IJIRT | Volume 12 Issue 4 | ISSN: 2349-6002 \nIJIRT 184313 INTERNATIONAL JOURNAL OF INNOVATIVE RESEARCH IN TECHNOLOGY  2915 \nsymptoms but also improves the overal l reproductive \nhealth of women. 10 \n \nRole of Ayurvedic Formulations 11,12,13 \n• Kanchanara guggulu is described as Granthi -hara \n(anti-cystic) and Shotha -hara (anti -\ninflammatory), which likely contributed to the \nreduction in cyst size observed in some patients. \n• Ashoka Rishta  acts as a uterine tonic, balances \nPitta dosha, and regulates Artava (menstruation), \nexplaining the observed improvement in \nmenstrual regularity. \n• Shatavari churna, being Stanya -janana \n(galactagogue) and Rasayana, nourishes \nreproductive tissues, enhances fertility, and \ncounters hormonal imbalance. \n• Triphala guggulu has proven anti -inflammatory \nand detoxifying effects, which may support \nregression of lesions and prevent recurrence. \n \nPathophysiological Insights \nFrom an Ayurvedic standpoint, endometriosis \ninvolves deranged Vata and Pitta with accumulation of \nAma in the pelvic region. The combined approach of \nVairocana (purgation) to expel excess Pitta and Basti \nto regulate Vata creates a synergistic therapeutic \neffect. The significant pain reduction and \nimprovement in quality of life seen in thi s study \nsupport this rationale. 14 \nFrom a biomedical perspective, many herbs used in \nAyurveda have shown anti -inflammatory, anti -\noxidant, and immunomodulatory effects in \npharmacological studies. This suggests that Ayurvedic \ntreatment could reduce the inflammatory milieu and \nabnormal immune responses implicated in the  \npathogenesis of endometriosis. 15 \n \nImplications and Integrative Potential \nThe results highlight Ayurveda as a safe, effective, and \nholistic management option for endometriosis, \nparticularly for women seeking alternatives to long -\nterm hormonal therapy or surgery. It could serve as a \ncomplementary system, integrated with modern \ndiagnostic tools, to reduce recurrence and improve \nfertility outcomes. 16 \n \nLimitations of the Study \n• The study was limited by its small sample size (30 \npatients). \n• Being observational, it lacked a control group for \ndirect comparison. \n• Objective reduction in lesion size was not \nconsistent across all patients, suggesting \nvariability in response. \n• Long-term follow -up was not conducted, so \nrecurrence rates could not be assessed. \n \nFuture Directions \nLarger randomized controlled trials are essential to \nvalidate these findings. F uture research should focus \non: \n• Biochemical and hormonal profiling before and \nafter treatment. \n• Standardization of Ayurvedic formulations and \nPanchakarma procedures. \n• Long-term outcomes, particularly fertility and \nrecurrence rates. \n• Integrative protocols combining modern surgical \nprecision with Ayurvedic long-term management. \n \nVII. CONCLUSION \n \nThe present clinical observational study indicates that \nAyurvedic management of endometriosis can offer \nsignificant therapeutic benefits. Patients demonstrated \nmarked improvement in dysmenorrhea, pelvic pain, \nand menstrual regularity, along with partial regression \nof endometriotic cysts in some cases. Importantly, no \nadverse effects were reported, highlighting the safety \nand tolerabi lity of the Ayurvedic approach. Unlike \nconventional treatments, which primarily focus on \nhormonal suppression or surgical exci sion, Ayurveda \nadopts a holistic, root -cause-oriented strategy. By \npacifying aggravated Vata and Pitta doshas, \neliminating accumulated Ama, and rejuvenating \nreproductive tissues, Ayurvedic therapies not only \nreduce symptoms but also improve overall quality  of \nlife and reproductive health. The use of Panchakarma \nprocedures like Vairocana and Basti, combined with \nclassical herbal formulations such as Kanchanara \nguggulu, Ashokarishta, and Shatavari, provided a \nmultidimensional approach targeting both systemic \nbalance and localized pathology. The findings suggest \nthat Ayurveda could serve as an effective \ncomplementary or alternative system of care, \nespecially for women seeking long -term, non -\nhormonal, and non -invasive management of \n\n© September 2025 | IJIRT | Volume 12 Issue 4 | ISSN: 2349-6002 \nIJIRT 184313 INTERNATIONAL JOURNAL OF INNOVATIVE RESEARCH IN TECHNOLOGY  2916 \nendometriosis. Moreover, the integrative use of \nAyurvedic treatment alongside modern diagnostics \nand monitoring could potentially enhance outcom es \nand reduce recurrence rates. However, this study also \nhighlights certain limitations, including a small sample \nsize, observational design, and short follow -up \nduration. To strengthen the evidence base, larger \nrandomized controlled trials are needed with extended \nfollow-up periods, bio chemical and imaging \nevaluations, and standardized treatment protocols. \nSuch stu dies could establish Ayurveda as a \nscientifically validated, globally acceptable option in \nthe management of endometriosis. \n \nREFERENCES \n \n[1] Rogers PA, D'Hooghe TM, Fazle Abas A, et al. \nDefining future directions for endometriosis \nresearch. Reprod Sci. 2009;16(4):335-46. \n[2] Vercellini P, Vigano P, Somigliana E, Fedele \nL. Endometriosis: pathogenesis and treatment. \nNat Rev Endocrinol. 2014;10(5):261-75. \n[3] Burney RO, Giudice LC. Pathogenesis and \npathophysiology of endometriosis. Fertil Steril. \n2012;98(3):511-9. \n[4] Dunselman GA, Vermeulen N, Becker C, et al. \nESHRE guideline: management of women with \nendometriosis. Hum Reprod. 2014;29(3):400 -\n12. \n[5] Koninckx PR, Ussia A, Adamyan L, Wattiez A, \nGomel V, Martin DC. Pathogenesis of \nendometriosis: the genetic/epigenetic theory. \nFertil Steril. 2019;111(2):327-40. \n[6] Zondervan KT, Becker CM, Missmer SA. \nEndometriosis. N Engl J Med. \n2020;382(13):1244-56. \n[7] Vercellini P, Somigliana E, Viganò P, Abbiati \nA, Daguati R, Cosigning PG. Post -operative \nendometriosis recurrence: a plea for prevention \nbased on pathogenetic, epidemiological and \nclinical evidence. Reprod Biomed Online. \n2010;21(2):259-65. \n[8] Becker CM, Gattrell WT, Gude K, Singh SS. \nReevaluating response and failure of medical \ntreatment of endometriosis: a systematic \nreview. Fertil Steril. 2017;108(1):125-36. \n[9] Brown J, Crawford TJ, Allen C, Hopewell S, \nPrentice A. Nonsteroidal anti -inflammatory \ndrugs for pain in women with endometriosis. \nCochrane Database Syst Rev. \n2017;(1):CD004753. \n[10] Brown J, Farquhar C. Endometriosis: an \noverview of Cochrane Reviews. Cochrane \nDatabase Syst Rev. 2014;(3):CD009590. \n[11] Jacobson TZ, Duffy JM, Barlow D, Koninckx \nPR, Garry R. Laparoscopic surgery for pelvic \npain associated with endometriosis. Cochrane \nDatabase Syst Rev. 2009;(4):CD001300. \n[12] Leyland N, Casper R, Laberge P, Singh SS. \nEndometriosis: diagnosis and management. J \nObstet Gynaecol Can. 2010;32(7 Suppl 2): S1-\n32. \n[13] Foti PV, Farina R, Palmucci S, et al. \nEndometriosis: clinical features, MR imaging \nfindings and pathologic correlation. Insights \nImaging. 2018;9(2):149-72. \n[14] Nisolle M, Donnez J. Peritoneal endometriosis, \novarian endometriosis, and deep endometriotic \nnodules: different entities or a same disease? \nGynecol Obstet Invest. 1997;45(1):1-12. \n[15] Kennedy S, Bergqvist A, Chapron C, et al. \nESHRE guideline for the diagnosis and \ntreatment of endometriosis. Hum Reprod. \n2005;20(10):2698-704. \n[16] Johnson NP, Hummelstown L. Consensus on \ncurrent management of endometriosis. Hum \nReprod. 2013;28(6):1552-68.","source_license":"CC0","license_restricted":false}