{"paper_id":"7acd748b-f333-495e-89ce-cd7266c9fed4","body_text":"~ 50 ~ \n \nISSN Print: 3078-6754 \nISSN Online: 3078-6762 \nJAMS 2025; 2(2): 50-53 \nwww.maulikjournal.com \nReceived: 16-08-2025 \nAccepted: 21-09-2025 \n \nKshama Kulkarni \nAssistant Professor, Bhagwan \nMahaveer Jain Ayurved \nMedical College, \nGajendragarh, Karnataka, \nIndia \n \nRakesh Mishra \nAyurved Physician/Scientist, \nKPREC, DSVC K University, \nDurg, Chhattisgarh, India \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \nCorresponding Author: \nKshama Kulkarni \nAssistant Professor, Bhagwan \nMahaveer Jain Ayurved \nMedical College, \nGajendragarh, Karnataka, \nIndia \n \n \n \nAn Ayurvedic perspective of Endometriosis: A Review \n \nKshama Kulkarni and Rakesh Mishra \n \nDOI: https://www.doi.org/10.33545/siddhant.2025.v2.i2.A.28 \n \nAbstract \nThe Name MAA (Mother) is the most precious blessing bestowed upon women by God. Consequently, \nwomen were designed with distinct anatomical and physiological traits that set them apart from men. \nAs a result, women experience a variety of health issues primarily related to their reproductive systems, \nunlike men. Some of these conditions can disrupt their sense of womanhood, while others may pose \nserious risks to their health if not appropriately addressed. One such condition is endometriosis. This \ndisorder occurs when endometrial tissue, typically found inside the uterus, is located outside of it. \nPatients suffering from this condition often endure intense pain that may progressively worsen. The \nmisplaced endometrial tissue functions like normal tissue and sheds blood monthly. This blood can \nbecome trapped, leading to the formation of a chocolate cyst, which may also burst. At this point, \nsurgical treatment becomes necessary to prevent potential life threatening situations for the patient. \nTherefore, it is crucial to have a treatment approach that not only addresses endometriosis but also \nprevents the formation of chocolate cysts. In Ayurveda, endometriosis is likened to \"Vyana Avruta \nApana Vata\" and must be treated accordingly. Treatment strategies encompass Amachikitsa, Vyana \nAvruta Apana Vata Chikitsa, and Samanatherapies. Additionally, lifestyle and dietary changes should \nbe emphasized, as their contribution to the development of diseases cannot be overlooked. This paper \nwill explore various Ayurvedic medications that have these beneficial properties and are effective in \nmanaging endometriosis. \n \nKeywords: Cyst. Maa, Endometriosis, Yonivyapad, Vata \n \nIntroduction \nEndometriosis is considered one of the most enigmatic and intriguing non-cancerous \ngynecological conditions, characterized by the presence of functional endometrial tissue \noutside the uterus. Its occurrence rate is around ten percent. Nevertheless, this rate elevates \namong women experiencing infertility, reaching 30 to 40 percent according to findings from \ndiagnostic procedures such as laparoscopy and laparotomy1. Endometriosis can manifest in \nvarious locations. The most frequently affected areas include the ovaries, the cul-de-sac with \nthe Uterosacral ligaments, the peritoneum that covers the bladder, the sigmoid colon, the \nposterior part of the uterus, and areas of the intestine and appendix [2]. The precise origin of \nthis condition remains unclear, though multiple theories have been proposed, including the \nimplantation theory, metaplasia theory, lymphatic spread theory, blood spread theory, \nimmune deficiency theory, and genetic theory, among others. Ectopic endometrial stroma \nand glands are capable of undergoing cyclical changes. While proliferative changes are \nroutinely observed, secretory changes are not present in the ectopic tissue. Blood that is shed \nperiodically may become encapsulated, causing the cyst to tense and eventually rupture. This \nblood acts as an irritant, resulting in a strong tissue reaction around the area that leads to \nfibrosis. As a consequence, adhesions and puckered areas of the peritoneum may develop. \nChocolate Cysts might form. Despite the significant adhesions within the pelvic region, the \nfallopian tubes usually remain unobstructed [3]. Endometriosis has been noted in various \nlocations such as the ovaries, uterine ligaments, rectovaginal septum, pelvic peritoneum, \nscars from laparotomy, vagina, umbilicus, hernia sacs, urinary tract, large and small \nintestines, appendix, and occasionally, even in areas like the pleura, diaphragm, arms, legs, \nand kidneys. Symptoms may include nausea or vomiting, abdominal bloating, painful \nmenstruation, painful intercourse, painful urination, painful bowel movements, lower \nabdominal discomfort, heavy menstrual bleeding, irregular periods, and chocolate cysts in \nadvanced stages [4]. \nJournal of Ayurvedic Maulik Siddhant 2025; 2(2): 50 -53\n \n\n\n \n~ 51 ~ \nJournal of Ayurvedic Maulik Siddhant https://www.maulikjournal.com \n   \n While it is mainly accepted that there is no definitive cure \nfor endometriosis, Ayurveda offers insights about the \nunderlying causes, contributing factors for triggering the \ncondition, and potential treatments for recovery. \n \nEndometriosis \nIn the lens of Ayurveda, this condition is seen as disturbance \nof the Tridoshas in various situations. An excessive growth \nof cells signifies a Kapha disturbance. Given the uterus's \nposition and the role of hormones along with blood flow, \nthis also points to a Pitta disturbance. Moreover, since the \nmenstrual cycle involves movement, it can be viewed as a \nVata issue. The disturbance of all three Doshas contributes \nto endometriosis, suggesting a state of imbalance in the \nTridoshas. The role of the Tridoshas in the development of \nendometriosis is outlined in the table below. \n \nPerspective of Endometriosis in Ayurveda \nAyurveda is a healing system that emphasizes the \nsignificance of Nidana, Doshas, Dushyas, and Udbhavastana \nin effectively treating illnesses in a clinical context. \nTherefore, Ayurveda scholars assert that a doctor can \nsuccessfully address a condition even if they are unable to \nidentify it by considering all these elements. The \nmanifestations of endometriosis can be linked to various \nYoni Vyapads mentioned in ancient texts. However, not all \nsymptoms associated with endometriosis can be classified \nunder one specific Yoni Vyapad. Thus, accurate diagnosis is \ncrucial at this time. This approach aids in developing \ntreatment strategies and managing the condition effectively, \nwhich in turn helps avoid potential complications. \n \nSamprapti \nIncorrect diet and lifestyle choices disturb the three doshas, \nparticularly affecting the Vata dosha in cases of \nendometriosis. Among the five types of Vata, it is the Vyana \nvata that becomes predominantly imbalanced. This \nimbalanced Vyana vata moves to the location of the Apana \nvata, causing a disturbance in the function of Apana vata. \nApana vata plays a crucial role in the processes of \nmenstruation, urination, excretion, semen production, and \nchildbirth5. Therefore, disturbances related to menstruation, \nurination, and excretion are observed in endometriosis6. The \nVyan Vayu facilitates movement within the body. When \nVyana vata reaches the site of Apana vata, it hinders the \nusual functions of Apana vata and pushes it in the wrong \ndirection, leading to a reversal of the menstrual flow. \n \nMidhyahara Vihara  Tridoshic Vitiation Mainly Vata \nVyanavata  Obstruction of Apana  Vata  Disturbed \nFunction of Apana Vata  Viloma Gati of Artava  Artava \nand Mutra Purisha Vikaras \n \nVikarasas Udavarta, Kastartava, Arti, Asrigdara, Gulma, \nMaithuna Ashishnuta, Vandhya, Mutrakricchra, \nParikartikacan arise due to the disturbed function of Apana \nvata. As it is a Pakwasaya Gata Sthana Vyadhi Adhmanacan \nalso be encountered. \n \nAyurveda Diagnosis \nDepending on the samprapti described in Ayurveda and \nsymptoms of endometriosis in Ayurveda can be diagnosed \nas “Vyana Avruta Apana Vata”. \n \nSymptoms of Vyana Avruta Apana Vata [7] \nVami, Adhmana, Udavarta, Gulma, Aarti, Parikartika. When \nVata is the main Dosha, the key characteristics include \nadhmana, Udavarta, and Aarti. In this situation, the patient \noften reports various types of pain, such as dysmenorrhea, \ndyspareunia, dysuria, low back discomfort, or abdominal \npain, along with a retrograde flow of menstrual fluid. If \nVyana avruta apana vata interacts with Pitta, the patient may \nface Gulma (Artava) and Asrugdhara. In this instance, \nGulma pertains to Artava Gulma, reflecting the buildup of \nnormal Artava. In this scenario, the patient might experience \nmenorrhagia and chocolate cysts [8]. Since chocolate cysts \narise from the buildup of menstrual debris, they are \nclassified as ArtavaGulma. When Vyana avruta apana vata \nis linked with Kapha, it can result in adhesions. \n \nTable 1: Types of Endometriosis and its comparison with Ayurved \nSamhita \n \nS.N. Endometriosis Vyana Avruta Apana Vata \n1 Nausea / vomiting Vami \n2 Bloating Adhmann \n3 Retrograde movement of the \nmenstrual blood Udavarta \n4 Chocolate cyst Gulm  \n5 Pain \nArti (Includes \nDysmenorrhoea, Dysperunia \nand Dysuria) \n6 Dyschezia Parikartika  \n \nContemporary Medical Science view of Endometriosis \nAlmost 10 to 15% of women in their reproductive years are \nprimarily impacted by endometriosis. Among women facing \ninfertility, approximately 25 to 50% have endometriosis, \nand between 30 to 50% of those with endometriosis \nexperience infertility [9].  \n \nThe three predominant forms of endometriosis \ncommonly seen in our clinical setting are as follows \n1. Peritoneal endometriosis, where endometrial-like \ngrowths are present on the pelvic peritoneum and \novaries. \n2. Endometriomas, which are ovarian cysts that are \ncovered by endometrial-like tissue. \n3. Rectovaginal endometriosis, characterized by \nendometrial-like tissue intertwined with fat and \nconnective muscle tissue located between the rectum \nand vagina [10]. \n \nRisk factors \nThe pathology of endometriosis is not clear even to this day \nand is full of theories. Yet the risk factors of this disease are \nidentified. They include low parity, delayed child bearing, \nfamilial history, genital tract obstruction, environmental \ntoxins (Dioxins) and molecular defects of cytokines, TNF, \nmacrophages, MMPs and the like [11]. \n \nClinical symptoms \nThe clinical symptoms include nausea or vomiting and \nbloating [12], dysmenorrhea, dyspareunia, dysuria, dyschezia, \nlower abdominal pain, menorrhagia, irregular bleeding and \nchocolate cyst in later stages [13]. \n \nPathology \nNumerous theories have been suggested to clarify the \ndevelopment of endometriosis.  \n\n\n \n~ 52 ~ \nJournal of Ayurvedic Maulik Siddhant https://www.maulikjournal.com \n   \n They consist of \n1. Retrograde Menstruation (Sampson’s Theory):  This \ntheory suggests that during the menstrual cycle, blood \ncan flow backward through the fallopian tubes into the \npelvic region [14]. \n2. Coelemic Metaplasia Theory:  This concept asserts \nthat the origin of endometriosis comes from the \ntransformation of the mesothelial lining cells within the \nabdominal and visceral peritoneum [15]. \n3. Hormone Theory:  This theory indicates that the \nabnormal endometrial tissue reacts to ovarian steroid \nhormones. Estrogens promote the growth of \nendometrial cells, causing the ectopic tissue to respond \nsimilarly, which heightens the likelihood of \nendometriosis occurring [16]. \n4. Immune Dysfunction:  The presence of ectopic \nendometrial tissue in the peritoneum triggers \ninflammatory responses. This situation leads to the \nlocal activation of macrophages [17] and leukocytes, \nresulting in a compromised immune response that \nhampers the clearance of menstrual debris and supports \nthe implantation and proliferation of endometrial cells \nin non-typical areas. \n5. Genetics: A hereditary tendency raises the likelihood of \ncellular damage. Genetic mutations that induce cell \nimpairment can drive the advancement of \nendometriosis. \n \nAyurvedic Management \nEndometriosis cannot be correlated to any single disease in \nAyurveda. As discussed earlier the diagnosis, hence has to \nbe based on the Ayurvedic pathogenesis and balancing of \nTridosha’s and symptomatic. So, treatment approach can be \nAmpachana & correction of Agni, Vaatanulomana, Mridu \nVirechana, Vatashamaka, Raktasravarodhaka, Granthihar \nand Lekhan Chikitsa. \n \nS.N. Mode of Chiktsa(Treatment) Vyakhya (Description) \n1 \nAampachana and Agni Chikitsa \n(Imrove Digestion and correction of \nAgni) \nDeepan-Pachan drug like Panchkol Churna, Ampachakvati, Chitrakadi Vati Agnitundi Vati, \nSankh Vati, Vaishwanara Churna, Jirakadyarishta etc. can be used to promote Agni and for \neleminatig Ama from Artavahasrotas i.e., removal of obstruction in the Srotas. \n2 Vatanuloman (regulation of Vaat) \nVatanulomak drug like Hingwastaka Vati, Hingwadi Churna, Avipattikara Churna, \nAbhayarista, Triphala Churna, Haritaki Churna, Trivrit Churna, etc. drugs which helps in \ndecreasing Pratiloma Gati of vitiated Vata \n3 Virechana (Purgation) Mridu Virechana can be given to correct the Vatadosha Vimarggaman and to balance Pitta \nDosha if there is any liver pathology involvement. \n4 Vatshaman (Pacification of Vaat) \nExternal oil massage with Vata pacifying oil like Bala Taila, Dhanwanthara Tailam, Sesame \noil, etc. Yoga Basti procedure eliminate the Ama Doshas from body and balances the Vata \nDosha. Drug formulation for Niruha Basti - (Dashmool Kwatha, Erandmuladi Kwatha etc.) \nand Anuvasana Basti - (Sahchar Taila Dashmool Taila etc.) can be given. \n5 Raktasravavrodhak (Controll the \nExcess Bleeding) \nPradarantaka Rasa, Bolabaddha Rasa, Pradarari Rasa, Pushyanuga Choorna, Puskaraleha, \nAsokarishta, Lodhrasava, Patrangasava etc. which help in stopping bleeding and prevent \nformations of cyst. \n6 Granthihar Kanchnara Guggul having Antitumor activity. Varunadi Kashaya \n7 Lekhana \nCollection of Kapha removed by Bhedana Shigru leaf powder. Kumari - Bhedan, \nKaphshamak and act on Liver. Manjishtha - Antitumor activity (Pitta Dosha) Gokshurdi \nGuggul - Anti tumour activity (if Kanchanar not work) Other drugs having antitumor activity \nlike Sariva, Methika can be used. \n8 Vedanasthapan (Analgesic) Dashmoolarishta, Dashmool Kwatha, Ashokarishta, Maharashnadi Kashaya, Kumariasav, etc. \ncan be used for pain relief \n9 Pathya-Apathya \nFavour warm, light and slightly oily, fresh home-cooked meals. Avoid dry, cold, excessively \nheating and fermented foods. Particularly avoid alcohol, caffeine (especially coffee), \ncarbonated drinks, red meat and refined sugar or flour. Red wine, chili, coffee and red meat \n(all very heating) should be the first things to go. As mentioned, women should avoid \nexercise during menstruation and should keep their exercise relatively moderate throughout \nthe month. \n10 Yog \n Supta Matsyendrasana \n Ananda Balasana \n Balasana \n Supta Baddha Konasana \n Malasana \n Yoga Nidra \n \n \nConclusion \nThe condition characterized by the existence of endometrial-\nlike tissue outside the uterine cavity is known as \nendometriosis. It is a disorder that is explained by various \ntheories. The disruption of Vata Dosha, particularly the \nApana and Vyana Vata, leads to the backward flow of \nmenstrual blood and the distribution of endometrial tissues \nthrough the bloodstream. The ectopic endometrial implants \nmay increase in size with each menstrual cycle. \nEndometriosis can be managed through methods such as \nAmpachana, improving Agni, Vaatanulomana, gentle \npurging (Mridu Virechana), reducing Vata (Vatashamaka), \npreventing blood loss (Raktasravarodhaka), addressing cysts \n(Granthihar), and tissue scraping (Lekhan Chikitsa). \nAdditionally, adopting changes in lifestyle and diet can aid \nin the treatment of this condition. \n \nReferences \n1. Dutta DC. Textbook of Gynecology including \nContraception. 7th ed. Konar H, editor. New Delhi: \nJaypee Brothers Medical Publishers; 2016. p. 248. \n\n \n~ 53 ~ \nJournal of Ayurvedic Maulik Siddhant https://www.maulikjournal.com \n   \n 2. Padubidri V, Daftary SN, editors. Shaw’s Textbook of \nGynaecology. 11th ed. Mumbai: B.I. Churchill \nLivingstone Pvt Ltd; 1994. p. 526. \n3. Padubidri V, Daftary SN, editors. Shaw’s Textbook of \nGynaecology. 11th ed. Mumbai: B.I. 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Heterotopic or misplaced endometrial \ntissue. Am J Obstet Gynecol. 1925;10(5):649-664. \n13. Gruenwald P. Origin of endometriosis from the \nmesenchyme of the celomic walls. Am J Obstet \nGynecol. 1942;44(3):470-474. \n14. Augoulea A, Alexandrou A, Creatsa M, Vrachnis N, \nLambrinoudaki I. Pathogenesis of endometriosis: the \nrole of genetics, inflammation and oxidative stress. \nArch Gynecol Obstet. 2012;1-5. \n15. Kyama CM, Mihalyi A, Simsa P, et al . Role of \ncytokines in endometrial-peritoneal cross-talk and \ndevelopment of endometriosis. Front Biosci.  \n2009;1:444-454. \n16. Christodoulakos G, Augoulea A, Lambrinoudaki I, \nSioulas V, Creatsas G. Pathogenesis of endometriosis: \ndefective immunosurveillance. Eur J Contracept \nReprod Health Care. 2007;12(3):194-202. \n17. Koninckx PR, Barlow D, Kennedy S. Implantation vs \ninfiltration: Sampson theory vs endometriotic disease \ntheory. Gynecol Obstet Invest. 1999;47(1):3-10.","source_license":"CC0","license_restricted":false}