ADENOMYOSIS: AN UNDERRECOGNIZED DISORDER IN AYURVEDA—A LITERARY REVIEW WITH CONCEPTUAL CORRELATION

Adenomyosis is a benign uterine disorder characterized by ectopic endometrial tissue within the myometrium, resulting in uterine enlargement, chronic inflammation, and fibrosis. It typically presents with heavy menstrual bleeding, dysmenorrhea, pelvic pain, and infertility, although some cases may remain asymptomatic. With advancements in imaging techniques such as transvaginal ultrasonography and magnetic resonance imaging, adenomyosis is increasingly recognized in reproductive-age women, shifting its understanding from a purely histopathological finding to a clinically relevant condition. The pathogenesis remains multifactorial and not fully elucidated, with theories including endometrial invagination, Müllerian remnants, and stem cell origin. Estrogen-dependent inflammatory mechanisms play a central role in disease progression and symptom manifestation. Conventional treatment options include hormonal therapies such as progestins, levonorgestrel-releasing intrauterine system, and gonadotropin-releasing hormone analogues, which effectively reduce symptoms but may not be suitable for women desiring conception due to their contraceptive effects. Surgical management, including adenomyomectomy, is reserved for severe or refractory cases but carries significant obstetric risks. From an Ayurvedic perspective, adenomyosis can be correlated with Vata-predominant conditions such as Vataja Asrigdara and Garbhashaya Granthi involving Artavavaha Srotodushti. Ayurvedic management emphasizes dosha balance, symptom relief, and fertility preservation through Shamana, Shodhana, and local therapies. Overall, an integrated, multidisciplinary approach is essential for optimal management of adenomyosis.