Nonsurgical management of Adenomyosis through Ayurveda: A single-case observation

Adenomyosis is a gynecological disorder, characterized by ectopic endometrial tissue infiltration into the myometrium leading to severe dysmenorrhea, menorrhagia, dyspareunia, and chronic pelvic pain. The conventional treatments include hormonal therapy and hysterectomy, but many patients seek alternative treatments due to the limitations of modern interventions. Ayurveda offers a customized approach, focusing on correcting the underlying imbalance in the Dosha (~regulatory functional factors of the body). A 42-year-old woman with a history of severe dysmenorrhea, menorrhagia with clots, dyspareunia, and dysuria for four years was diagnosed with Adenomyosis based on clinical findings and Ultrasonography (USG) was presented to the Outpatient Department of the Ayurveda hospital. Clinical examination revealed a bulky uterus, cervical hypertrophy, and Nabothian cysts. USG confirmed adenomyotic changes in the myometrium. The patient was previously managed with oral contraceptive pills and analgesics but showed no significant improvement. The patient was further advised hysterectomy but she opted for Ayurveda management. The patient was provided a treatment protocol including Deepana (~enhancing metabolic fire), Pachana (~enhancing digestion), and Vatanulomana (~proper elimination of flatus, feces, urine, etc.), Raktashodhana (~blood purifier) therapies, along with internal medications such as Ajamodadi churna , Dashamoola ksheerapaka , and Yogaraja guggulu . In addition, Yogabasti (~therapeutic enema) and Matra basti (~a form of unctuous enema) were administered. Dietary modifications and lifestyle changes, including Yoga and Pranayama (~breathing exercise), were also advised. After five months of treatment, outcomes demonstrated marked clinical improvement, with Pictorial Blood Loss Assessment Chart score reducing from 179 to 80 and Working ability, Location, Intensity, Days of pain, and Dysmenorrhea WaLIDD score from 12 to 0, along with normalization of uterine zonal anatomy on follow-up USG. This case highlights the efficacy of Ayurveda in managing Adenomyosis, providing a nonsurgical alternative, consequently, improving the quality of life. However, further clinical studies are needed to establish the standardized Ayurveda protocols for Adenomyosis management.