E-ISSN:2456-3110

Case Report

Haemorrhagic Ovarian Cyst

Journal of Ayurveda and Integrated Medical Sciences

2022 Volume 7 Number 11 December
Publisherwww.maharshicharaka.in

Ayurvedic management of Haemorrhagic Ovarian Cyst (Andashayagata Raktaja Granthi) - A Case Report

R. Halagatti A.1*
DOI:

1* Anita R. Halagatti, Professor & HOD, Department of Prasooti Tantra and Stree Roga, Ayurveda Mahavidhyalaya, Hubballi, Karnataka, India.

Ovarian cyst is closed sac like structure on or within the ovary that is filled with liquid or semi-solid substance. Hemorrhagic cyst is a type of functional cyst usually these are called as Corpus luteal cyst. A 43 year old female patient with hemorrhagic cyst came for Ayurvedic treatment, she has severe lower abdominal and lower back pain. USG finding was right ovarian cystic lesion with thick content and multiple septae of size 3.3×3.2cms. Though hormonal or surgical treatments are the line of treatment but it can be effectively treated on the basic concepts of ayurvedic classics. Acharyas explained about Granthi but Raktaja Granthi is specially explained by Acharya Vagbhata which develops due to vitiation of Rakta caused by Vatadhi Dosha characterized with features of Pittaja Granthi. Patient was treated with only Ayurvedic Oral Medicines. After completion of 2 months of treatment the USG report revealed completely resolved cysts.

Keywords: Granthi, Raktaja Granthi, Cyst, Hemorrhagic Cysts, Corpus Luteum Cysts

Corresponding Author How to Cite this Article To Browse
Anita R. Halagatti, Professor & HOD, Department of Prasooti Tantra and Stree Roga, Ayurveda Mahavidhyalaya, Hubballi, Karnataka, India.
Email: 		Anita R. Halagatti, Ayurvedic management of Haemorrhagic Ovarian Cyst (Andashayagata Raktaja Granthi) - A Case Report. J Ayu Int Med Sci. 2022;7(11):228-231.
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https://jaims.in/jaims/article/view/2064

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2022-10-27 2022-10-29 2022-11-05 2022-11-12 2022-11-19
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Nil Yes 17%

© 2022by Anita R. Halagattiand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Halagatti A: Ayurvedic management of Haemorrhagic Ovarian Cyst

Introduction

In women’s life hormones play an important role from menarche to menopause. Abnormality in the ovarian hormones in coordination with HPO axis influences her physical, psychological and reproductive health. The ovaries are suspended laterally to the uterus via the utero-ovarian ligament, covered by meso-ovarium. The non-neoplastic enlargement of the ovary is usually due to accumulation of fluid inside the functional unit of the ovary.

Abnormal food habits and altered life have influence on secretion of female hormones and there by leads to manifestation of ovarian cyst. If not diagnosed or treated on time, the ovarian cyst can also start to affect ovulation; contribute to PCOS and rare conception.

A hemorrhagic cyst[1] is a kind of functioning cyst that arises when cyst bleeds within the ovary during ovulation. A Graffian follicle instead of releasing an ovum, continue to swell with fluid or blood rather than disintegration. Most of the hemorrhagic ovarian cysts are Corpus luteal cysts which occur due to hemorrhage into a cyst usually painful, triggering the patient to consult physician. Excessive hemorrhage takes place inside the corpus luteum in spite of blood filled cyst, the progesterone and estrogen secretion continues due to which the menstrual cycle may be normal or absent or delayed which is usually followed by heavy and/ or prolonged bleeding. Few of them can be neoplastic but they are usually benign. Granthi[2] refers to consolidated, solidified, swelling which looks like nodular mass. The Raktaja Granthi[3] develops due to vitiation of Rakta caused by Vatadi Dosha characterized with features of Pittaja Granthi.

Pathogenesis of Granthi Roga is Väta Kapha dominating Tridosha, for which Vata Kapha Hara medications are required, whereas involved Dushya are Rakta, Mamsa, Meda hence the medications should possess Vatahara and Lekhana properties. Treated with Oral Ayurvedic Medicine.

Case Report

A 43 years old female patient visited OPD of Prasooti Tantra and Stree Roga on 29/09/2020 with complaints of severe lower abdominal pain since 15 days, low back ache, indigestion,

bloating of abdomen, associated with pain in lower limbs and general body weakness since 2 months.

Patient had history of Hypertension since 3 months and already is on medication and currently hypertension is under control. She had H/O Renal Calculi 1 year back and treated effectively. Patient’s personal history was mixed diet, non-alcoholic and non-smoker.

Patient has regular Menstrual cycle. She has 4 children normally delivered and has underwent Tubectomy.

Patient had Madhyama Sara, Madhyama Samhanana, Sama Pramana, Madhyama Satmya, Madhyama Satva, Madhyama Vyayama Shakthi, Avara Ahara Shakti and Avara Jarana Shakti.

P/A examination revealed Tenderness in lower abdomen more of at Rt. iliac region, P/V examination revealed that the uterus is anteverted, normal in size and position, Cervix has normal consistency and texture and all fornices are free. Patient was advised for Blood and urine test.

Investigation

Blood group: B+ve

Hb%: 10.2gm%

ESR: 25mm/1st hr

Cholesterol: 215.5mg/dl

RBS: 106.6mg/dl

Urine Albumin: Nil

Sugar: Nil

Micro: 2-3 pus cells / cumm

Patient visited with USG of Abdomen and Pelvis which revealed that uterus was anteverted with normal in size and shape, Endometrial thickness measures 8mm. Myometrial texture appears normal, left ovary appear normal in size and texture. A well defined cystic lesion with thick content and multiple septae of size 3.3×3.2 cms seen in Right adnexal region, also reported hepatomegaly & fatty changes.

Therapeutic Intervention: Hemorrhagic ovarian cyst can be correlated to Raktaja Granthi Roga, Pathogenesis of Granthi Roga is Vata Kapha dominating Tridosha, for which Vata Kapha Hara


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Halagatti A: Ayurvedic management of Haemorrhagic Ovarian Cyst

medications are required, whereas involved Dushya are Rakta, Mamsa, Meda hence the medications should possess Vatahara and Lekhana properties. Prescribed medicines are Varunadhi Kashaya[4], Shiva Gutika[5], Kanchanara Guggulu[6] and Dhanvantari Vati[7]

Table 1: Treatment prescribed

Date Complaints Treatment
29/09/2020 Severe lower back pain. Indigestion, bloating abdomen Name Dose Time Anupana
Chandraprabha Vati 1-0-1 B/F Ushna Jala
Kanchanara Guggulu 1-0-1 A/F Ushna Jala
Varunadi Kashaya 2tsp-0-2tsp A/F Ushna Jala
Shivagutika ½-0-½ A/F Takra
Dhanvantri Vati 2-2-2 B/F Ushna Jala
Medication was prescribed for 15 days
15/10/2020 lower back ache, burning sensation in chest   Name Dose Time Anupana
Laghusuta Shekara Rasa 1-0-1 B/F Ushna Jala
Kanchanara Guggulu 1-0-1 A/F Ushna Jala
Varunadi Kashaya 2tsp-0-2tsp A/F Ushna Jala
Shivagutika ½-0-½ A/F Takra
Medication was prescribed for 15 days
30/10/2020 Lower back Ache Name Dose Time Anupana
Laghusuta Shekara Rasa 1-0-1 B/F Ushna Jala
Kanchanara Guggulu 1-0-1 A/F Ushna Jala
Varunadi Kashaya 2tsp-0-2tsp A/F Ushna Jala
Shivagutika ½-0-½ A/F Takra
Medication was prescribed for 15 days
18/11/2020 No any complaints sent for investigation USG abdomen-both ovaries appear normal right ovarian cyst completely resolved Name Dose Time Anupana
Chandraprabha Vati 1-0-1 B/F Ushna Jala
Arogya Vardhini Vati 1-0-1 A/F Ushna Jala
Medication was prescribed for 15 days

Post Treatment USG

Both ovaries appeared normal, right ovarian cyst completely resolved.

Time Line of Case

Date Management
29/09/2020 C/O severe lower abdomen pain, low back pain, Indigestion, bloating. USG-Rt. adnexa shows well defined cystic lesion, with thick contents and multiple septae lesion 3.3×3.2cm. Adviced Ayurvedic medicines.
15/10/2020 C/O lower back ache, burning sensation in chest treated with Ayurvedic medicines
30/10/2020 Reduced abdomen pain and burning sensation in chest but present with persistent lower back ache
18/11/2020 No any complaints. Sent for USG Abdomen and Pelvis-both ovaries appear normal, right ovarian cyst completely resolved.

Discussion

Ovarian cyst is one of the pervasive reasons for ovarian dysfunction, which directly affects the fertility potential. The present finding based on USG and effective management of ovarian cyst with Ayurvedic formulations with no adverse effect highlights the promising scope of traditional medicine in the ovarian and infertility disorders.

The patient has been suffering from this condition since 15 days, she was not relieved from the symptoms even though she was treated by contemporary medicine. As in contemporary science most of cysts are to be treated by surgical means. Here we looked into elaborative view of management of haemorrhagic ovarian cyst through Ayurveda. There is evidence of use of Shiva Gutika, Kanchanara Guggulu in ovarian cystic diseases.

In this study along with these two medicines Varunadhi Kashaya was used because of its Lekhana action to reduce the size of cyst and relieve from the symptoms, Dhanvantari Vati was used for its Shoolahara nature.

The patient was relieved from symptoms in her 4th visit within 2 months of treatment.

Granthihara and Bhedana properties of Kanchanara Guggulu and Varunadi Kashaya act on reproductive system and improve the functions of ovary and Artava.

Along with this Lekhaniya property of Kanchanara Guggulu, helps in reducing the size and arrest the further growth of cyst and Shiva Gutika helps in complete resolvement of cyst and even acts on Yakrit. After the treatment, the USG report revealed no cyst in the right ovary.

Conclusion

Haemorrhagic cyst based on its shape, consistency and nature can be probably co-related to Raktaja Granthi. There is no direct classical reference for few of the medicines selected in Granthi & Arbuda Roga. Kanchanara Guggulu, Varunadi Kashaya and Sh  iva Gutika formulations have been used as they all are Katu, Tiktha, Ushna, Lekhana, Rukshana, Shophahara, Granthihara and Arbudahara in nature. Thus, prescribed for Samprapti Vighatana of the disease.


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Yet, more research work is needed in this field by which we can minimize or avoid surgical interventions by practicing ayurvedic treatment methods.

Patient Consent: Taken

Reference

1. D.C.Dutta edited by Hirlal Konar, Textbook Of Gynecology Enlarged and Revised Reprint of 6th Edition, Jaypee Brothers Medical Publishers, New Delhi, Pp-686, P- 289

2. Acharya Yadavji Trikamji, Granty Apachi Arbuda Galaganda Nidana, Sushruta Samhita, with Nibanda sangraha commentary by Dalhana, Varanasi, Choukhamba Sanskrit Sansthan; 2022, Reprint. Pp-824, P-310

3. Hari Sadasiva Sastri, Granthi Arbuda Shlipada Apachi Nadi Vijnaniyam, Astanga Hrudya with Sarvangasundara of Arunadutta and Ayurveda Rasayana of Hemadri, Varanasi, Choukambha Sanskrit Sansthan; 2022 Reprint. Pp-956, P-881

4. Acharya Ambikadutta Shastry, Ashmari Chikitsa Prakaranam, Bhaishajya Ratnavalli, Varanasi, Choukamba Prakashan, Pp-1312, P-712

5. Acharya Ambikadutta Shastry, Rasayanaprakaranam, Bhaishajya Ratnavalli, Varanasi, Choukamba Prakashan, Pp-1312, P-1102

6. Acharya Ambikadutta Shastry, Galagandarogadhikara, Bhaishajya Ratnavalli, Varanasi Choukamba Prakashan, Pp1312, P830

7. Ramnivas Sharma and Dr.Surendra Sharma, Gutika Prakaran, Sahasrayogam, Choukambha Sanskrit Pratishtan, Delhi, Pp318, P247.


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