E-ISSN:2456-3110

Case Report

Cervical Erosion

Journal of Ayurveda and Integrated Medical Sciences

2023 Volume 8 Number 11 November
Publisherwww.maharshicharaka.in

An Ayurvedic approach for management of Cervical Erosion - A Case Study

Sahoo M1, Preeti Lagna S2*
DOI:10.21760/jaims.8.11.36

1 Manjusri Sahoo, Reader, PG Department of Prasuti Tantra and Stree Roga, Gopabandhu Ayurveda Mahavidyalaya, Puri, Odisha, India.

2* Swati Preeti Lagna, Post Graduate Scholar, Pg Department Of Prasuti Tantra And Stree Roga, Gopabandhu Ayurveda Mahavidyalaya, Puri, Odisha, India.

Amongst various gynecological disorders seen by gynecologists in day-to-day practice, cervical erosion forms a sizeable group (60-80%) especially in a country like ours due to its poor hygiene and nutritional status. It is a condition where columnar epithelium of the cervical canal proliferates downwards and encroaches over the squamous epithelium of the portio vaginalis around the external os. Though mostly it is influenced by over activity of ovarian hormones but it can also be due to some bacterial infections of the cervix or because of inflammation. There is no disease given in Ayurvedic classics which can be directly correlated with cervical erosion but the best analogue can be with Garbhasaya Greevagata Vrana. A 32 years old patient came to the out -patient division of the hospital with complains of excessive white discharge and backache since 4 months. She was treated with Ayurvedic Sthanik Chikitsa - Yoni Dhavan with Triphala Kasaya followed by Yoni Pichu with Sallakyadi Taila for 14 days. Significant improvement was noticed after the treatment and restricted disease progression was observed.

Keywords: Cervical erosion, Garbhasaya Greevagata Vrana, Sthanik Chikitsa, Triphala Kasaya, Sallakyadi Taila

Corresponding Author How to Cite this Article To Browse
Swati Preeti Lagna, Post Graduate Scholar, Pg Department Of Prasuti Tantra And Stree Roga, Gopabandhu Ayurveda Mahavidyalaya, Puri, Odisha, India.
Email: 		Sahoo M, Preeti Lagna S, An Ayurvedic approach for management of Cervical Erosion - A Case Study. J Ayu Int Med Sci. 2023;8(11):221-224.
Available From
https://jaims.in/jaims/article/view/2749

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2023-09-14 2023-09-25 2023-10-06 2023-10-16 2023-10-23
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None declared Nil Yes 22.96

© 2023by Sahoo M, Preeti Lagna Sand 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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Manjusri Sahoo et al. An Ayurvedic approach for management of Cervical Erosion

Introduction

Females are the one of the most important pillars of the family and society. They take major part in fulfilment of biological cycle, that’s why Nari is said as Apatyamula. Diseases that cause a woman to feel uneasy both physically and psychologically should be promptly attended to and appropriately treated, as any variation from her normal state might have a negative impact on the family. Cervical erosion is one of the commonest benign conditions of female genital tract in all age groups and one of the commonest findings on routine pelvic examination during the fertile age group. It is characterized by displacement of squamo columnar junction and replacement of squamous epithelium of infra vaginal portion cervix with columnar epithelium of endocervix. This may be a cause of many gynecological symptoms such as excessive vaginal discharge, dyspareunia, contact bleeding, itching, backache etc. Though mostly it is influenced by over activity of ovarian hormones but it can also be due to some bacterial infections of the cervix or because of inflammation. In chronic cervicitis, pus and mucus are discharged from the cervical canal and bathe the cervix. This alkaline discharge tends to cause maceration of the squamous epithelium so, after a time the cells desquamate and leave a raw red area exposing the epithelium around the external os. In the process of healing, columnar epithelium from the cervical canal grows over and cover the denuded area so that macroscopically the red area is covered by smooth glistening translucent epithelium. The affected area around the external os is simple flat type erosion.

While going through Ayurvedic literature, it is evident that there is no disease which can be directly co-related with cervical erosion but the best analogue can be with Garbhasaya Greevagata Vrana. Erosion means destruction of tissue and in Ayurveda it is called Vrana. In Garbhasaya Greevagata Vrana, the Twak and Mamsa Dhatu of the Garbhasaya Grivamukha (cervix) are involved. Intake of abnormal Ahara & Vihar can lead to infection and injury of the reproductive organs especially cervix and hence cause cervical erosion. As Garbhasaya Grivagata Vrana has Pitta-Kapha predominance in the pathogenesis, it requires treatment which has property of Pitta-Kapha Hara. In this case, Ayurvedic Sthanik Chikitsa – Yoni Dhavan by Triphala Kasaya followed by Yoni Pichu

with Sallakyadi Taila is done. Most of the drugs present in Sallakyadi Taila have Pitta-Kapha Samak action and significant improvement was noticed after use of it. 

Case Report

A 32 year old female patient with registration number 33970/5317 (OPD/IPD) came to Gopabandhu Ayurveda Mahavidyalaya & Hospital, Puri, Odisha on 18.10.2022. She had complaints of excessive white discharge from vagina since 4 months along with contact bleeding and pain during coitus. She also had lower back pain since 2 months. She had taken Allopathy treatment but got temporary relief from the symptoms.

Past medical history

  • Patient had recurrent infection with vaginal discharge
  • No h/o DM/HTN/Bronchial asthma/ hypothyroidism.

Past surgical history: No h/o past surgical illness

Menstrual history: 3-5 days per 28-30 day cycle, regular, moderate and had pain on the first day of menstrual cycle. There was no contraceptive history.

Obstetric History: G2/P2/L2/A0

Last Delivery - Full term LSCS at hospital 5 years back

General examination: On examination, it was found that she was belonging to Vatapittaja Prakriti and there was no abnormal finding seen in general and systemic examination.

BP - 110/70 mmHg

Pulse - 72/min

Weight - 62 kg

Height -168 cm.

On examination

On per speculum examination, it was found that both the lips of the cervix were eroded and a bright red inflamed cervix was seen along with foul smelling discharge which confirmed it as cervical erosion. She also had a tendency of bleed on touch during insertion of speculum for which she was suggested for PAP smear test. The


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report showed Negative for intraepithelial lesion or Malignancy (NILM).

On bimanual digital examination it was found that the uterus was anteverted, antiflex and normal in size and mobility. Both the fornixes were normal.

Investigations

  • Hematology (Hb%, DC, TLC) and urine (R/M) parameters were found within normal limit.
  • Blood sugar was also under normal range.
  • PAP Smear test - NILM

Therapeutic Interventions

Patient was treated on IPD basis.

Yoni Dhavan was done with Triphala Kasaya and Yoni Pichu was given with Sallakyadi Taila

MedicinesFormPropertiesRoute of administrationDuration
Triphala KasayaKasayaTridosaharaLocally14 days
Sallakyadi TailaTailaPitta-Kapha ShamakaLocally14 days

Table 1: Ingredients of Triphala Kashaya

SNSanskrit nameRasaGunaViryaVipakaDosa Karma
1.HaritakiPancha Rasa, Lavana Varjita,Kasaya PradhanLaghuRukshaUshnaMadhuraLekhaniyaSothanut,Doshaghna
2.AmalakiPancha Rasa, Amla PradhanGuru, SheetaSheetaMadhuraTridosahara
3.BibhitakiKasayaLaghuRukshaUshnaMadhuraPitta-KaphaSamak

Table 2: Ingredients of Sallakyadi Taila

SNSanskrit nameRasaGunaViryaVipakaDosa Karma
1.Vata(Ficus bengalensis Linn.)KasayaGuru, RukshaSheetaKatuKapahapitta Samak
2.Udumbara(Ficus recemosa Linn).Kasaya, MadhuraGuru, RukshaSheetaKatuKaphapitta Samak
3.Aswatha(Ficus religiosaLinn.)Kasaya, MadhuraGuru, RukshaSheetaKatuKaphapitta Samak
4.Parisha(Thespesia populnia Linn)Kasaya, MadhuraGuru, RukshaSheetaKatuKaphapitta Samak
5.Plaksha(Ficus lacor Buch)Kasaya, KatuGuru, RukshaSheetaKatuKaphapitta Samak
6.Jambu(Syzygium cumini Linn)Kasaya, Madhura, AmlaGuru, RukshaSheetaKatuKaphapitta Samak
7.Dhava(Anogeissus latifolia Wall).Kasaya, MadhuraGuru, RukshaSheeta,KatuTridosa Samak
8.Jingini(Odina woodier Roxb).Kasaya, Madhura UshnaKatuKaphavata Samak
9.Sallaki(Boswellia serrata Roxb).Kasaya, Madhura, TiktaLaghu, RukshaUshnaKatuKaphapitta Samak
10.Til Taila(Sesamum indicum Linn).Kasaya,Madhura, TiktaGuru, Snigdha, Ushna, Sukshma, VyavayiSheetaKatu, MadhuraVata SamakPitta Kapha Vardhak

Observation and Results

DaysFindings
0th DayWhite discharge++, erosion++,
7th DayWhite discharge reduced to 50%Cervical erosion color changed from bright red to light red
14th DayWhite discharge reduced to 80%Cervical erosion got 70% healed

Jaims_2749_01.JPG
Day-1

Jaims_2749_02.JPG
Day-7

Jaims_2749_03.JPG
Day-14

Discussion

Triphala Kwatha was effective in Vrana and also helpful in combating microbial infection by its Sodhana, Ropana, Sravahara, Vedana Samaka and Rasayan Properties. It is Tridosa Samaka as well as Kaphapittahara based on Kasaya Rasa Pradhanya. It also exhibits Sangrahi, Ropana (healing), and Lekhana (scrapes out unwanted tissues) properties which are most essential in healing the Vrana.


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Sallakyadi Taila mainly possesses Kasaya, Madhura Rasa, Laghu and Ruksha Guna. It mainly possesses pharmacological properties like Stambhana, Samgrahi, Soshana, Kleda Sosaka and Kaphanasak. So, by this way it decreases the Srava, minimize inflammation, infection. Tanins and Anthraquinones present in Sallakyadi Taila are all astringent and anti- inflammatory, thus prevent discharge, helps in quicker reepithelialisation, contract tissues of the body and improve their resistance to infection.

Tila Taila present in Sallakyadi Taila possesses Usna, Visad Guna which decreases Yoni Picchilata.

Conclusion

Irrespective to wealth of recent advances in diagnosis and treatment facilities, symptoms of cervical erosion form major complaint of patients attending gynecological outpatient department. We can prevent the incidence of this disease by educating the women for improving their general health and personal hygiene. The Sthanik Chikitsa mentioned in Ayurvedic texts like Yoni Prakshalana, Yoni Pichu play an important role in curing cervical erosion and other infections also. This Sthanik Chikitsa has no side effect and is cost effective also.

References

1. Tiwari R, Buduru P, Karini BK. Yonivyapad w.s.r to Cervical Erosion- A Case Study. AYUSHDHARA. 2020.

2. Konhar H, editor. DC Dutta’s Textbook of Gynaecology. 6th ed.

3. Howkin’s & Bourne. Shaw’s Textbook of Gynaecology. 15th ed.

4. Jawale V, Patil SR. A Literary review on Garbhasaya Grivagata Vrana w.s.r to Cervical Erosion.

5. Shindhe P, Rachana HV. Role of Ayurveda in Treating Cervical Erosion- A Case Study.

6. Khare CP. Indian Medicinal Plants - An Illustrated Dictionary.


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