Introduction

Adenomyosis is a gynecologic condition defined by presence of ectopic endometrial tissue embedded within myometrium. This leads to uterine changes that often cause symptoms such as heavy menstrual bleeding, painful menstruation, and chronic pelvic pain. It can significantly affect a patient's quality of life and may also contribute to infertility. ^[1] Exact cause of adenomyosis remains unknown, but several contributing factors have been proposed, such as repeated childbirth, vigorous curettage, and excessive estrogen effect.^[2] It predominantly affects multiparous women (those who have given birth multiple times) between ages of 40 and 50.^[3] It produces symptoms such as menorrhagia, menometrorrhagia, and congestive dysmenorrhea. Treatment of this condition involves use of non-steroidal anti-inflammatory drugs, COC pills to encounter heavy menstrual bleeding, levonorgestrel-releasing intrauterine system, danazol-loaded IUD, and hysterectomy.^[4]

Long-term use of drugs commonly prescribed in allopathic medicine, particularly hormonal treatments and NSAIDs for conditions like adenomyosis, can have adverse effects on women’s health. As an alternative, Ayurveda, with its holistic approach, offers potential therapeutic strategies that are generally safer & can help to maintain overall well-being. Although adenomyosis is not directly correlated with any disease in Ayurveda, based on its symptom, it is mostly like Vataj Asrigdara. Hence, treatment approach should be Raktastambhan, Raktavardhak, & Vata Shamak.^[5]

Methodology

A case study involving a 43-year-old female patient with bulky uterus (adenomyosis), splenomegaly and mild hepatomegaly was admitted to Shuddhi Ayurveda Panchakarma Clinic, Baltana, Zirakpur, Punjab, on July 24, 2024, showed that combining Ayurvedic interventions along with conventional treatments can be very beneficial in relieving the symptoms of adenomyosis and improving the overall health of the patient. Panchakarma (mainly Virechan) plays a major role in it. After Ayurvedic therapy, significant improvements were observed, including symptom relief and weight loss. USG Reports showed the reduction in size and shape of Uterus, Liver and Spleen.

Samprapti Ghataka

Case Report

A 43-year-old female patient visited to Jeena Sikho Lifecare Limited, Baltana, Zirakpur, Punjab on July 24, 2024 with chief complaints of pain during menstruation, dull aching pain in lower abdomen along with heavy bleeding per vagina, burning epigastric region on and off, pain in shoulder joint and mood swings. She was known case of (K/C/O) Spleenomegaly and Adenomyosis. On examination, tenderness was felt around left hypochondrium and patient had palpable uterus, spleen and liver. She was advised for USG of Abdomen and Pelvis (TVS). Reports showed some abnormalities which indicated bulky uterus (adenomyosis), splenomegaly and mild hepatomegaly. Her evaluation included thorough medical history (Prashna pariksha),

The vitals observed during follow ups are detailed in Table 6.

Table 6: Vitals observed on the Follow ups.

The vitals at the time of discharge are mentioned in Table 7.

Treatment Plan:

1. Diet Plan:^[9]

Dietary Guidelines:

1. Avoid wheat, refined foods, dairy, coffee, tea and packaged foods.
2. Do not eat after 8 PM.
3. When eating solid foods, take small bites and chew each bite 32 times.

Hydration:

1. The daily routine includes sipping 2 liters of hot water throughout the day and consuming DAP tea twice. To prepare 750 ml of DAP tea, combine 2 cloves, 5 cardamom pods, 25 black pepper seeds, 2 small cinnamon sticks and a spoon of fennel seeds, with continuous hot water.
2. Alkaline water is made with ½ cucumber, ½ lemon, a small piece of ginger, turmeric, tomato, 3 green chilies, coriander, mint leaves and Tulsi (750 ml/day).
3. Black or green tea is consumed without milk or sugar.

Meal Timing and Structure:

1. Early Morning (5:45 AM): Chew 2 cloves (long) and crushed garlic (lehsoon) and Curry leaves in a manner that 1 leaf in 1 minute/ 5 leaves in 5 minutes.
2. Breakfast (9:00 AM): Have Steamed fruits [83Kg (Pt’s weight) × 10 = 830 gms] and a fermented millet shake.

शाल्यादीनां तु धान्यानां यवकाः श्यामकाः प्रियङ्गवः।

कोद्रवाः शालिपर्ण्यश्च लघवः कषायोष्णगुणाः स्मृताः॥ (Ch.Su.27/88)

3. Morning Snacks (11:00): Mugda Yusha, and 4-5 soaked almonds.
4. Lunch (12:30 PM – 2:00 PM): Plate 1: Steamed Salad (83Kg (Pt’s weight) × 5 = 415 gms); Plate 2: fermented millets with five different leaves (Dhania, Pudina, Peepal, Kari Patta and Tulsi), which can be prepared in chutney form in addition with onion, tomato, garlic, green Chilli and turmeric.
5. Evening Snacks: Green juice (100-150 ml) prepared of 10 curry leaves, 2 Ajwain leaves, 5 Giloy leaves, 2-inch Aloe Vera, 2 Neem leaves, 5 Tulsi, Dhania, Pudina and ½ Paan.
6. Dinner (6:00 PM): Plate 1: Steamed Salad (83Kg (Pt’s weight) × 5 = 415 gms);

3. Holistic Approach: The regimen incorporated diet, lifestyle changes and Ayurvedic treatment, addressing underlying causes rather than merely managing symptoms.

Implications

Long-term Benefits: Ayurveda’s focus on root causes may reduce relapse rates compared to conventional treatments.

Conclusion

The report suggests a promising role for Ayurvedic treatments in managing adenomyosis (bulky uterus) and associated conditions like a splenomegaly, overweight and fatty liver. The documented improvements in both clinical symptoms and diagnostic parameters highlight Ayurveda’s potential to complement conventional medicine. Modern medical science only focuses on subsiding symptoms and not eliminating the cause. So, if the treatment is withdrawn, relapse is seen. But, Ayurveda focusses on the cause and according to that the treatment protocol is designed. These findings warrant further investigation through controlled clinical studies to validate efficacy, optimize treatment protocols and ensure safety for broader application.

References