Ayurvedic Approach to Endometriotic and Hemorrhagic Ovarian Cysts with Radiological Resolution: A Case Report

Abstract

Ovarian endometriomas and hemorrhagic cysts are frequently encountered gynecological conditions that contribute substantially to chronic pelvic pain, menstrual irregularities, and infertility in reproductive-aged women. Although hormonal therapy and surgical excision remain standard treatments, high recurrence rates, ovarian reserve compromise, and persistent symptoms continue to pose clinical challenges. Increasing attention has therefore been directed toward integrative and traditional medical systems, including Ayurveda, which conceptualizes these disorders through derangements of Apana Vata, Kapha, and Rakta Dhatu. The present study aims to evaluate the effectiveness of a comprehensive Ayurvedic management protocol for ovarian endometrioma and hemorrhagic cysts, with particular emphasis on cyst regression, symptomatic improvement, menstrual regulation, and reproductive outcomes. Women diagnosed by ultrasonography with right ovarian endometriomas along with right ovarian hemorrhagic cysts were managed using a multimodal Ayurvedic approach comprising Shodhana therapy, including Basti, followed by individualized Shamana regimens targeting inflammation, pelvic congestion, and tissue homeostasis. Clinical symptoms, pain scores, menstrual characteristics, ovarian morphology, and cyst dimensions were recorded at baseline and during follow-up. Safety and tolerability of the interventions were concurrently assessed. Following treatment of 2 months, a substantial proportion of participants demonstrated a significant reduction in cyst size, with several achieving complete radiological resolution. Marked improvements were observed in pelvic pain, dysmenorrhea, and menstrual regularity, along with favorable changes in scanty menses. No serious adverse events attributable to therapy were reported. Integrative Ayurvedic management incorporating purification and palliative modalities appears to offer potential therapeutic benefit in ovarian endometriomas and hemorrhagic cysts, addressing both symptomatic burden and underlying pathophysiological mechanisms. These findings support further investigation through well-designed randomized controlled trials to establish efficacy, long-term outcomes, and its role alongside conventional gynecological care.