International Journal of AYUSH; 2022: 12 (1); 30-38

Original Research Article Volume 12 Issue 1 Jan-Feb 2022

ROLE OF AYURVEDA IN TREATING CERVICAL EROSION- A CASE STUDY

*Dr. Pooja Shindhe1, Dr. Rachana H.V.2

1. Post Graduate Scholar, Department of Prasooti Tantra and Stree Roga, Sri Sri College of
Ayurvedic Science and Research, Bengaluru, Karnataka, India.

2.Professor, Department of Prasooti Tantra and Stree Roga, Sri Sri College of Ayurvedic
Science and Research, Bengaluru, Karnataka, India.

*Corresponding Author’s Email ID: poohshindhe10@gmail.com

Abstract:

Cervical erosion is a condition where the squamous epithelium of the ectocervix is replaced by columnar
epithelium, which is continuous with the endocervix. Cervical erosion is most common in people of
reproductive age, from 17% to 50% of people with cervixes likely have this harmless variation. But in some
cases will have the symptoms of White discharge which may contain blood or mucus, dyspareunia, Pain and
bleeding during a pelvic exam etc leads to infertility also. In Ayurveda classics there is no disease that can
directly correlate with cervical erosion. But in some aspect of symptoms and signs this can correlate
with Karnini yonivyapad.

In this case a patient of 32 years old female came to OPD with complaints of per vaginal thick white
dischargewith itching over the vulva since one month. Per speculum examination showed the findings of
congested vagina and cervical erosion followed by thick milky white discharge sticking to vaginal walls. We
managed the case with Ayurvedic line of treatment locally by yoni Prakshalana followed by Yoni pichu for 7
days with internal Ayurvedic medicines for 1 month. The yoni prakshalana and pichu in this case has showed
the good results in improvement of cervical erosion.

Key words:Cervical Erosion, Karnini ypnivyapad, Yoni prakshalana, Yoni pichu, Panchavalkala kashaya,
triphala kashaya.

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DR. POOJA SHINDHE AND DR. RACHANA H.V. ROLE OF AYURVEDA IN TREATING CERVICAL EROSION- A CASE STUDY
 International Journal of AYUSH; 2022: 12 (1); 30-38

INTRODUCTION:

Cervix is a muscular, tunnel-like organ. It’s the lower part of your uterus, and it connects
your uterus and vagina. Sometimes called the “neck of the uterus,” Cervix plays an
important role in allowing fluids to pass between your uterus and vagina. Cervix consists of
strong fibromuscular tissue. Two main types of cells line the cervix those are Glandular
cells (these cells line the endocervical canal, the innermost part of cervix) and Squamous
cells(these cells cover the ectocervix, the outermost part of cervix, and vagina).These
different cell types meet at the transformation zone, where cell changes frequently take
place and leads to erosion/ectopy1.

Cervical erosion/ectropion is said as ek-tro-pee-un. It is common and harmless. It is

not linked to cervical cancer or anything that causes cancer. Cervical ectropion
happens when Glandular cells from inside the cervical canal grow onto the outside of
the cervix. Glandular cells are red, so the area may look red. Cervical ectropion is
sometimes called cervical erosion or cervical ectopy.

The squamocolumnar junction is not static and its movement, either inwards or outwards
is dependent on estrogen. When the estrogen level is high, it moves out so that the
columnar epithelium extends onto the vaginal portion of the cervix replacing the squamous
epithelium2.

There is a significant but modest association between erosion and vaginal discharge, it is
significantly more common in women taking the pill, and less common in using barrier
method of contraception3. In modern science persistent ectopy with troublesome discharge
should be treated surgically by thermal cauterization, cryosurgery and laser vaporization.
All the methods employed are based on the principle of destruction of the columnar
epithelium to be followed by its healing by the squamous epithelium4, but these will have
side effects like heavy bleeding, damage to healthy tissue of cervix, abdominal pain after
surgery, abnormal vaginal discharge etc.

Karnini yoni vyapad is one among the 20 yoni vypads, it develops due to vitiation of Vata
and Kapha or only Kapha according to Charaka as well as both Vagbhata and Sushruta
respectively. Karnika of Yoni may give rise to blood stained vaginal discharges. Sushruta
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DR. POOJA SHINDHE AND DR. RACHANA H.V. ROLE OF AYURVEDA IN TREATING CERVICAL EROSION- A CASE STUDY
 International Journal of AYUSH; 2022: 12 (1); 30-38

has described presence of unctuousness etc features of vitiation of Kapha which refers
mucoid vaginal discharge. In Karnini Yonivyapad due to involvement of Rakta in the
development of Karnini, sometimes blood stained or pinkish vaginal discharges coming
from that Karnikamay be found. According to Sushrutasays that vitiated Kapha along
RaktaProducesKarnika inYoni5.

In Ayurveda charaka has explained the treatment protocol as kaphahara line of treatment,
and kaphahara herbs can be used in the form of yoni varti.

CASE REPORT

A 32 years female Patient with marital life of 5 years, came to OPD of Prasuti
tantra and Streeroga, S.S.C.A.S.R&H. Bengaluru with the complaints of per vaginal thick
white discharge with itching over the vulva since one month.

Personal History

Diet: Non-Vegetarian, Meat weekly thrice, Dadhi sometimes at night time.

Sleep: 6-7 hours of sound sleep

Appetite: Normal – 3 times a day

Bowel: Once per day(constipated sometimes)

Habits: - coffee at evening time

Micturition: 5-6 times per day, no burning sensation.

Obstetric history: P1A0L1D0

Menstrual history:

Age of Menarche: 13 years

Flow: Regular

D1 & d2– 3 pads – 100 % soakage

D3 – 3 pad – 80 % soakage

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DR. POOJA SHINDHE AND DR. RACHANA H.V. ROLE OF AYURVEDA IN TREATING CERVICAL EROSION- A CASE STUDY
 International Journal of AYUSH; 2022: 12 (1); 30-38

D4 & D5 – 2 pad – 50 % soakage

• Interval – 28-32 days

• Anubandhi Vedana:

Clots –Present

Pain – Present +

Color – Dark red

Samsthanika Pareeksha / Sroto Pareeksha (systemic examination) :

• R/S - Nvbs heard, no added sound

• CVS – S1 S2 heard, no murmur sound heard

• CNS – Well oriented to time, place, person

• P/A - Soft. Mild lower abdominal pain present by palpation.

LSCS scar mark present.

P/S- Congested vagina+

Cervical erosion followed by thick milky white discharge sticking to vaginal walls++

P/V- Uterus is anteverted, anti-flexed normal sized.

Fornix- free

Pain during bimanual examination +

INVESTIGATIONS

CBC- Hb%- 11.5gm%, WBC- 6000/cumm.

Urinary routine and microscopy

Albumin -Nil

Sugar: Nil

Microscopy:

Pus cell –5-6 cells

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DR. POOJA SHINDHE AND DR. RACHANA H.V. ROLE OF AYURVEDA IN TREATING CERVICAL EROSION- A CASE STUDY
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Epi cell –3-4 cells.

DIAGNOSIS: CERVICAL ECTOPY/ EROSION (KARNINI YONI VYAPAD).

TREATMENT

Sthanika chikitsa for 7 days once in a day on OPD bases by

Prakshalana with freshly prepared PANCHAVALKALA KASHAYA (500ML) by

Panchavalkala kwatha churna + TRIPHALA KASHAYA (500ML) by Triphala kwatha
churna.

Yoni pichu with freshly prepared DURVA+NIMBAPatra kalka after Yoni Prakshalana once
in a day kept for 2hours.

INTERNAL MEDICINES FOR 1 MONTH

Chandraprabha vati 1-1-1 After food

Durvadi ghrita 1 TSP Empty stomach

Musalikhadiradi kashaya 20ml-0-20ml with equal Before food

amount of water

OBSERVATIONS DURING TREATMENT

DAYS FINDINGS

0th day Itching, white discharge, cervical erosion ++, pain +

3rd day Itching reduced to 30%, white discharge reduced to 40%,

Cervical Erosion color changed from dark red, yellow to light
red.

5th day Itching reduced to 80%, white discharge reduced to 60%,

Cervical Erosion 50% got healed.

7th day Itching - nil,

White discharge reduced to 70%,
Cervical Erosion got healed 80%.

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DR. POOJA SHINDHE AND DR. RACHANA H.V. ROLE OF AYURVEDA IN TREATING CERVICAL EROSION- A CASE STUDY
 International Journal of AYUSH; 2022: 12 (1); 30-38

FOLLOW UP

After 1 month

P/S: Cervix healthy

No Cervical erosion

No white discharge

No itching and lower abdominal pain

RESULTS

BEFORE TREATMENT AFTER TREATEMNT

DISCUSSION:

Panchavalka, the bark of Nyagrodha (Ficus bengaenesis Linn.), Udumbara (Ficus glomerata
Roxb.), Ashvatha (Ficus religiosa Linn.), Parisha (Thespesia populanea Soland ex correa),
Plaksha (Ficus lacor Buch-Ham.). Panchavalkala kwatha is kapha shamaka, stambhaka and
having the properties like astringent, antiseptic (kashaya rasa) and wound healing (vrana
ropana). Panchavalkala (Bark) is found to have Antiinflammatory, Analgesic and
Antimicrobial properties. Tannins present in Nyagrodha and Udumbara are antioxidants
and blood purifiers with anti-inflammator actions. They hence might have helped to
decrease the swelling/ congestion in vagina. The phytosterols and flavonoids are anti-
inflammatory and analgesics reducing the pain. Tannins also proved to have antimicrobial

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DR. POOJA SHINDHE AND DR. RACHANA H.V. ROLE OF AYURVEDA IN TREATING CERVICAL EROSION- A CASE STUDY
 International Journal of AYUSH; 2022: 12 (1); 30-38

property which might have reduced the discharge. Hence these constituents in the
Panchavalkala might have helped in regression of erosion on cervix also6.

Panchavalkala along with Triphala has activities like vranaprakshalana, vranaropana,

shothahara7.

Triphala Kwatha was effective in vrana by its Shodhana, Ropana, Sraavahara, Vedana
Shamaka and Rasayana properties. It is Tridosha shamaka as well as Kaphapittahara based
on Kashaya Rasa Pradhanya and it exhibits Sangrahi, Ropana (Heals up), Sharirakleda
Upayukta (Absorbs the fluid) and Lekhana (Scrapes out unwanted tissues) which are most
essential in healing the vrana8 (cervical erosion).

Yoni Pichu Oil sustain in vagina for long time. Pichu makes the muscle soft and smooth and
also enhances Bala and Tanutva (thinning action) so, Muscles stretch very well. It
lubricates the whole vaginal canal due to its unctuousness and thus prevents unnecessary
friction was found to be helpful in maintaining vaginal flora and healing of wound, good
acceptability by patients9.

Durva having madhura, kashaya, tikta rasa, sita virya, tridoshashamaka helps in vrana
shodhana, ropanakaraka. Especially swaras or kalka of durva has been mentioned for
vranaropanakaraka guna10.

Nimba Rasa is Tikta, Kashaya, Guna are Laghu, Ruksha, Veerya is Sheeta, Vipaka is Katu and
Karma are Kaphaghna, Pittaghna karma. Nimbapatra is shothghna ,twagadoshahar,
krimighna, kushthahar, vranashodhak and vranaropak. Nimbatwak is graahi, jwaraghna,
twagadoshahar & krimighna11.

Studies showed that leave extracts of Azadirachta indica promote wound healing activity
through increased inflammatory response and neovascularization. Nimba leaves showed in
vitro antibacterial activity against many micro-organisms12. Which in turn helps in healing
of erosions and reduction in abnormal discharges from yoni.

Chandraprabha Vati is having the ingredients like triphala, guggulu, shilajatu, trivrut,
chitraka, shunhti, darvi, pippali, pippalimoola, kshara, trijataka etc are having effects
against various bacterial and fungal infections, helps to control abnormal discharges from

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DR. POOJA SHINDHE AND DR. RACHANA H.V. ROLE OF AYURVEDA IN TREATING CERVICAL EROSION- A CASE STUDY
 International Journal of AYUSH; 2022: 12 (1); 30-38

the vagina, cervix, and helps in kushtarogas, vrana shodhana, ropana. It improves the
immunity and general health of body.

Durvadi ghrita having the ingredients of durva, musta, manjishta, kamala/utpala, ushira,
chandana, ela, haritaki, lodhra, tandulodaka having the property of stambhaka, grahi,
sheeta virya which reduces the white discharge, other symptoms and vranaropana
property helps for cervical erosions.

Musalikhadiradi kashaya contains musali, amalaka, khadira, shatavri, jambu, trikantaka

acts as kapha pittashamaka, and mainly indicated for the gynaecological disorders like
sweta pradara, srava.

CONCLUSION:

Cervical erosions are more prevalent in women during menstrual years, who is having
cervical and vaginal infections. Erosions itself is insignificant, occasionally it may precede
to cervical cancer. Thermal cautery advised for extensively formed erosions which is
having side effects on health of the women. So Ayurveda has explained the treatment
protocols which are having less side effects, treating the disease fully and also improve the
overall health of the body. In this case symptoms of the patient has reduced fully after one
month of treatment and recurrence of same symptoms has reduced.

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DR. POOJA SHINDHE AND DR. RACHANA H.V. ROLE OF AYURVEDA IN TREATING CERVICAL EROSION- A CASE STUDY
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DR. POOJA SHINDHE AND DR. RACHANA H.V. ROLE OF AYURVEDA IN TREATING CERVICAL EROSION- A CASE STUDY