Ayurvedic Management of Endometrial Hyperplasia in Perimenopausal Age – A Case Report

Perimenopause is the menopausal transition in which variation in normal cyclic pattern may be due to physiological hormonal changes or pathological. The histological changes in the perimenopausal endometrium are non-proliferative or proliferative benign or malignant lesions. The risk of endometrial hyperplasia may exceed 30% in perimenopausal women with abnormal uterine bleeding1 . Atypical endometrial hyperplasia may progress to or co-exist with endometrial cancer results from oestrogen stimulation unopposed by progesterone. Medical and surgical management options are available for endometrial hyperplasia. Patients may resort to medical management like hormonal therapy as the first line of treatment, which can cause severe complications including malignancy. In Ayurveda it can be correlated with asrigdara or pradara. Vitiated rakta & pittavrutha apana vata are involved in its samprapthi. This is the case report of a 50 years old female subject, came to the OPD of prasutitantra evum Streeroga of P.N.N.M. Ayurveda Medical College and Hospital, Cheruthuruthy c/o intermittent spotting per vaginam with a variable interval of 10-15 days and she unable to distinguish the menstrual phase since 4 months associated with hot flashes and tiredness. On pelvic examination she had normal sized retroverted uterus with endometrial polyp and mild blackish discharge from internal os. To rule out the underlying pathology, Ultrasound scan and Pap smear were done. USG report showed that thickened uterine endometrium with E.T-14.6 mm central. Pap smear report with heavy inflammatory smear. She was treated with Ayurvedic medications both internally and externally. Drastic improvement was observed in signs and symptoms as well as in USG report within few days