Exploring the efficacy of Basti and Sthanika Chikitsa in Ovarian Endometrioma Management: A Case Study

Introduction: Endometriosis, prevalent in 10-12% of women of reproductive age worldwide, is a common gynecological disorder that is increasingly observed in developing countries like India. It involves endometriomas - cystic lesions, often called chocolate cysts, primarily located in the ovaries. Symptoms include chronic pelvic pain, dysmenorrhea, dyspareunia, depression, and infertility. A 32-year-old software engineer presented to SDM Institute of Ayurveda and Hospital, Bengaluru, with a 2-year history of painful menstrual cycles. Investigations revealed left ovarian endometriomas. Method: Panchakarma Chikitsa was initiated with Ama Pachana, followed by Lekhana Basti and local treatments on an inpatient basis. Shamana Aushada was recommended for continued care after discharge. Result: Before treatment (April 13, 2023), pelvic ultrasound revealed two endometriotic cysts in the left ovary: 2.5×2.1×2.2 cm (10cc) and 4.5×4.2×4.3 cm (40cc). After Lekhana Basti (April 22, 2023), follow-up ultrasound showed no remaining cysts. Discussion: Endometriotic cysts, or chocolate cysts, can be managed similarly to Granti (cysts) with Chedana (surgical intervention) as the primary approach. Due to recurrence and financial constraints, the patient chose non-invasive Ayurvedic treatment. Basti and Sthanika Chikitsa with Lekhana and Ropana properties was used for effective management. After treatment, the patient experienced only mild dysmenorrhea and has resumed normal daily activities.