Ayurvedic Management of Post-hysterectomy Osteoporosis: A Case Report

Osteoporosis is a systemic metabolic bone disorder characterized by decreased bone mass and microarchitectural deterioration. These changes increase fragility and fracture risk. The condition is seen particularly in postmenopausal and post-hysterectomy women. Hormone decline-related bone loss is often linked to chronic musculoskeletal pain, functional limitation, and reduced quality of life. Long-term use of modern antiresorptive therapies, though effective, may be limited by tolerability concerns and adherence challenges. This creates a rationale for safer, multimodal conservative approaches. A 55-year-old female with a history of hysterectomy in 2017 presented with a three-month history of generalized musculoskeletal pain predominantly affecting the knees and small joints of the hands, accompanied by thigh discomfort and functional limitation, and associated with generalized weakness, increased fatigue, and reduced mobility, prompting evaluation for underlying metabolic bone disease. She first reported to the OPD on February 4, 2025. Baseline evaluation showed low serum calcium (6.7 mg/dL), and bone density screening using quantitative ultrasound (QUS) of the right tibia showed a T-score of -2.6, which may suggest low bone density, including osteoporosis or possible osteomalacia. She received structured Ayurvedic integrative management over six months, with a short treatment gap due to self-discontinuation and later resumption. Clinically significant improvement was observed across validated outcome measures, including pain reduction, improvement in functional disability, and resolution of exertional limitation. Follow-up assessment demonstrated correction of hypocalcemia and improvement in QUS-based parameters, along with sustained symptomatic relief. This case describes symptomatic and biochemical improvement in a patient receiving an Ayurvedic intervention, with concurrent changes in QUS-based parameters. However, these findings are derived from a single case and a screening modality; hence, despite cautious interpretation, this observation generates a research question to evaluate the Ayurveda-based approach for improvement in bone mineral density or underlying mechanisms. The observations are hypothesis-generating and warrant further investigation using standardized interventions, dual-energy X-ray absorptiometry-based assessment, comprehensive metabolic evaluation, and controlled study designs to establish clinical efficacy, safety, and biological relevance.