ENDOMETRIAL HYPERPLASIA – A CASE REPORT

Abstract

Endometrial hyperplasia represents a spectrum of morphologic and biologic alterations of the endometrial glands and stroma, ranging from an exaggerated physiologic state to carcinoma in situ. Endometrial hyperplasia is important clinically because it will cause abnormal bleeding and precede or occur simultaneously with endometrial cancer. The premalignant potential of hyperplasia is influenced by age, underlying ovarian disease, endocrinopathy, obesity and exogenous hormone exposure. In patients where there is excessive bleeding with endometrial hyperplasia, Ayurvedic procedures play significant role, both in reducing excessive bleeding as well as endometrial thickness. Vasti (medicated enema) is one of the best procedures in such conditions. Reproductive system is considered to be the place of Vata which is one of the 3 humors mentioned in Ayurveda (Vata, Pitta & Kapha). Apana vata is one type of Vata which is responsible for excretion and reproduction and also expulsion of fetus during labor. Vasti is like nectar in diseases related to genito-urinary system. The present study is a case report of a patient suffering from excessive bleeding for a long time and transvaginal ultrasonography measured endometrial thickness of 2.4cm. Uttaravasti (intra- uterine instillation of medicated oil) and Yogavasti (enema with medicated oil and decoction) were done to the patient for 3 cycles. After 3 cycles of the treatment, endometrial thickness reduced to 1cm. Hence Vasti (both uttaravasti and yogavasti) is considered to be more effective in treating endometrial hyperplasia and offers scope for prevention of endometrial carcinoma and conduct a phased clinical trial to prove cause and effect relationship.