Managing Chronic Pelvic Pain and Endometriosis - #46951

Chronic endometriosis with bilateral chocolate cysts Right ovarian cyst >5 cm → higher risk of pain persistence, torsion, rupture, ↓ ovarian reserve Pain irrespective of cycle → deep inflammatory

Surgical Opinion (Strongly advised) Indications present: Bilateral endometriomas Right cyst 5.6 cm Chronic pain despite long duration Preferred Laparoscopic cystectomy (ovarian tissue-sparing) Excision of endometriotic deposits Pre-surgery AMH (ovarian reserve) CA-125 Pelvic MRI (if deep infiltrating endometriosis suspected)

Ayurvedic Management Shamana (Pain + Inflammation) Kanchanara Guggulu 2 tabs BD Triphala Guggulu 2 tabs BD Dashamoola Kwatha 20 ml BD Ashokarishta 20 ml BD after food Guduchi / Rasna-Erandadi Kwatha 20ml bd for pelvic & back pain Yogabasti Anuvasana – Sahacharadi / Dhanwantaram Taila Niruha – Dashamoola-based

Reduces pelvic congestion, Vata-Kapha involvement Lifestyle

Avoid curd, cheese, fried foods, red meat Warm, anti-inflammatory diet

Hello I get how tough dealing with constant pelvic pain and endometriosis can be, especially when it doesn’t even care about your period. But don’t worry, Ayurveda has a solid, long-term plan to help with the pain, slow down cyst growth, and just make life better.

YOUR CONCERN

–28 years old –Pelvic Endometriosis for 5 years –The scans show: * Left ovary: 3.2 cm chocolate cyst * Right ovary: 5.6 cm chocolate cyst -What you’re feeling: * Bad ongoing pelvic pain * Ongoing back pain * Pain that’s there all the time, not just with your period

What you’re doing now: Only taking pain meds

AYURVEDIC UNDERSTANDING

In Ayurveda, endometriosis is kind of like a mix of internal imbalances, mostly involving:

–Vata dosha:This is linked to the bad, constant pain. –Kapha dosha: This is involved in forming those cysts. –Pitta involvement: This brings on inflammation and tenderness. –Manda Agni & Ama: Basically, weak digestion and built-up toxins, which lead to unhealthy tissue growth. –Artavavaha srotas dushti: Problems in the reproductive channels.

TREATMENT GOAL

* Less chronic pelvic and back pain * Balancing Vata and Kapha * Stopping cysts from getting bigger * Better blood flow in your pelvis * Helping with reproductive health and future chances of getting pregnant * Not needing painkillers as much

AYURVEDIC PLAN OF TREATMENT

1. Deep Cleaning (Shodhana) This is super important for long-term endometriosis.

Virechana (cleansing): To clear out Pitta-Kapha imbalances. Basti therapy (enemas): Great for pain. Anuvasana Basti: Oil-based, good for Vata pain. Uttara Basti: this can help with ovarian cysts.

Important: You should only do these at a proper Panchakarma center after a check-up.

INTERNAL MEDICATION

1. Kanchanar Guggulu: 2 tablets, twice a day after meals (Helps control cyst size and shrink growths.)

2.Triphala Guggulu: 2 tablets, twice a day ( Fights inflammation and helps clear toxins.)

3.Ashokarishta: 20 ml with equal water, twice a day after food (Helps balance hormones in the pelvis and eases pain.)

4. Dashmoolaristha 30 ml twice a day before food (Really good for pelvic and back pain.)

5. Shallaki (Boswellia) capsules 1 capsule, twice a day ( A natural way to reduce inflammation and pain.)

How long: At least 3 to 6 months. We’ll check in every 6 to 8 weeks.

EXTERNAL THERAPIES

Abhyanga (Oil massage) Oil: - Ksheerabala Taila or Mahanarayana Taila Where to put it: Lower belly, lower back, pelvic area How often: Daily, or at least 5 days a week.

Hot water bag / Nadi Sweda (steam) Use after you’ve put on the oil. Helps with stiffness and deep pelvic pain.

DIET PLAN

✅ INCLUDE

* Warm, freshly cooked meals * Rice, wheat, moong dal * Ghee (1–2 teaspoons a day) * Cooked veggies (like bottle gourd, pumpkin, carrot) * Cumin, ajwain, turmeric

❌ AVOID

* Cold foods and drinks * Curd at night * Cheese, baked goods, junk food * Refined sugar * Too much tea/coffee * Eating late at night

How to Live Your Life:

Try to sleep by 10–10:30 pm. Don’t sit for too long. Gentle yoga: * Baddha Konasana (Bound Angle Pose) * Supta Baddha Konasana (Reclined Bound Angle Pose) * Viparita Karani (Legs-Up-The-Wall Pose) Breathing exercises (Pranayama): * Anulom Vilom (Alternate Nostril Breathing) * Bhramari (Humming Bee Breath – good for pain and stress)

–Endometriosis is a long-term thing, but you can manage it. –Painkillers are a quick fix; Ayurveda goes for the root cause. –If your cysts are over 5 cm, we need to keep a close eye on them. –Surgery isn’t always needed if your symptoms get better and cysts don’t get worse.

With a consistent Ayurvedic plan, your pain can really drop, your periods can get easier, and we can keep those cysts from growing.

Warm Regards Dr. Snehal Vidhate

Medicines 1 Kumaryasava – 20 ml + 40 ml warm water after lunch & dinner 2 Kanchanar Guggulu – 2 tablets morning + 2 tablets night after food 3 Dashmoolarishta – 20 ml + 40 ml warm water after breakfast & dinner 4 Chandraprabha Vati – 2 tablets morning + 2 tablets night after food 5 Shatavari Kalpa – 10 gm night with warm milk

Local Application (must use daily) Warm Kumkumadi Taila + Castor oil and apply at lower abdomen massage nightly followed by hot water bag for 20 min

Diet Give only: moong khichdi + ghee, pomegranate, beetroot juice 100 ml, thin buttermilk + roasted jeera Avoid completely: dairy after noon, sugar, spicy/sour, maida, packaged food

Lifestyle 30-min gentle walk daily Vajrasana 10 min after meals Sleep 10 PM – 6 AM strictly

Regards Dr Gursimran Jeet Singh MD Panchakarma

No worries You can start with Kanchanar guggulu 1-0-1 Strirasayana vati 1-0-1 Asoka aristha 10-0-10 ml Dashamoola aristha 10-0-10 ml with warm water Do reg walking Avoid oily fried junk processed foods

HELLO,

You are 28 year old woman suffering from endometriosis for last 5 year with severe continuous pelvic and back pain and chocolate cysts In both ovaries -Left ovary= 3.2 cm -Right ovary= 5.6 cm

WHAT IS ENDOMETRIOSIS? Normally, the uterus has a lining that sheds during periods In endometriosis, this tissue grows outside the uterus- on ovaries, tubes, ligaments, or pelvic walls

Every month this tissue also reacts to hormones, but there is no outlet for the blood, leading to -inflammation -swelling -adhesions (organs sticking together) -chronic pain

WHAT ARE CHOCOLATE CYSTS? When endometriosis affects the ovaries, old trapped blood accumulates and forms dark brown cysts, called chocolate cysts

These cysts -increase pelvic pressure -cause constant pain even without periods -can affect fertility -can worsen over time if untreated

In Ayurveda, this condition mainly involves

1) VATA DOSHA= main cause of pain -controls movement and flow -when blocked or disturbed> severe, chronic pain

2) KAPHA DOSHA (cyst formation) -causes heaviness, growth, and stagnation -leads to granthi cyst formation

3) RAKTA DUSHTI (impure blood) -leads to inflammation, congestion and abnormal tissue growth

4) APANA VATA DISTURBANCE -Apana vata controls menstruation and pelvic organs -when disturbed-> pain, cysts, irregular tissue growth So your condition is mainly vata-kapha dominant when rakta involvement

WHY YOUR PAIN IS SEVERE AND CONTINUOUS -chronic obstruction of pelvic channels -long standing disease 5 years -bilateral ovarian involvement -large cysts on right ovary -only painkillers used so far

TREATMENT GOALS -reduce pain naturally without dependency on painkillers -correct apana vata -reduce cyst size/prevent further growth -reduce inflammation -improve pelvic circulation -preserve fertility -prevent recurrence

INTERNAL MEDICATIONS

1) YOGARAJ GUGGULU= 1 tab twice daily after meals =best for chronic pelvic pain,paicifies vata, reduces stiffness, back pain, deep pelvic pain

2) KANCHANAR GUGGULU= 2 tabs twice daily after meal =specifically reduces cysts, nodules, helps in chocolate management, prevents further enlargement

3) DASHMOOLA KASHAYA= 20 ml twice daily after meals with warm water =powderful anti inflammatory, deep vata pacification, reduces pelvic congestion and back pain

4) VARUNADI KASHAYA= 20 ml + equal water twice daily before meals =works on ovarian cysts, reduces kapha stagnation, improves pelvic metabolism

5) ASHOKARISHTA= 20 ml twice daily after meals with warm water =strengthens uterus, regulates hormones, reduces pelvic heaviness and pain

6) SHATAVRI KALPA = 1 tsp with warm milk at night =nourishes reproductive system, anti inflammatory, supports fertility, calms vata

PANCHAKARMA (very important) Medicines alone are often not sufficient in chronic cases

-BASTI THERAPY= gold standard treatment basti is the best treatment for vata disorders =directly corrects apana vata, significant pain relief, helps reduce cyst progression, improves pelvic blood flow, reduces recurrence

-KATI BASTI= warm medicated oil retained over low back =reduces back pain, relaxes pelvic muscles, improves circulation

EXTERNAL TREATMENTS -Oil massage with SAHACHARADI TAILA -local fomentation

DIET -warm, freshly cooked food -rice, wheat, moong dal -ghee small amount -cooked vegetables -warm milk with turmeric -herbal teas - jeera, ajwain

AVOID -cold food and drinks -curd at night -cheese, pizza, bakery -fried food -sugar exces -red meat -carbonated drinks Cold heavy and processed foods worsen kapha and cysts

LIFESTYLE CHANGES -avoid late nights -do not suppress natural urges -avoid prolonged sitting -manage stress -gentle walking daily

YOGA ASANAS -supta baddha konasana -bhujangasana -pawamuktasana -setu bandhasana

PRANAYAM -nadi sodhana -bhramari -deep abdominal breathing

Avoid intense yoga during pain days

HOME REMEDIES -warm castor oil pack on lower abdomen 2-3 times/week -turmeric milk at night -ajwain water for bloating

INVESTIGATION NEEDED -Pelvic ultrasound ever 3-6 months -CA-125 -Hemoglobin chronic pain ma cause anemia

DURATION OF TREATMENT -pain relief= 4-6 weeks -Quality of life improvement= 2-3 months -cyst stabilisation/reduction= 3-6 months -long term management required

Endometriosis is chronic but manageable Ayurveda aims to -reduce pain naturally -avoid repeated surgeries if possible -preserve fertility -improve overall health

DO FOLLOW

HOPE THIS MIGHT BE HELPFUL

THANK YOU

DR. MAITRI ACHARYA

To help dissolve the cyst: Start with Kanchanar guggul 1-0-1 after food with water Vriddhivadhika vati 1-0-1 after food with water Tablet M2TONE 1-0-1 after food with water will help balance your hormones. Do pranayam lom -vilom bhastrika bhamri 5-10mins twice daily. Follow up after 1 month.

1.Kanchnar guggulu 2 tab twice daily with water after meals 2.Ashokarishta 20 ml with 20 ml water twice daily after meals 3.Shatavari kalp 1 tsp twice daily with warm milk after meals 4.Triphala churna 1 tsp at bedtime with warm water

🍲 Diet -Eat anti-inflammatory foods: fruits, leafy greens, whole grains, flaxseed, walnuts. -Use light proteins: lentils, beans, sprouts, moderate dairy. -Avoid caffeine, sugar, fried/oily foods, processed snacks, and red meat. -Drink warm water and herbal teas (ginger, fennel, coriander). -Include iron-rich foods: spinach, beetroot, dates, jaggery.

🧘 Lifestyle -Ensure 7–8 hours of sleep and rest during pain episodes. -Gentle yoga: Supta Baddha Konasana, Balasana, Setu Bandhasana. -Walking and light stretching for circulation. -Meditation and pranayama (Anulom Vilom, Bhramari) for stress relief. -Warm compress on abdomen/back for pain.

Warm Regards Dr. Anjali Sehrawat