Kshara Karma as a Minimally Invasive Ayurvedic Approach to Cervical Erosion (Karnini Yonivyapada)

Abstract

Cervical erosion, clinically presenting with mucoid or mucopurulent discharge, contact bleeding and local discomfort, is closely correlated with Karnini Yonivyapada in Ayurveda, a Kapha‑Pitta‑pradhana Yonivyapad involving abnormal epithelial proliferation at Garbhasaya‑mukha. Case presentation: A 45‑year‑old married woman (G2P2L2) presented to the Stree Roga and Prasuti Tantra OPD with complaints of profuse yellowish-white, curdy thick discharge per vagina for 1–2 weeks, intermittent vaginal itching for 6 months, and lower abdominal pain for 2 months. She was a known case of type 2 diabetes mellitus on Metformin, with regular but reduced menstrual flow for the last 6 months and disturbed sleep due to stress. The diagnosis of cervical erosion (Karnini Yonivyapada) with Kapha‑Pitta predominance and associated Madhumeha was made. Intervention: The patient underwent Pratisaraneeya Kshara Karma using Apamarga Kshara applied locally over the eroded cervical area for approximately 50 Matra‑Kala in two sittings on consecutive days, preceded and followed by Yoni Prakshalana and followed each day by Yoni Pichu. Outcomes: The procedure was well tolerated with stable vital signs and no procedural complications such as excessive bleeding or severe pain. Subjectively, the patient reported relief from yellowish-white discharge, itching and lower abdominal pain during follow‑up; objectively, reduction in congestion and extent of erosion was observed, aligning with findings from previous Apamarga Kshara clinical studies. Conclusion: This case supports the clinical utility of Apamarga Kshara‑based Kshara Karma, followed by Yoni Pichu and internal Kapha‑Pitta‑hara therapy, as a safe and economical option for managing Karnini Yonivyapada (cervical erosion), and highlights the need for larger controlled trials using standardized Ayurvedic diagnostic frameworks.