Integrative Ayurvedic Management of Postmenopausal Bleeding with Thickened Endometrium: A CARE-Aligned Case Report

Abstract

Background: Postmenopausal uterine bleeding demands prompt clinical investigation to exclude endometrial malignancy. When conventional management is declined, contraindicated, or supplemented by patient preference, integrative approaches merit structured documentation. Case Summary: A 58-year-old postmenopausal woman (G2P2L2) presenting with one year of heavy, prolonged uterine bleeding (10–11 days/cycle; ~6–7 pads/day) with clot passage and foul-smelling discharge, pallor, hemoglobin 10 g/dL, and ultrasonographic endometrial thickness of 10.9 mm, was managed with a 21-day stepwise integrative Ayurvedic protocol comprising internal Śamana medicines and topical Udarlepa with structured dietary support. Bleeding reduced substantially by Day 7 (1–2 pads/day) and to mild spotting by Day 14, with sustained improvement at Day 21. Conclusion: These findings are hypothesis-generating. Rigorous prospective evaluations incorporating standardized bleeding scores, malignancy exclusion, and objective safety parameters are warranted.