A 40-year-old female presented on 26 November 2013 with multiple complaints including bilateral hip pain, cervical giddiness, occipital neuralgia and nuchal migraine. Her giddiness and head–neck pain were managed successfully with Marma Chikitsa, and she experienced significant relief within two sessions spaced two days apart.Her menstrual history suggested fibroid uterus: cycles lasting 6 days every 26–34 days, occasional clots, profuse bleeding using 6–8 pads per day, dark blackish-red flow and associated mild, non-offensive, non-itchy leucorrhoea. She also reported markedly frequent urination, especially in the supine position, a common symptom in uterine fibroids due to pressure effects.

The patient had undergone surgical excision of fibroadenoma of the right breast on 25 August 2013 and was emotionally reluctant to face another surgery for her uterine fibroids. Therefore, she actively sought Ayurvedic treatment as a non-surgical, organ-preserving option for fibroid uterus management. Such conservative approaches are discussed in Ayurvedic literature as management of Granthi and Garbhashayagata Granthi.

Ultrasound (USG) findings from 24 November 2013 confirmed multiple uterine fibroids, three in number:

• One subserous fibroid in the anterior myometrium.
• One subserous fibroid in the posterior myometrium of the fundus.
• One submucosal fibroid on the right side of the uterine body.

The sizes from the initial scan are described below in comparison with the post-treatment findings. Fibroid mapping through USG is a standard way to monitor the conservative management of uterine fibroids.

Based on dosha–dushya sammurchana, a kashayam powder was formulated from seven classical herbs taken from authoritative Ayurvedic pharmacopoeia. The decoction was advised to be prepared fresh at home and taken twice daily on an empty stomach along with Palasha Kshara. The combined actions were aimed at correcting Kapha and Rakta vitiation, normalizing Mamsa and Medo dhatus and promoting Vata anulomana, which aligns with described principles for managing uterine granthi and associated menorrhagia.

In addition, a supportive homeopathic combination containing Frax. am and AMN was prescribed in globule form at a dose of two globules four times daily. This integrative approach was continued for five months, after which a follow‑up ultrasound scan was performed on 22 April 2014 to objectively assess the uterus and fibroid size. Integrative non-surgical management is increasingly documented for fibroid care where patients wish to avoid hysterectomy.

For clarity, the USG dated 24 November 2013 is referred to as the previous scan, and the USG dated 22 April 2014 as the recent scan. The recent USG showed complete resolution of the anterior subserous fibroid, which previously measured 1.8 × 1.7 cm. Only two fibroids were visualized in the recent scan, indicating disappearance of one lesion. Such reduction in number and size is considered a positive outcome in conservative fibroid management.

The posterior subserous fibroid at the fundus reduced from 2.8 × 2.2 cm to 1.2 × 1.0 cm. The submucosal fibroid on the right side of the uterine body decreased from 2.2 × 2.0 cm to 1.4 × 0.9 cm. Endometrial thickness measured 6 mm on day 9 of the cycle in the recent scan, compared with 10 mm on day 6 in the earlier scan, indicating a more physiological endometrial profile. Fibroid shrinkage and normalization of bleeding patterns are key clinical goals in non-surgical fibroid therapies.

In both scans, the uterus remained anteverted. Uterine size changed from 8.9 × 4.7 × 5.1 cm previously to 8.1 × 4.2 × 4.6 cm in the recent scan, suggesting an overall reduction in uterine bulk. For a patient who wished to avoid surgery, this measurable reduction in fibroid size and uterine volume, along with symptomatic relief, reflects a successful outcome of individualized Ayurvedic treatment for fibroid uterus.