Vulvar Itching Research Articles

Understanding lichen sclerosus: pathogenesis and treatment

Lichen sclerosus is a chronic inflammatory autoimmune skin disease that primarily affects the genital area, especially the vulva. It predominantly affects women and shows a bimodal incidence distribution. The principal clinical manifestations include vulvar itching, pain, and depigmentation, potentially leading to scarring, anatomical distortion, and malignant transformation if left untreated. The etiology is uncertain but may involve autoimmune factors, genetics, infections, hormones, trauma, chronic irritation, and oxidative stress. The diagnosis is primarily clinical, and histological confirmation is not always necessary when characteristic clinical signs are present. Although lichen sclerosus is incurable, it is manageable with appropriate treatment. This review summarizes the epidemiology, clinical features, complications, etiology, diagnosis, and treatment of lichen sclerosus.

Prevalence, Risk Factors, Hesitancy, and Attitudes Toward Vaccination Against Reproductive Tract Infections Among Women in an Urban Setting: A Cross-Sectional Survey Study.

Reproductive tract infections (RTIs) including sexually transmitted infections (STIs), endogenous and iatrogenic infections are a major health concern globally, particularly among young women in developing nations. If untreated, they can lead to infertility, increased HIV susceptibility, and cervical cancer. This study examines RTI symptoms prevalence, risk factors, and hesitancy toward STI vaccination. A cross-sectional study was conducted among 1,920 urban women (predominantly aged 18-25) in Delhi/NCR using a structured questionnaire. Data on demographics, reproductive health, RTI symptoms, and vaccine awareness were analyzed using SPSS 20. Chi-square tests, Fisher's exact tests, and Bonferroni corrections were applied, with multinomial logistic regression identifying RTI risk predictors. Among respondents, 1,240 (64.6%) reported RTI symptoms, with 1,029 (83%) experiencing vaginal discharge and 974 (78.5%) vulval itching. Significant risk factors included early menarche, irregular menstrual cycles, poor menstrual hygiene, and prior RTI medication use. Additionally, 1,033 (53.8%) were hesitant about STI vaccination, citing safety concerns (36%, 372) and cost (18.6%, 192). However, 826 (43%) reported that healthcare provider recommendations positively influenced their decision to vaccinate. The high prevalence of RTI symptoms highlights the urgent need for improved awareness, accessible healthcare services, and stronger vaccination promotion efforts to enhance RTI prevention and management.

Women's self-reported symptoms of reproductive tract infection, medical consultations, and factors influencing them in less developed regions: perimenopausal and older women in need of urgent attention.

Reproductive tract infections (RTIs) represent a critical public health concern impacting women's health, particularly pronounced in developing countries. We aim to investigates the prevalence of self-reported RTI symptoms in women aged 18 to 65 and the factors influencing gynecological examination behavior and associated risks are explored. From May 6, 2022, to September 20, 2022, a comprehensive survey engaged 20,864 women aged 18 to 65 in 19 townships in Lueyang, Shaanxi. Each survey team, comprising a gynecologist, two female health center staff, and a master's student, conducted face-to-face questionnaire surveys in villages and households. The questionnaire featured three sections: prevalence of self-reported RTI symptoms, gynecological examination history, and factors influencing examination behavior. The high response rate of 98.69% yielded 20,590 valid questionnaires. Among surveyed women, 42.04% reported RTI symptoms, with a higher prevalence in those aged 30 and above, peaking at 44.88% in the 50-59 age group. Vulvar itching (24.73%), abnormal vaginal discharge (17.41%), and urinary tract irritation signs (11.73%) were most common. Older adult women (≥60) reported higher frequency and longer duration of symptoms. Only 9.88% of symptomatic women underwent gynecological examinations in 2022. Examination likelihood decreased with age, presenting a critical gap in healthcare utilization among older women. Reasons for checkups included routine checkups (47.02%), symptom concerns (41.29%), and the availability of free medical checkup programs (9.82%). Barriers included perceived lack of serious symptoms (23.7%), lack of necessity (4.41%) and lack of time (3.98%). Among those examined, 40.58% had a diagnosis of gynecological disorders, including pelvic inflammatory disease, human papilloma virus infection and cervical cancer. Widespread RTI symptoms, particularly in perimenopausal and older women, underscore the need for enhanced healthcare. Barriers to gynecological examinations include awareness, education, and accessibility issues. Strategies must prioritize health education, routine examinations, and improved healthcare infrastructure in underdeveloped regions.

Efficacy of Guduchyadi Kwatha Yoni Prakshalana on Acharana Yonivyapad

Acharana Yonivyapada is related to inflammatory conditions of reproductive system. On reviewing its features it can be possibly considered as Vulvovaginitis. Vulvovaginitis is defined as infections of vulva and vagina causing vulvar and vaginal itching, burning sensation, irritation and vaginal discharges of various types. Present study was framed to establish an Ayurvedic way of management to vulvovaginitis requiring minimal hospital visits. Considering the prevalence of this disease, we have planned this study and selected Guduchyadi Kwatha Yoni Prakshalana as Sthanika chikitsa.

A Randomized Controlled Clinical Trial to Evaluate the Efficacy of Rohitaka (Tecomella undulata) in the Management of Shwetpradar w.s.r. Trichomonas Vaginitis

Introduction: Trichomonas vaginitis (TV) is one of the most common sexually transmitted infections found in day-to-day practice and caused by protozoa. It increases the risk of complications such as pelvic inflammatory disease, human immunodeficiency virus, cervical cancer, and infertility. Based on high prevalence, risk factors, increased complication, and antibiotic resistance, there is a need to develop an alternative effective treatment. It shares many characteristics with Kaphaj yonivyapada (KY) described in Ayurvedic texts. The classical text describes the usage of Rohitaka moola Kalka along with water in Shwetpradar. Aim: This study aims to evaluate the efficacy of Rohitaka mula churna (RC) (Tecomella undulata) in managing KY. Material and Methods: A total of 100 patients were selected randomly, among the women having Yonigata shweta–picchilstrava, vulval itching, and symptoms and signs of TV. RC 3 g twice daily was given to 50 patients for 15 days, and the remaining 50 participants received metronidazole (M) tablets 200 mg thrice daily for 7 days as a standard control drug. Subjective and objective parameters scores were used to compare the results before and after therapy. Results: The mean age of the participants was 32.92 ± 2.3 years. In the trial group, 6% of individuals showed mild improvement, 66% of participants showed moderate improvement, and 28% of participants showed marked improvement. In the control group, most patients (78%) experienced moderate improvement, followed by mild improvement (16%), and finally, marked improvement in symptoms and signs was seen by 6% of people. The trial group had a significant effect on the consistency of discharge, itching, and inflammation of the vagina compared to the control group. Over 68.98% of relief was found in the trial group across all assessing parameters, compared to 60.20% in the control group across all assessing parameters. Conclusions: A highly significant (P < 0.001) effect was observed in both the trial and control group on the parameter odor, dyspareunia, burning micturition, cervix congestion, strawberry appearance, and punctate hemorrhagic spot. During the follow-up period, no recurrence of symptoms and adverse drug reactions was observed. RC was clinically equally effective compared to the standard drugs in managing the signs and symptoms of KY.

(037) VESTIBULODYNIA SECONDARY TO LUMBOSACRAL ANNULAR TEAR-INDUCED SACRAL RADICULOPATHY

(037) VESTIBULODYNIA SECONDARY TO LUMBOSACRAL ANNULAR TEAR-INDUCED SACRAL RADICULOPATHY

Advances in the pathogenesis of vulvar lichen sclerosus.

Vulvar lichen sclerosus (VLS) is a chronic non-neoplastic skin lesion characterized by vulvar itching, pain, atrophy, whitening of the skin and mucous membranes, and gradual atrophy and disappearance of the labia minora, which can eventually lead to vulvar scarring, causing functional impairment and seriously affecting the patient's physical and mental health. VLS can occur at any age, however, its pathogenesis and etiology are not fully understood. Considerable progress has been made in related research on genetic susceptibility factors, autoimmune disorders, collagen metabolism abnormalities, and their triggering factors in disease formation and progression. This article reviews the etiology of vulvar lichen sclerosus.

The Need of Differential Diagnosis Between Vulvar Lichen Sclerosus and Autoimmune Dermatoses in Adolescent Girls.

Vulvar lichen sclerosus (VLS) is a chronic inflammatory condition affecting the anogenital region, which can manifest in prepubertal or adolescent patients. The prevailing theories point to autoimmune and genetic factors. The primary symptoms of VLS typically include vulvar itching, discomfort, dysuria, and constipation. Physical examination often reveals a characteristic figure8 pattern, involving the labia minora, clitoral hood, and perianal region. However, these symptoms and the age of onset are nonspecific and require differentiation from autoimmune dermatoses such as bullous diseases, pemphigus diseases, epidermolysis bullosa acquisita, and dermatitis herpetiformis. We performed this study to distinguish VLS from autoimmune dermatoses, and in doing so, uncover the underlying causes of chronic vulvar changes. This knowledge will enable healthcare providers to offer appropriate medical care to affected patients. The study was conducted between July 2020 and February 2021, with a sample of 55 girls aged 2-18years who did not have any systemic diseases. The study group was composed of 20 girls previously diagnosed with vulvar lichen sclerosus, while the control group included 35 girls without VLS. Questionnaires regarding the medical history of the children were completed by their legal guardians. Blood samples were collected and analyzed biochemically to assess human immunoglobulin A (IgA), IgG, and IgM antibodies against various substrates, including the desmosome of stratum spinosum, basement membrane zone, desmoglein 1 (DSG1), desmoglein 3 (DSG3), BP180-NC16A-4X, BP230gC, pemphigoid antigen, collagen type VII NC1, transitional epithelium, gliadin (GAF-3X), endomysium (EMA), and cellular nucleus (ANA). The analysis of the study group revealed that the most commonly observed signs and symptoms included: itching, soreness, burning sensations, and excoriation, as well as erythema or/and pallor of the skin and perineal mucosa. Among the assessed antibodies, only anti-GAF3x antibodies and ANA antibodies were detected. However, the results did not reach statistical significance (p > 0.5).

The LADY study: epidemiological characteristics of prevalent and new genitourinary syndrome of menopause cases in Greece

Objective The genitourinary syndrome of menopause (GSM) is often underdiagnosed and undertreated despite its significant impact on postmenopausal quality of life. We assessed the prevalence of GSM and associated symptoms in Greek perimenopausal/postmenopausal women attending gynecology clinics. Methods Four hundred and fifty women, aged 40–70 years (93.1% postmenopausal), attending three gynecology clinics at university hospitals completed a validated questionnaire and underwent pelvic examination. Results GSM was diagnosed in 87.6% of the women at the study visit, whereas only 16% of the overall sample had been previously diagnosed with the condition. Vaginal dryness (72.7%), vulvar burning sensation or itching (58.0%) and dyspareunia (52.7%) were the most prevalent symptoms. Pelvic signs consisted of vaginal dryness (89.1%), loss of vaginal rugae (80.6%) and vulvovaginal pallor (86.9%). However, only 31.3% of the participants had discussed genitourinary symptoms with their health-care professionals (HCPs). Regarding management, only 11.1% of women had prior experience with any form of therapy, and currently only 8.7% were receiving treatment. Conclusion GSM is highly prevalent in this Greek perimenopausal/postmenopausal population. Nevertheless, the majority of women remain undiagnosed and untreated. Education for both women and HCPs regarding GSM will lead to improved diagnosis and better management of this syndrome.

The Potential Coexistence of Autoimmune Thyroid Diseases and Pediatric Vulvar Lichen sclerosus.

Vulvar lichen sclerosus (VLS), a chronic inflammatory skin disorder, often coexists with autoimmune thyroid disease (AITD). VLS presents with subtle symptoms including vulvar itching and discomfort. Clinically, a "Figure 8" pattern involving the labia minora, clitoral hood, and perianal region is often observed. It is prevalent both in pre-pubertal girls and women aged 40-60, and the link between VLS and AITD remains unclear, with proposed causes including autoimmune, hormonal or genetic factors, and environmental triggers. This study addresses the lack of research on the association in children, aiming to investigate the largest group of underage girls to date. This study aimed to investigate the coexistence of thyroid autoimmune diseases in girls diagnosed with vulvar lichen sclerosus (VLS) and to assess the presence of antibodies for specific thyroid autoimmune diseases. Our study was conducted from July 2020 to February 2021, involving a sample of 55 girls aged 2-18 years old, all free from systemic diseases. The study group comprised 20 girls previously diagnosed with vulvar lichen sclerosus (VLS), while the control group included 35 girls without VLS. Legal guardians completed questionnaires detailing the medical history of their children. Blood samples were collected from all participants and subjected to biochemical analysis. The presence of human IgG antibodies against thyroid peroxidase and IgG antibodies against thyroglobulin was assessed using the immunoenzymatic method with commercially available ELISA kits. In the study group, common symptoms included itching, soreness, burning sensation, excoriation, and erythema or pallor of the skin and perineal mucosa. An evaluation of anti-thyroglobulin and anti-thyroid peroxidase antibodies revealed no statistical significance between the study and control groups (anti-TG p = 0.379, anti-TPO p = 0.96). Family history of autoimmune diseases showed no significant correlation with anti-thyroid antibodies in girls. Although no significant relation between VLS occurrence and antibody levels was found, it emphasizes the need for multidisciplinary medical care. Further research with larger patient groups is necessary.

Wide Local Excision versus Simple Vulvectomy in Vulval Intraepithelial Neoplasia 3: Case Report and Literature Review

Vulvar intraepithelial neoplasia is a premalignant lesion of the vulva. Women with vulvar cervical intraepithelial neoplasia 3 are at high risk of recurrence and vulvar carcinoma. They warrant a surgical management for the same reason. It may be either ablative or excisional, sometimes can be a combination of both. The decision for wide local excision or simple vulvectomy depends on clinical factors. Case: We present a case of a 67-year-old lady who presented with vulvar itching and a large black vulvar lesion involving the fourchette area, with HPV 16 positive. Initially, there was a doubt of melanoma, but vulval biopsy was suggestive of high-grade squamous intraepithelial lesion (HSIL) (vulval intraepithelial neoplasia 3 [VIN 3]). As it was a single large lesion, the initial plan was wide local excision but as the lesion was large and occupying almost half of the vulva, the decision of simple vulvectomy was taken. A wide local excision would have resulted in vulvar asymmetry and since there was a big lesion, chances of satellite lesions over the vulva were there; decision was made for simple vulvectomy. In this case report, we will review the literature on the surgical management of VIN 3. Conclusion: Treatment is recommended for all vulvar HSIL because of the potential for invasion. Simple vulvectomy is an easy procedure, with less hospital stay, less blood loss, and least recurrence rates. It is a suitable treatment option for multifocal and large lesions of the vulva.

Structure of pathology in vulva area

This article describes the structure of morbidity in the vulvar area in women 45–72 years old, and analyzes the frequency of discrepancies in diagnoses among dermatovenerologists and gynecologists. It has been established that nonspecific vulvitis / vulvovaginitis (23%), lichen sclerosus (20%), genitourinary menopausal syndrome (20%), contact dermatitis (12%), lichen planus (7%), atopic dermatitis (6%), vulvar itching (5%), psoriasis (2%) predominate in the structure of vulvar pathology in women.

Clinical Review of Urethral and Vaginal Discharge Syndrome: A Comprehensive Case Series from Primary Care Centers in Bahrain

Background: This case series presents a comprehensive clinical review of twelve cases exhibiting symptoms of urethral and vaginal discharge syndrome in men and women attending primary care centers in Bahrain. The cases encompassed a diverse range of clinical manifestations, including dysuria, frequency, pyuria, urethral pruritus, malodorous urine, vulval itching, purulent vaginal discharge, abnormal vaginal bleeding, dyspareunia, lower abdominal pain, anorectal pain, and anal skin lesions. The individuals included in the case series engaged in various types of sexual activities, ranging from heterosexual intercourse, unsafe sexual behavior, a history of sexual abuse, to homosexual activity. This study aims to provide a scientifically rigorous analysis of these cases, highlighting the clinical presentation, potential risk factors, and implications for diagnosis and management of urethral and vaginal discharge syndrome in the primary care setting in Bahrain. Methods: The clinical evaluation of the patients encompassed a comprehensive assessment of their medical history, physical examination, and laboratory investigations. Urethral and vaginal swabs were collected for culture and sensitivity testing, urine analysis, microscopy, and imaging studies were performed. The most frequently identified etiological agents in this study were Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, Candida yeasts infection. This study provides valuable insights into the clinical management of urethral and vaginal discharge syndrome, aiding in accurate identification and appropriate treatment of patients with similar symptoms. Results: Management of the patients involved a combination of antibiotic therapy, antifungal medications, and symptomatic relief measures. Safe sexual behaviors were highlighted as a preventive measure against sexually transmitted infections, which were identified as the primary causative agents of urethral and vaginal discharge syndrome. These findings have significant implications for primary care providers, offering valuable insights into the clinical presentation, diagnosis, and management of these conditions, particularly in primary care.

A prospective multicentre controlled study of Gaoweikang (Chinese multiherb extract-based tincture) used in high-risk HPV infections.

The aim of the study was to investigate the safety and antiviral efficacy of a Chinese multiherb extract-based tincture (GWK) on a population of patients with high-risk human papilloma (hrHPV) infections and hrHPV-caused cervical low-grade squamous intraepithelial lesions (LSILs). Patients with persistent hrHPV infection were enrolled in Group A, including A1 subjects, who received the intervention, and A2 subjects, who received the control. Patients with hrHPV infection causing cervical LSIL were enrolled in Group B, which included B1 subjects, who received the intervention, and B2 subjects, who served as the control. For Groups A1 and B1, hrHPV was tested at 3 months (M3) and 6 months (M6) after the intervention. The side effects were also analyzed. At baseline (D0), a total of 99 patients were enrolled in Group A, with 50 subjects in Group A1 and 49 subjects in Group A2. A total of 91 patients were enrolled in Group B, with 45 subjects in Group B1 and 46 subjects in Group B2. There was no significant difference in the characteristics, including average age, age stratification, and HPV genotype. At M6, both Group A1 and Group B1 had a higher hrHPV clearance rate than the control group (A1/A2: 80.0% vs. 20.4%; B1/B2: 64.4% vs. 15.2%, p<0.001). At M6, the effective rates of Group A1 and Group B1 were 84% (42/50) and 68.9% (31/45), respectively. The side effect rates of Groups A1 and B1 were 11.5% (6/52) and 11.1% (5/45), respectively. Most adverse reactions involved local discomfort, including vulvar erythema, vulvar itch, increased vaginal discharge, cervical bleeding, and mild pain in the lower abdomen. Univariate logistic regression analysis showed that the intervention had an OR of 12 (95% CI 4.431-32.50) for clearing persistent HPV infection (p<0.001). For cervical LSIL, the intervention had an OR of 10.1 for clearing persistent HPV infection (95% CI 3.68-27.7) (p<0.001). The results of this study suggest that the Chinese multiherb extract-based tincture GWK is safe and well tolerated. Furthermore, this preliminary study showed that this Chinese multiherb extract-based tincture is helpful for promoting HPV clearance in cases of persistent HPV and HPV-induced LSIL.

CLINICAL PRESENTATION OF TRICHOMONAS VAGINITIS IN TERTIARY CARE CENTRE IN KATHMANDU

Background: Cervical-vaginal infections are common problems in women of reproductive age groups. Trichomonas vaginalis is one of the major organisms causing vaginitis. Trichomonas vaginalis is an anerobic, flagellated protozoan. The main objective of this study was to study the clinical findings of women with Trichomonas vaginitis.&#x0D; Methods: This was a hospital based descriptive study carried out in the Department of Pathology and Gynaecology of Nepal Medical College Teaching Hospital in one year (January- December 2020). A total of 163 Pap smear examination were included in study. Specimen were stained using conventional Papanicolaou method. After staining, slides were examined under the light microscopy. The cytological diagnosis was correlated with the clinical findings. The collected data was analyzed using SPSS software version 16. Mean, Standard deviation, frequencies and percentages were calculated.&#x0D; Results: A total of 163 cases were evaluated. The mean age of women who underwent Pap smear examination was 37.5 10.5 years. Out of 163 cases, there were 42 cases of Trichomonas vaginitis. The prevalence of Trichomonas vaginalis was 25.8%. The common age group was 20 to 40 years. Most of the women were symptomatic (64.3%) while rest were asymptomatic (35.7%). Per vaginal discharge (35.7%) was the most common complain followed by vulval itching (16.7%).&#x0D; Conclusions: Trichomonas vaginalis are commonly found in reproductive age group presented with clinical manifestations or may be asymptomatic at all too. Vaginal discharge is the commonest presentation.

(070) Treatment of Genitourinary Syndrome of Menopause is Beneficial for Lichen Sclerosus Patients

(070) Treatment of Genitourinary Syndrome of Menopause is Beneficial for Lichen Sclerosus Patients

AKT question relating to vulval soreness and itch

AKT question relating to vulval soreness and itch

AKT answer relating to vulval soreness and itch

AKT answer relating to vulval soreness and itch

Lichen Sclerosus Throughout Childhood and Adolescence: Not Only a Premenarchal Disease

ABSTRACT Lichen sclerosus (LS) is a chronic dermatologic condition most commonly seen in prepubertal girls or postmenopausal women that causes inflammation and epidermal thinning in the anogenital region. Lichen sclerosus is suspected to have a genetic component due to a strong association with family history and is associated with various autoimmune diseases. Treatment involves medium- and high-potency topical corticosteroids, as well as calcineurin inhibitors; however, the optimal treatment regimen is unknown. LS follows a chronic and recurring pattern that causes significant discomfort and impaired quality of life over time; however, little data exist on the disease course in adolescent patients. This retrospective cohort study aimed to characterize and compare symptoms and physical examination findings of a cohort of pediatric, adolescent, and young adult females with vulvar LS. Patients 21 years or younger presenting to the University of Michigan between January 2006 and September 2020 with vulvar LS were included. Demographic data, personal and family history of autoimmune disease, specialty of provider, age of onset, age at menarche, presenting symptoms, and physical examination findings were abstracted from the chart. Patients were grouped for analysis based on symptom onset, first clinical visit, and the most recent clinical visit. Group 1 was patients who were premenarchal at their first clinic visit, and group 1a included those within group 1 who were postmenarchal at the most recent clinical visit. Group 2 included patients who were postmenarchal at the first clinic visit, and group 2a were those within group 2 who reported first onset of symptoms postmenarche. A total of 196 patients met inclusion criteria, with 141 in group 1, 26 in group 1a, 55 in group 2, and 36 in group 2a. The average age in group 1 was 7.02 years and in group 2 was 19.08 years. Patients in group 2 were more likely to have a personal history of autoimmune disease compared with group 1 (P = 0.04). Of the 26 patients in group 1a, 10 (38.5%; 95% CI, 19.8–57.2) continued to have symptoms of LS after undergoing menarche. Compared with patients with symptom onset postmenarche (group 2a), the premenarchal cohort (group 1) was significantly more likely to present with vulvar itching (70.2% vs 52.8%), vulvar bleeding (26.2% vs 5.6%), and bowel symptoms (16.3% vs 0%). The premenarchal cohort (group 1) was significantly more likely than the postmenarchal cohort (group 2a) to have subepithelial hemorrhages (24.8% vs 5.6%), whereas the postmenarchal group (group 2a) was significantly more likely to have architectural changes of the vulva including clitoral adhesions (25.0% vs 4.3%) and loss of labia minora (47.2% vs 2.1%). Of the 55 postmenarchal patients (group 2), 39 had at least 1 architectural change of the vulva, and among the 36 with first onset of symptoms postmenarche (group 2a), 20 (55.6%) had at least 1 vulvar skin change. This study of the largest cohort to date of young patients with vulvar LS demonstrates approximately 40% of patients with LS that went through puberty continued to have symptoms, and that symptoms and examination findings were different and often more severe among those who developed symptoms postmenarche versus premenarche.

A Case Report on Ayurvedic Management of Secondary Infertility

Secondary Infertility is defined as the inability to conceive following at least one prior conception. Ovulatory dysfunction contributes 30-40% of infertility. Polycystic ovarian syndrome is a common endocrinopathy typified by oligo/anovulation, signs of androgen excess, and multiple ovarian cysts. In Ayurveda, Vandhyatha (infertility) is considered as a complication of Yoni vyapath and is also considered as Artavavaha srotodushti lakshana. This is a case report of 30 years old lady complaining of inability to conceive a second child, heavy menstrual bleeding and curdy white discharge per vagina associated with itching. On USG, she was diagnosed with Polycystic Ovarian Syndrome. She also had severe allergic complaints and skin rashes. In this case treatment was given primarily to correct the Rakta dushti which was causing Artava dushti in the form of excessive bleeding. For that, initially in the bleeding phase, medicines for Rakta sthambana were given and after the stoppage of bleeding, medicines were given for correction of Rakta dushti. After achieving the menstrual regulation, the patient was given medicines for Vata kapha dushti for treating her Upaplutha condition. For the management of Yoni roga, she was given Sthanika karmas (local treatment) Yoni dhawana and Yoni pichu. Also local application of Nalpamaradi keram was done to reduce her vulval itching. The outcome of the treatment resulted in conception and delivered a full term female baby. So the present case signifies the effect of Ayurvedic management in the field of infertility.