KARNINI YONIVYAPAD (CERVICAL EROSION AND ECTROPION): KSHARA KARMA AND JATYADI TAILA — A REVIEW OF CLINICAL STUDIES
Background: Cervical ectropion (ectopy), still widely called cervical erosion, is the presence of columnar epithelium on the ectocervix. It is common and usually physiological, but some women have persistent discharge, postcoital bleeding, pelvic pain and dyspareunia. Symptomatic cases are usually treated by ablation, most often cryotherapy. Ayurvedic gynaecologists commonly interpret the condition as Karnini yonivyapad or Garbhashaya grivamukhagata vrana and treat it with local application of medicated alkali (Pratisaraniya kshara) followed by Jatyadi taila. Objective: To review the classical basis and the clinical and experimental evidence for Kshara karma and Jatyadi taila in symptomatic cervical ectropion, in the context of current conventional evidence. Methods: Charaka Samhita, Sushruta Samhita and Sharangadhara Samhita were reviewed for Karnini yonivyapad, Kshara and Jatyadi preparations. PubMed was searched for clinical trials, observational studies, systematic reviews and experimental studies on cervical ectropion, Kshara, Jatyadi and related Ayurvedic local therapies. Findings were synthesised narratively. Results: Randomised trials support cryotherapy, and one trial found intravaginal tranexamic acid comparable to it. No PubMed-indexed clinical trial of Kshara karma or Jatyadi taila specifically in cervical ectropion was identified. Indirect evidence includes a randomised trial and a multicentre controlled trial showing that Jatyadi preparations heal clean wounds and chronic ulcers comparably to standard dressings, experimental studies showing anti-inflammatory, antibacterial and wound-healing actions, case reports of Kshara karma in chronic wounds, and an older study of an Ayurvedic ointment after cauterisation of cervical erosion. Conclusion: Kshara karma followed by Jatyadi taila is a rational Ayurvedic analogue of ablation followed by wound care, but its use in cervical ectropion rests on classical authority and indirect evidence. Cervical screening must precede treatment, asymptomatic ectropion should not be treated, and randomised trials against cryotherapy are needed.