Table 1.
Summary of randomized placebo-controlled trials of aromatherapy for dysmenorrhea (pain).
| First Author (Year) [Ref] Country |
Sample Size; Age (years); Severity |
Intervention | Control | Treatment Duration | Result | Comments Design/AEs |
|---|---|---|---|---|---|---|
| Uysal (2016) [16] Turkey |
105 19–30 Pain on VAS ≥5 |
(A) Rose oil (Inhalation, <1 m above patients, n = 52), plus diclofenac sodium (75 mg) | (B) Placebo (saline, <1 m above patients, n = 53), plus diclofenac sodium (75 mg) | 1 time (10–30 min) | p < 0.01 in favor of aromatherapy | Diclofenac 75 mg Treatment time is not clear Parallel/n.r. |
| Raisi Dehkordi (2014) [17] Iran |
96 18–28 Mild or moderate (AMVMS) |
(A) Lavender (Inhalation, 7–10 from the nose, rub their palm with aroma oil, n = 48) | (B) Placebo (sesame oil, same methods with A, n = 48) | 5 min (1 h after experiencing dysmenorrhea) every 6 h for the 1st 3 days of menstruation, one or two treatments in 2 consecutive menstrual cycle | p < 0.01 in favor of aromatherapy | Not validated questionnaire Retrospective registration Parallel/n.r. |
| Nikjou (2017) [18] Iran |
200 19–30 n.r. |
(A) Lavender (Inhalation, 3 drops, n = 100) | (B) Placebo (diluted milk, same methods with A, n = 100) | 30 min (0.5 h after experiencing dysmenorrhea) for the 1st 3 days of menstruation, one treatment in 2 consecutive menstrual cycle | p < 0.01 in favor of aromatherapy | Registration while recruiting Parallel/n.r. |
| Choi (2009) [19] Korea |
74 not clear Pain on VAS ≥7 |
(A) Lavender (Inhalation, n = 18) (B) Lavender (Massage abdomen, n = 24) |
(C) Placebo (vitamin C, same methods with A, n = 15) (D) Placebo (Massage, almond oil, n = 17) |
Wearing necklace for the daytime during the menstruation Massage was done 10 min once a day for 1 menstrual cycles |
NS | Parallel/n.r. |
| Davari (2014) [20] Iran |
150 18–29 Mild or moderate MDQ |
(A) Lavender (Inhalation, n = 28) (B) Rosemary (Inhalation, n = 29) (C) Lavender and rosemary (Inhalation, n = 29) |
(D) Placebo (n = 30) (E) mefenamic acid (n = 28) † |
Twice daily for 3 days the start of menstruation | p < 0.001, in favor of aromatherapy | Parallel/n.r. |
| Iravani (2009) [21] Iran |
108 18–24 Moderate to severe |
(A) Zataria Multiflora (Inhalation, 1%, 25 drops, n = 36) (B) Zataria Multiflora (Inhalation, 2%, 25 drops, n = 36) |
(C) Placebo (Inhalation, 25 drops, n = 36) | 25 drops every 4 h from the beginning of pain for 3 cycles | p < 0.001 in favor of aromatherapy | Parallel/n.r. |
| Salmalian (2014) [22] Iran |
84 18–24 Mild or moderate |
(A) Thymus vulgaris (Inhalation, 25 drops, n = 28), plus placebo capsule | (B) Placebo (Inhalation, n.r., n = 28), plus placebo capsule (C) Ibuprofen (200 mg capsule, n = 28), plus placebo oil |
25 drops every 6 h on 1st day of menstrual cycle and the beginning of pain for 2 consecutive cycles | p < 0.001 in favor of aromatherapy | Triple-blind but no reporting of details Registration while recruiting Parallel/n.r. |
| Bakhtshirin (2015) [23] Iran |
80 18–24 Pain on VAS ≥6 |
(A) Lavender oil (Massage abdomen, n = 80) | (B) Placebo (Massage abdomen, n = 80) | 15 min for 1 cycle (2nd and 3rd cycle) by nursing and midwifery students |
p < 0.001 in favor of aromatherapy | 1 cycle washout period Cross-over/n.r. |
| Apay (2012) [24] Turkey |
44 20.3 ± 1.1 Pain on VAS ≥6 |
(A) Lavender oil (Massage abdomen, n = 44) | (B) Placebo (Massage odorless liquid petrolatum, n = 44) | 15 min for 1 cycle (2nd and 3rd cycle) | p < 0.001 in favor of aromatherapy | 1 cycle washout period Cross-over/n.r. |
| Beiranvand (2015) [25] Iran |
60 18–26 Pain on VAS >5 |
(A) Lavender oil (Massage, 2 drops in 2.5 cc of almond oil, 15 min, n = 30) | (B) Placebo (Massage with almond oil only, n = 30) | 48 h before and after menstruation. Massage was done 15 min twice a day for two menstrual cycles above the pubic area |
p < 0.001 in favor of aromatherapy | Retrospective registration Parallel/n.r. |
| Sadeghi (2015) [26] Iran |
75 18–35 Pain on VAS ≥5 |
(A) Rose oil (Massage, n = 25) | (B) Placebo (Massage, almond oil, unscented, n = 25) (C) Massage only (n = 25) † |
1 time, 5 drops, 15 min on the 1st day of menstruation Self-massage |
p < 0.005 in favor of aromatherapy | Registration while recruiting Parallel/None |
| Rizk (2013) [27] Egypt |
120 17–21 Moderate to severe |
(A) Peppermint oil (Massage abdomen, n = 40) (B) Ginger oil (massage, n = 40) |
(C) Placebo (Massage abdomen, almond, n = 95) | 15 min daily for 5 days for 2 cycles | p < 0.001 in favor of aromatherapy | Parallel/n.r. |
| Marzouk (2013) [28] Egypt |
95 17–20 Pain on VAS ≥6 |
(A) Essential oils (cinnamon, clove, rose and lavender, massage, n = 95) | (B) Placebo (Massage abdomen, sweet almond, n = 95) | Once daily, 10 min for 7 days before menstruation by a researcher in a student clinic |
p = 0.006 in favor of aromatherapy | 1 cycle washout period Cross-over/n.r. |
| Amiri Farahani (2012) [29] Iran |
90 21 verbal multi-dimensional scoring system ≥2 |
(A) Essential oils (Massage, lavender oil 2% (2 drops), peppermint oil 2% (2 drops) in 4 mL of almond oil, n = 30) | (B) Placebo (Massage, almond oil, n = 30) (C) Massage only (n = 30) † |
A week before the start of menstrual cycle until the presence of pain, massage at the top of pubic area for 15 min per day. To be repeated for two cycles |
p = 0.03 in favor of aromatherapy | Retrospective registration Parallel/n.r. |
| Han (2006) [30] Korea |
75 19–26 Pain on VAS ≥6 |
(A) Essential oils (Massage abdomen, lavender, clary sage, rose, n = 25) | (B) Placebo (Massage abdomen, almond oil, n = 25) (C) No treatment (n = 25) † |
1 time, 15 min | p = 0.008 in favor of aromatherapy | Parallel/None |
| Cheon (2013) [31] Korea |
30 Pain on VAS ≥6 |
(A) Essential oils (Massage abdomen, nutmeg, fennel, marjoram, n = 15) | (B) Placebo (Massage abdomen, almond oil, n = 15) | 3 mL, 10 min, once a day from 14 days before menstruation to the starting date of next menstruation | p < 0.001 in favor of aromatherapy | Parallel/n.r. |
| Ou (2012) [32] Taiwan |
48 Over 18 Pain on VAS ≥5 |
(A) Essential oils cream (Massage abdomen, cream, lavender, clary sage, marjoram, massage, n = 24) | (B) Placebo (Massage abdomen, cream, synthetic fragrance, massage, n = 24) | From the end of the last menstruation continuing to the beginning of the next menstruation Self-massage |
p = 0.02 in favor of aromatherapy | Compare the data of 1st cycle (pre) with the data of 2nd cycle (post) Pain measured with NRS did not show significance Parallel/n.r. Pain (VRS) |
| Khorshidi (2003) [33] Iran |
60 17–25 Mild or moderate (AMVMS) |
(A) Fennel oil (Oral, 1%, n = 60) (B) Fennel oil (Oral 2%, n = 60) |
(C) Placebo (n.r., n = 60) | 1 time, administrated as soon as pain felt | (1) p < 0.05 in favor of aromatherapy (A and B) (2) p < 0.05 in favor of aromatherapy (A and B) |
n.r. in details of treatment n.r. in washout period Cross-over/n.r. Pain (LS) |
| Ataollahi (2015) [34] Iran |
110 21.4 Moderate to severe pain (VAS ≥5) |
(A) Rosaceous extract (Oral, n = 55) | (B) Placebo (n.r., n = 55) | 10 drops twice daily or the first three days of the cycle for two consecutive cycles | p = 0.001 in favor of aromatherapy | Retrospective registration Parallel/n.r. Pain (VRS) |
AMVMS: Andersch’s and Milsom’s verbal multi-dimensional scoring system; LS: Likert scale; MDQ: menstrual distress questionnaire; n.r.: not reported; NS: not significant; VAS: visual analogue scale; VRS; verbal rating scale. † These controls were not placebo group and we excluded them from analysis.