Abstract
Aromatherapy, the therapeutic use of essential oils, is often used to reduce pain in primary dysmenorrhea. Eleven databases, including four English (PubMed, AMED, EMBASE, and the Cochrane Library) and seven Korean medical databases, were searched from inception through August 2018 without restrictions on publication language. Randomized controlled trials (RCTs) testing aromatherapy for pain reduction in primary dysmenorrhea were considered. Data extraction and risk-of-bias assessments were performed by two independent reviewers. All of the trials reported superior effects of aromatherapy for pain reduction compared to placebo (n = 1787, standard mean difference (SMD): −0.91, 95% CI: −1.17 to −0.64, p < 0.00001) with high heterogeneity (I2 = 88%). A sub-analysis for inhalational aromatherapy for the alleviation of pain also showed superior effects compared to placebo (n = 704, SMD: −1.02, 95% CI: −1.59 to −0.44, p = 0.0001, I2 = 95%). With regard to aromatherapy massage, the pooled results of 11 studies showed favorable effects of aromatherapy massage on pain reduction compared to placebo aromatherapy massage (n = 793, SMD: −0.87, 95% CI: −1.14 to −0.60, p < 0.00001, I2 = 70%). Oral aromatherapy had superior effects compared to placebo (n = 290, SMD: −0.61, 95% CI: −0.91 to −0.30, p < 0.0001, I2 = 0%). In conclusion, our systemic review provides a moderate level of evidence on the superiority of aromatherapy (inhalational, massage, or oral use) for pain reduction over placebo in primary dysmenorrhea.
Highlights
Dysmenorrhea is characterized by lower abdominal pain that occurs during menstruation [1,2]
Current evidence shows that non-steroid anti-inflammatory drugs (NSAIDs) are beneficial for reducing pain in primary dysmenorrhea compared to placebo controls [2,3]
Compared to a recently published systematic review of aromatherapy massage only [13], we identified a total of 13 new Randomized controlled trials (RCTs) [16,17,18,19,20,21,22,25,27,29,31,33,34] (4 evaluated massages [25,27,29,31]) that assessed all types of aromatherapy and have comprehensively updated the evidence for aromatherapy
Summary
Dysmenorrhea is characterized by lower abdominal pain that occurs during menstruation [1,2]. Current evidence shows that non-steroid anti-inflammatory drugs (NSAIDs) are beneficial for reducing pain in primary dysmenorrhea compared to placebo controls [2,3]. Simple analgesics (aspirin, paracetamol) are likely beneficial for alleviating pain in the short term but may have potential adverse events (AEs) including skin reactions [2,3]. Combined oral contraceptives may provide effective management for dysmenorrhea, but they exhibit AEs including irregular uterine bleeding and the induction of endometriosis [2,4]. Many women try CAM as an alternative or complementary therapy to conventional drug therapy for healthcare [5]. One of the main reasons is to avoid the AEs of conventional treatments [5,6]
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