Aromatherapy for Managing Pain in Primary Dysmenorrhea: A Systematic Review of Randomized Placebo-Controlled Trials

Myeong Soo Lee, Hye Won Lee, Mohamed Khalil, Hyun Suk Lim, Hyun-Ja Lim, Myeong Soo Lee, Hye Won Lee, Mohamed Khalil, Hyun Suk Lim, Hyun-Ja Lim

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.

Keywords: aromatherapy; dysmenorrhea; essential oil; inhalation; meta-analysis; pain; systematic review.

Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Flow diagram of selection process. CCT: non-randomized controlled trial; RCT: randomized controlled trial.
Figure 2
Figure 2
(A) Risk of bias graph: review authors’ judgements about each risk of bias item presented as percentages across all included studies. (B) Risk of bias summary: review authors’ judgements about each risk of bias item for each included study. +: low risk of bias; −: high risk of bias; ?: unclear risk of bias.
Figure 3
Figure 3
Forest plot of effects of aromatherapies on pain of primary dysmenorrhea.
Figure 4
Figure 4
Funnel plot for aromatherapies for pain management compared with placebo aromatherapies.

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