The Effect of Lavender Aromatherapy on the
Symptoms of Menopause
Roya Nikjou, M.Sc., Rafat Kazemzadeh, M.Sc., Firoozeh Asadzadeh, M.Sc., Razzag Fathi, M.Sc.,
Farideh Mostafazadeh, M.Sc.
Conflict of interest: The authors declare no conflict of interest in this study.
Acknowledgments: The researchers would here thank the authorities and
officials of the school of Nursing Midwifery and the Deputy of Research Council
of Ardabil University of Medical Sciences for their financial aids, and also all those
who helped us in this study.
Abstract: Objectives: The menopause is a natural biological process that is
happened by a permanent regal stop due to the loss of performance. The aim
of this research is to evaluate the effect of lavender aromatherapy on the
menopause symptoms.
Study design: This double-blind cross over clinical trial carried out on 100
menopause women (between 45 and 155 years old) referring to health centers
in Ardabil in 2013-14. The samples blocked randomly, placed in two
experimental (Lavender) and control (diluted milk) groups. Lavender aroma is
smelled two times daily for 20 min during 12 weeks by research subjects. Data
were collected by Green questionnaire and the analysis of data carried out in
SPSS v.16 by paired t-test.
Main outcome measures: The level of the symptoms has been decreased
significantly after using lavender.
Results: Comparing the level of the symptoms before and after using lavender in
experimental group suggested that the rate of the menopause symptoms has
been decreased significantly (P ¼ 0.000). The comparison of the mean of the
menopause symptoms after intervention between two groups suggested that
the menopause symptoms in the experimental group had a significant
decrease comparing the control group (P ¼ 0.000).
Conclusion: Using the lavender aromatherapy decreases menopause
symptoms. According to the undesirable effect of the menopause symptoms on
the quality of life of the menopausal women, these interventions may be
instructed by midwives in the treatment and care centers as a health activity.
Keywords: Lavender oil-Aromatherapy-Menopause
Author affiliations: Roya Nikjou, Department of Midwifery, School of Nursing and Midwifery,
Ardabil University of Medical Sciences (ARUMS), Ardabil, Iran; Rafat Kazemzadeh,
Department of Midwifery, School of Nursing and Midwifery, Ardabil University of Medical
Sciences (ARUMS), Ardabil, Iran; Firoozeh Asadzadeh, Department of Midwifery, School of
Nursing and Midwifery, Ardabil University of Medical Sciences (ARUMS), Ardabil, Iran;
Razzag Fathi, Department of Physiology, Deputy Health Sarein, Ardabil University of
Medical Sciences, Ardabil, Iran; Farideh Mostafazadeh, Department of Midwifery, School
of Nursing and Midwifery, Ardabil University of Medical Sciences (ARUMS), Ardabil, Iran
Correspondence: Rafat Kazemzadeh, Department of Midwifery, School of Nursing and
Midwifery, Ardabil University of Medical Sciences (ARUMS), Ardabil, Iran., email: r.
kazemzadeh@arums.ac.ir
ª 2017 Published by Elsevier Inc. on behalf of the National Medical Association.
http://dx.doi.org/10.1016/j.jnma.2017.06.010
INTRODUCTION
T
he population of Menopause women in the world is
near to one billion1 that is estimated to increase by
50% till 2015.2 Almost women experience the
signs of menopause initiation during their lives.3,4
Decreasing ovarian hormones including Estrogen, Pro-
gesterone, Androstenedione and Testosterone in meno-
pause causes various physical, mental and genitourinary
symptoms.5 Epidemiological studies have suggested that
JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION
about 65-68% of women experience the symptoms of
menopause onset.6 About 80% of women in this period
have flushing, night sweet, heartthrob, giddiness, fatigue
and irritability and 9% of them have more intensive
symptoms that affect the quality of their lives.7,8
Regarding to increased life expectancy, and the stability
of menopause age, women spend more than one third of
their lives in post-menopause period, so maintaining the
women’s welfare and health in this period has a high
priority in preventing socioeconomical harms.9 In the past,
complementary and alternative medicine was a selective
therapy for improving the menopause symptoms10; how-
ever, most women has lost the opportunity of uncompli-
cated and simple treatment by HRT due to a report
introduced by the World health organization and look for a
proper treatment among complementary and alternative
methods.11 The results of an Iranian research in 2001
showed that only 8.57% of menopausal women use
alternative hormone treatments.3
Despite the advantages of hormone therapy in meno-
pausal women, the results of studies of women researchers
have showed that these methods may not be completely
harmless.12 This subject caused the researchers look for
drugs similar to hormones but with fewer side effects.13
Complementary and alternative medicine is a therapeutic
method that today is used by menopausal women.14 The
World health organization has suggested complementary
and alternative medicine as a method that can be effective
in improving the symptoms of menopause.15 Using vola-
tile oil or aroma extracted from aromatic plants for thera-
peutic goals is called aromatherapy.16 The oil extracted
from lavender is a plant aromatic volatile oil which is
widely applied in aromatherapy. This plant belongs to
Lamiaceae family and is a gramineous plant which is al-
ways green and has some properties as anti-anxiety,
sedative and preventing sleep disorders.17,18
Scientifically, a theory proposed that aromatherapy
could be efficient psychologically and physiologically.
There is a belief that the smell of aromas activates neurons
and leads to limbic stimulation. Based on the kind of
aroma, neurons release various neurotransmitters including
encephalin, noradrenalin, and serotonin; furthermore, ac-
cording to the relationship between olfactory and the
human feelings and soul, aromas are able to influence
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EFFECT OF AROMATHERAPY ON THE SYMPTOMS OF MENOPAUSE

human’s body and soul simultaneously.19 Menopause may
provide a challenge in individual’s life, because these side
effects cause illness and disability and has an undesirable
effect on the quality of individual’s life and is a start point
for a series of subsequent complications; the health of
family may be endangered, so studying this problem is
very important. Regarding to the high tendency of the
menopausal and middle aged women to use herbal sup-
plements and limited studies in the field of these supple-
ments efficiency in mentioned ages, more studies about
aromatherapy is needed and according to the undesirable
effects of the menopause symptoms in the physical and
mental dimensions of menopausal women life’s quality,
we decided to do a research to maintain the health and
improving the quality of women’s life.
4 and 6, and by allocation ratio of 1:1. Then using random
numbers table, sequential allocation was applied. To
blinding, some glasses containing lavender essence or
diluted milk (which were same according to the form, color
and size) were used. At first the demographic questionnaire
completed by face to face interview for both groups. The
glasses were given to the participants to smell them two
times a week for 20 min. The duration of the therapy was
two weeks in each group. The Green questionnaires were
completed again by the researcher after treatment. After 4
weeks of the wash out period, first group received placebo
and second group received lavender and questionnaires
completed once more. The researcher assistant and the
participants were not informed about transposition of main
aroma and placebo (blinding).

METHODS SAMPLE SIZE

This double-blind cross over clinical trial is carried out in According to previous research, with 90% power and
2013-14 aiming to explore the effect of aromatherapy on the a ¼ 0/05 using the formula of means’ comparison were
symptoms of menopause in women referring to the health
and treatment centers covered by Ardabil University of
Medical Sciences. Firstly, all treatment and health centers
Table 1. Comparison of the demographic characteristics of the study
were listed then four health centers which had the most participants in intervention and control groups.
clients were selected. Sampling started from the centers
which had the most clients and continued respectively to Control Control
other centers until completing purposed sample size. The group group
target population was 45-55 years old women referring to Variable N [ 50 N [ 50 P
above centers. Provided by documents, the women who Age, year 52.24 51.5 0.74
received services for family planning and now were in the Number of childbirth 0.17
menopause age and women who complained about meno-
Less than 4 24 21
pause symptoms and flushing were called and everybody
More than 4 26 29
willing to participate in this research was invited. The study
is performed according to Helsinki principals in ethics. Education 0.21
After receiving permission from ethics committee, selection Elementary 31 28
of participants was done by non-probability sampling Secondary 10 11
method, and the women who had the inclusion criteria (lack High school 5 9
of menstruation in recent 12 months, having normal blood Academic 4 7
pressure, and married and literate) were selected. The
Menopause time 0.53
exclusion criteria were taking anti-anxiety, anti-depression,
Less than 2 years 17 19
estrogen and progesterone drugs in recent six years, and
having asthma and allergy. After giving some explanations More than 2 years 33 31
about the research method and goal, Green Score calculated Occupation 0.67
for each sample. All women were visited by the researcher Housewife 39 37
and were asked about the uterine bleeding, background of Employee 3 5
uterine and breast cancer, liver disorders, and depression, Retired 8 8
hyperthyroidism and using herbal or hormonal drugs. Data
Income adequacy 0.21
were collected with face to face interview and the tool for
Yes 16 12
gathering data was demographic questionnaire and the
Green standard test. Subjects who had inclusion criteria and No 25 30
signed written informed consent were allocated in group of Partially 9 8
lavender (n ¼ 50) or placebo (n ¼ 50) by blocking randomly

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 --

Table 2. Comparison of variables between two groups before intervention.

Variable Means of differences Criterion error Degree of freedom t Significance Level (sig)
Anxiety 0.937 1.025 98 0.914 0.363 ns
Depression 0.204 0.659 98 0.310 0.757 ns
Physical signs 0.480 0.905 98 0.530 0.597 ns
Vasomotor signs 0.051 0.278 98 0.184 0.485 ns
Sexual desire 0.041 0.214 98 0.191 0.849 ns

ns, non-significant in the level of 95%.

calculated 45 persons for each group, and allowing for
10% sample decrease, 50 persons allocated for each group.
Applied statistical methods were paired and indepen-
dent t-test, and chi-square. The data analyzed by spss v.16,
and the values of P < 0.05 were considered significant.
IRCT: IRCT 2014011816255N1.
RESULTS
This research carried out on 100 menopause women (50
people in each group) who were suffering from flushing
symptoms and had the Green score of 15-42.
Two groups were same in demographic characteristics
and there were no significant differences between them.
The average age in first group was 52/24 and in the second
group was 51/5. Almost participants had elementary edu-
cation, were housewives and were in the second year after
their menopause (Table 1).
Independent t-test showed that, there was no significant
difference between two groups in symptoms of menopause
before intervention (Table 2).
Results showed that symptoms have decreased signifi-
cantly after intervention (Table 3).
The independent t-test also showed that, there was
significant difference between the intervention and control
groups after the intervention. In another word, the symp-
toms have declined significantly in the intervention group
compared to the control group (Table 4).
DISCUSSION
The results of this research showed that the inhalant lav-
ender reduced early menopause symptoms. In this
research, inhalant lavender caused significant reduction in
anxiety, depression, physical and vasomotor symptoms
and sexual desire; this reduction may be due to the
decreasing in releasing stress hormones and Beta-endor-
phin.20 Several studies have shown that non pharmaco-
logical methods have decreased vasomotor symptoms in
menopausal women.21 Also the desire to use non-
pharmacological methods by menopausal women is
increasing.22 According to Taavoni et al. 30 min
massaging the organs and abdomen with lavender two
times a week during 4 weeks causes reducing menopause
symptoms.19 Also, Bradley et al. suggested the menopause
symptoms decrease after drinking 200 cc of lavender.23
Li-Wei Chien suggested that inhalation of lavender for
20 min two times a week during 12 weeks resulted in
improvement of sleep quality.24 According to Oliveria
et al. massage with lavender decreases physical symptoms

Table 3. Menopause symptoms before and after intervention.

Variables Groups Numbers Difference means Standard error t Sig

Anxiety Pre-post treatment 7.27 0.979 98 7.42 0.00
Depression Pre-post treatment 4.13 0.592 98 6.98 0.00
Physical signs Pre-post treatment 9.56 0.748 98 12.77 0.00
Vasomotor signs Pre-post treatment 1.63 0.232 98 7.02 0.00
Sexual desire Pre-post treatment 1.13 0.129 98 8.76 0.00

Significance level: 99%.

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EFFECT OF AROMATHERAPY ON THE SYMPTOMS OF MENOPAUSE

Table 4. Comparing means in control and intervention groups after treatment.

Difference Standard Degree of

Variables Study Time means error freedom t
Anxiety Control 50 10.80 3.74 0.00
Experimental 50 4.04 2.59
Depression Control 50 9.0 3.12 0.00
Experimental 50 4.03 2.59
Physical Control 50 12.60 4.37 0.00
Experimental 50 3.05 2.57
Vasomotor Control 50 3.60 1.24 0.00
Experimental 50 1.94 1.05
Sexual desire Control 50 1.8 0.62 0.00
Experimental 50 0.76 0.52
Total Control 50 37.80 13.11 0.00
Experimental 50 13.85 9.66

of menopause.25 According to the result of authors’ pre-
vious study the use of lavender aromatherapy reduced
menopause flushing.18
Galler et al. suggested that women have a tendency to
use medicinal herbs in menopause ages, so 50% of middle
aged people use herbal supplements which have no side
effect for them and are so satisfied.1
In a study by Taavoni et al. (2013), The effect of aroma-
therapy massage on the psychological symptoms of Iranian
postmenopausal women, the results showed that the use of
aromatherapy massage decreased the menopause symp-
toms.19 In another study by Darsareh et al. it was demonstrate
that both massage and aromatherapy massage were effective
in reducing menopausal symptoms. However, aromatherapy
massage was more effective than only massage.26
Multiple studies have shown the efficacy of both
non-pharmacologic and pharmacologic agents for the
treatment of psychological symptoms of menopause in
general.27 Although physicians have traditionally relied on
pharmacologic methods to reduce psychological symp-
toms, interest in the use of Complementary and alternative
medicine is growing.22
In our research, only short term effect of massage
therapy has been studied which is considered research
constraint, thus we suggest studying the effect of these
interventions in long term.
CONCLUSIONS
In our research, the effect of lavender aromatherapy in
decreasing menopause symptom was obvious. Considering
undesired effects of menopause symptoms in physical and
psychological dimensions of menopausal women lives,
these interventions may be instructed to menopausal women
in treatment and care centers by midwives.
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