Effect of Aromatherapy with Essential oil of Lavandula Angustifolia Mill Citrus Bergamia and Mindfulness Based Intervention on Sexual Function, Anxiety, and Depression in Postmenopausal Women: A Randomized Controlled Trial with Factorial Design

Mandana Mojtehedi, Hanieh Salehi Pourmehr, Alireza Ostadrahimi, Solmaz Asnaashari, Khalil Esmaeilpour, Azizeh Farshbaf Khalili

Abstract


Background: Due to the importance of psychological support for women during menopause as a period with a high prevalence of mental health problems, this study aimed to evaluate the effect of the essential oil of lavender‑Bergamot (La‑Ber) and Mindfulness‑Based Intervention (MBI) on sexual function, anxiety (primary outcome), and depression score (secondary outcome) in postmenopausal women with sexual dysfunction.

Materials and Methods: This controlled randomized trial with a factorial design was performed on 132 postmenopausal women. Participants were randomly allocated into four equal groups: Aromatherapy‑Routine Care (Aroma‑RC), MBI‑Placebo (MBI‑P), Aromatherapy‑MBI (Aroma‑MBI), or Routine Care‑Placebo (RC‑P). Two to three drops of La‑Ber or a similar placebo were inhaled three times a day for 8 weeks. Eight sessions of MBI intervention were conducted. At the end of the intervention and eight weeks afterward, the outcomes were assessed.

Results: The sexual function score improved significantly in Aroma‑MBI (adjusted Mean Difference [aMD]: 2.4, 95% CI: 0.01 to 4.80) and MBI‑P (aMD: 2.6, 95% CI: 0.2 to 5.1) groups compared to the RC‑P group. The anxiety score was reduced in the Aroma‑RC group at the end of the intervention (aMD: ‑4.12, 95% CI: ‑7.41 to ‑0.72; p = 0.020) and eight weeks later as well as in the Aroma‑MBI group. In terms of depression, the mean score of depression was significantly lower than the RC‑P group in the Aroma‑RC group at the end of the intervention (p = 0.011).

Conclusions: MBI and aromatherapy seem effective on sexual function and menopausal anxiety. MBI improves sexual function, while aromatherapy ameliorated anxiety and depression.


Keywords


Anxiety, behavior therapy, complementary therapies, depression, menopause, psychological, sexual

Full Text:

PDF

References


Col NF, Fairfield KM, Ewan Whyte C, Miller H. In the clinic. Menopause. Ann Intern Med 2009;150:ITC4 1 15; quiz ITC4 6.

Fan X, Bialecka M, Moustakas I, Lam E, Torrens Juaneda V, Borggreven NV, et al. Single cell reconstruction of follicular remodeling in the human adult ovary. Nat Commun 2019;10:3164.

Thurston RC, Joffe H. Vasomotor symptoms and menopause: Findings from the Study of Women’s Health across the Nation. Obstet Gynecol Clin North Am 2011;38:489 501.

Gracia CR, Freeman EW. Onset of the menopause transition: The earliest signs and symptoms. Obstet Gynecol Clin North Am 2018;45:585 97.

Freeman EW, Sammel MD, Lin H, Nelson DB. Associations of hormones and menopausal status with depressed mood in women with no history of depression. Arch Gen Psychiatry 2006;63:375 82.

Scheyer O, Rahman A, Hristov H, Berkowitz C, Isaacson RS, Diaz Brinton R, et al. Female sex and alzheimer’s risk: The menopause connection. J Prev Alzheimers Dis 2018;5:225 30.

Arora N, Brotto LA. How does paying attention improve sexual functioning in women? A review of mechanisms. Sex Med Rev 2017;5:266 74.

Velten J, Margraf J, Chivers ML, Brotto LA. Effects of a mindfulness task on women’s sexual response. J Sex Res 2018;55:747 57.

van Driel CM, Stuursma A, Schroevers MJ, Mourits MJ, de Bock GH. Mindfulness, cognitive behavioural and behaviour based therapy for natural and treatment induced menopausal symptoms: A systematic review and meta analysis.BJOG 2019;126:330 9.

Goyal M, Singh S, Sibinga EM, Gould NF, Rowland Seymour A, Sharma R, et al. Meditation programs for psychological stress and well being: A systematic review and meta analysis. JAMA Intern Med 2014;174:357 68.

Pilkington K, Kirkwood G, Rampes H, Richardson J. Yoga for depression: The research evidence. J Affect Disord 2005;89:13 24.

Duan Porter W, Coeytaux RR, McDuffie JR, Goode AP, Sharma P, Mennella H, et al. Evidence map of yoga for depression, anxiety, and posttraumatic stress disorder. J Phys Act Health2016;13:281 8.

Chen KW, Berger CC, Manheimer E, Forde D, Magidson J, Dachman L, et al. Meditative therapies for reducing anxiety: A systematic review and meta analysis of randomized controlled trials. Depress Anxiety 2012;29:545 62.

Choi J, Lee HW, Lee JA, Lim HJ, Lee MS. Aromatherapy for managing menopausal symptoms: A protocol for systematic review and meta analysis. Medicine 2018;97;e9792.

Buckle J. Clinical Aromatherapy e book: Essential Oils in Practice: Elsevier Health Sciences; 2014.

Saiyudthong S, Marsden CA. Acute effects of bergamot oil on anxiety related behaviour and corticosterone level in rats. Phytother Res 2011;25:858 62.

Chughtai A, Navaee M, Alijanvand MH, Yaghoubinia F. Comparing the effect of aromatherapy with essential oils of Rosa damascena and lavender alone and in combination on severity of pain in the first phase of labor in primiparous women. Crescent J Medical Biol Sci 2018;5:312 9.

Baumgardner DJ. Lavender aromatherapy: Ready for prime time office use? J Patient Cent Res Rev 2020;7:5 7.

Navarra M, Mannucci C, Delbò M, Calapai G. Citrus bergamia essential oil: From basic research to clinical application. Front Pharmacol 2015;6:36.

Salehi Pourmehr H, Ostadrahimi A, Ebrahimpour Mirzarezaei M, Farshbaf Khalili A. Does aromatherapy with lavender affect physical and psychological symptoms of menopausal women? A systematic review and meta analysis. Complement Ther Clin Pract 2020;39:101150.

Khadivzadeh T, Najafi MN, Ghazanfarpour M, Irani M, Dizavandi FR, Shariati K. Aromatherapy for sexual problems in menopausal women: A systematic review and meta analysis. J Menopausal Med 2018;24:56 61.

Scuteri D, Rombolà L, Morrone LA, Bagetta G, Sakurada S, Sakurada T, et al. Neuropharmacology of the neuropsychiatric symptoms of dementia and role of pain: Essential oil of bergamot as a novel therapeutic approach. Int J Mol Sci 2019;20:3327.

Firoozeei TS, Feizi A, Rezaeizadeh H, Zargaran A, Roohafza HR, Karimi M. The antidepressant effects of lavender (Lavandula angustifolia Mill.): A systematic review and meta analysis of randomized controlled clinical trials. Complement Ther Med 2021;59:102679.

Niazi A, Moradi M. Sexual satisfaction and function in postmenopausal women treated with herbal medicines: A review of clinical trials. Evid Based Care J 2019;9:7 16.

Kim S, Song JA, Kim ME, Hur MH. Effects of Aromatherapy on Menopausal Symptoms, Perceived Stress and Depression in Middle-aged Women: A Systematic Review. J Korean Acad Nurs 2016;46:619 9.

Gava G, Orsili I, Alvisi S, Mancini I, Seracchioli R, Meriggiola MC. Cognition, mood and sleep in menopausal transition: The role of menopause hormone therapy. Medicina 2019;55:668.

Frey BN, Lord C, Soares CN. Depression during menopausal transition: A review of treatment strategies and pathophysiological correlates. Menopause Int 2008;14:123 8.

Malakouti J, Farshbaf KA, Asghari JM, Jabbari F. Effect of combined inhaler aromatherapy on sexual function in postmenopausal women: A randomized controlled trial. The Iranian Journal of Obstetrics, Gynecology and Infertility 2016; 19:9-15.

Malakouti J, Jabbari F, Jafarabadi M, Javadzadeh Y, Khalili A. The impact of ginkgo biloba tablet and aromatherapy inhaler combination on sexual function in females during postmenopausal period: A double blind randomized controlled trial. Int J Womens Health Reprod Sci 2017;5:129 36.

Farshbaf Khalili A, Kamalifard M, Namadian M. Comparison of the effect of lavender and bitter orange on anxiety in postmenopausal women: A triple blind, randomized, controlled clinical trial. Complement Ther Clin Pract 2018;31:132 8.

Creswell JD. Mindfulness interventions. Annu Rev Psychol 2017;68:491 516.

Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, et al. The female sexual function index (FSFI): A multidimensional self report instrument for the assessment of female sexual function. J Sex Marital Ther 2000;26:191 208.

Beck AT, Steer RA. Manual for the Beck Anxiety Inventory. San Antonio, TX: Psychological Corporation; 1990.

Beck AT, Steer RA, Brown GK. Manual for the Beck depression inventory-II. San Antonio, TX: Psychological Corporation. 1996.

Mohammadi K, Heydari M, Faghihzadeh S. The female sexual function index (FSFI): Validation of the iranian version. Payesh 2008;7:269 78.

Ulusoy M, Sahin NH, Erkmen H. Turkish version of the Beck anxiety inventory: Psychometric properties. J Cogn Psychother 1998;12:163.

Dijkstra P, Barelds DP. Examining a model of dispositional mindfulness, body comparison, and body satisfaction. Body Image 2011;8:419 22.

Fink S, Foran KA, Sweeney AC, O’Hea EL. Sexual body esteem and mindfulness in college women. Body Image 2009;6:326 9.

Krieger JF, Kristensen E, Marquardsen M, Giraldi A. [Mindfulness in the treatment of sexual difficulties]. Ugeskr Laeger 2019;181:V12180853.

Jaderek I, Lew Starowicz M. A Systematic review on mindfulness meditation–based interventions for sexual dysfunctions. J Sex Med 2019;16:1581 96.

Jaderek I, Lew Starowicz M. A systematic review on mindfulness meditation based interventions for sexual dysfunctions. J Sex Med 2019;16:1581 96.

Hearn JH, Finlay KA. Internet delivered mindfulness for people with depression and chronic pain following spinal cord injury: A randomized, controlled feasibility trial. Spinal Cord 2018;56:750 61.

Hickey M, Bryant C, Judd F. Evaluation and management of depressive and anxiety symptoms in midlife. Climacteric 2012;15:3 9.

Lee HW, Ang L, Choi J, Lee MS. Aromatherapy for managing menopausal symptoms: A systematic review and meta analysis of randomized placebo controlled trials. J Altern Complement Med 2021;27:813 23.

Murakami S, Shirota T, Hayashi S, Ishizuka B. Aromatherapy for outpatients with menopausal symptoms in obstetrics and gynecology. J Altern Complement Med 2005;11:491 4.

Taavoni S, Darsareh F, Joolaee S, Haghani H. The effect of aromatherapy massage on the psychological symptoms

of postmenopausal Iranian women. Complement Ther Med 2013;21:158 63.

Bagetta G, Morrone LA, Rombolà L, Amantea D, Russo R, Berliocchi L, et al. Neuropharmacology of the essential oil of bergamot. Fitoterapia 2010;81:453 61.

McCaffrey R, Thomas DJ, Kinzelman AO. The effects of lavender and rosemary essential oils on test taking anxiety among graduate nursing students. Holist Nurs Pract 2009;23:88 93.

Carresi C, Gliozzi M, Musolino V, Scicchitano M, Scarano F, Bosco F, et al. The effect of natural antioxidants in the development of metabolic syndrome: Focus on bergamot polyphenolic fraction. Nutrients 2020;12:1504.

Cho MY, Min ES, Hur MH, Lee MS. Effects of aromatherapy on the anxiety, vital signs, and sleep quality of percutaneous coronary intervention patients in intensive care units. Evid Based Complement Alternat Med 2013;2013:381381.

Kamalifard M, Farshbaf Khalili A, Namadian M, Ranjbar Y, Herizchi S. Comparison of the effect of lavender and bitter orange on sleep quality in postmenopausal women: A triple blind, randomized, controlled clinical trial. Women Health 2018;58:851 65.

de Sousa DP, de Almeida Soares Hocayen P, Andrade LN, Andreatini R. A systematic review of the anxiolytic like effects of essential oils in animal models. Molecules 2015;20:18620 60.

Morrone LA, Rombolà L, Pelle C, Corasaniti MT, Zappettini S, Paudice P, et al. The essential oil of bergamot enhances the levels of amino acid neurotransmitters in the hippocampus of rat: Implication of monoterpene hydrocarbons. Pharmacol Res 2007;55:255 62.

Rombola L, Scuteri D, Adornetto A, Straface M, Sakurada T, Sakurada S, et al. Anxiolytic like effects of bergamot essential oil are insensitive to flumazenil in rats. Evid Based Complement Alternat Med 2019;2019:2156873.


Refbacks

  • There are currently no refbacks.