The Study Question
As levels of reproductive hormones drop during menopause, 80 percent to 85 percent of women will experience bothersome symptoms such as hot flashes and mood disturbances, which can negatively impact their quality of life. While hormone replacement therapy (HRT) is effective for relieving these symptoms,many women are reluctant to use HRT because of long-term safety concerns, and HRT is contraindicated for breast cancer survivors. Previous surveys have estimated that approximately 75 percent of women are interested in nonhormonal options for menopausal symptoms. This study, conducted by nursing faculty at the Tehran University of Medical Sciences, investigated whether aromatherapy massage could reduce symptoms of menopause.
The Study Methods
Participants were recruited from 251 eligible patients at a meno- pausal clinic at a gynecology hospital in Tehran between June and September 2011. Inclusion criteria were married women between the ages of 45 and 60 years experiencing symptoms of natural menopause, amenorrhea for at least 12 months, no serious chronic medical conditions, normal pap tests in the past 12 months, and no abnormal clinical findings or other medications.
The 90 participants who consented were each randomly assigned to one of three groups, with 30 participants per group: a control group that did not receive massage, a placebo group that received only massage using liquid paraffin, and a third group that received aromatherapy massage. Both the placebo and aromatherapy massage groups received 30-minute treatment sessions twice a week for four weeks, or eight sessions in total.
The massage for both groups was performed with the patient supine and a pillow under the knees using light pressure on the abdomen, upper legs and arms. The aromatherapy essential oil blend was composed of lavender, rose gera- nium, rose and rosemary in a 4:2:1:1 ratio, diluted almond (90 percent) and evening primrose oil (10 percent) at a final concentration of 3 percent. Massages were performed at the same time each day by a certified midwife, who had completed a training course in aromatherapy and massage.
The main outcome measure used was the Menopausal Rating Scale (MRS), an 11-item scale assessing common menopausal symptoms, including depressive mood, irritability, anxiety, hot flashes, sleep disturbance, muscle and joint problems, bladder problems and vaginal dryness. Each symptom is scored as 0 (no complaints) to 4 (severe symptoms), and the total score is the sum of all items. The original MRS scale was trans- lated from English into Farsi, and the translation validated in a pilot study of 50 women who were demographically similar to the participants.
No statistically significant dif- ferences were observed among the three groups in terms of age, age at menopause or body mass index. The baseline scores for menopausal symp- toms were comparable across each group, ranging from 21.72 to 22.13. Menopausal symptoms did show a decrease from 21.86 (sd 2.86) to 13.11 (sd 2.91) after aromatherapy massage, compared to a decrease from 21.72 (sd 3.09) to 19.07 (sd 2.84) after the paraffin massage. These scores both showed a statistically significant difference, while the score in the control group did not differ significantly.
Limitations of the Study
This is a thoughtfully designed study that was carefully conducted, and the use of random assignment to the three comparison groups adds rigor. Whether the results can be generalized outside of Iran is not clear. The emotional support provided by the massage may have also influenced the short-term reduction in symptoms over the four-week study period. No follow-up was conducted to determine whether the symptom reduction was maintained.
Implications for Evidence-Informed Practice
Women experiencing menopausal symptoms may benefit from massage and from aromatherapy massage using the blend specified in this study in particular.
Massage Therapy Research
Massage Therapy Journal
Research: Massage & Sleep
1. Darsareh F, Taavoni S, Joolaee S, Haghani H. "Effect of aromatherapy massage on menopausal symptoms: a randomized placebo-controlled clinical trial." Menopause 2012 Sep;19(9):995-9.