Physical and psychologic effects of aromatherapy inhalation on pregnant women: a randomized controlled trial

The Effect of Short-term Inhalation of Fir Essential Oil on Autonomic Nervous Activity in Middle-aged Women

This study aimed to investigate the effect of short-term inhalation of fir essential oil on autonomic nervous activity in middle-aged women. Twenty-six women (mean age, 51.0 ± 2.9 years) participated in this study. The participants sat on a chair, closed their eyes, and inhaled fir essential oil and room air (control) for 3 min. A crossover trial was performed to eliminate the effect of the order of olfactory stimulation. Approximately half of the participants were administered stimuli in the following order: exposure to fir essential oil, then control. The remaining participants were administered control, followed by fir essential oil. Heart rate variability, heart rate, blood pressure, and pulse rate were used as indicators of the autonomic nervous system activity. The Semantic Differential method and Profile of Mood States were used as psychological indicators. The High Frequency (HF) value, an indicator of parasympathetic nerve activity reflecting a relaxed state, was significantly higher during stimulation with fir essential oil than during the control condition. The Low Frequency (LF)/(LF+HF) value, an indicator of sympathetic nerve activity reflecting awake state, was marginally lower during stimulation with fir essential oil than during the control condition. No significant differences were found in heart rate, blood pressure, and pulse rate. After inhaling fir essential oil, "comfortable," "relaxed," and "natural" feelings improved, negative moods decreased, and positive moods increased. In conclusion, inhalation of fir essential oil can help menopausal women in their physiological and psychological relaxation.

Aromatherapy for the brain: Lavender's healing effect on epilepsy, depression, anxiety, migraine, and Alzheimer's disease: A review article

Neurological diseases affect the nervous system, including the brain, spinal cord, cranial nerves, nerve roots, autonomic nervous system, neuromuscular junctions, and muscles. Herbal medicine has long been used to cure these diseases. One of these plants is lavender, which is composed of various compounds, including terpenes, such as linalool, limonene, triterpenes, linalyl acetate, alcohols, ketones, polyphenols, coumarins, cineole, and flavonoids. In this review, the literature was searched using scientific search engines and databases (Google Scholar, Science Direct, Scopus, and PubMed) for papers published between 1982 and 2020 via keywords, including review, lavender, and neurological disorders. This plant exerts its healing effect on many diseases, such as anxiety and depression through an inhibitory effect on GABA. The anti-inflammatory effects of this plant have also been documented. It improves depression by regulating glutamate receptors and inhibiting calcium channels and serotonergic factors, such as SERT. Its antiepileptic mechanism is due to an increase in the inhibitory effect of GABA and potassium current and a decrease in sodium current. Therefore, many vegetable oils are also used in herbal medicine. In this review, the healing effect of lavender on several neurological disorders, including epilepsy, depression, anxiety, migraine, and Alzheimer's disease was investigated. All findings strongly support the traditional uses of lavender. More clinical studies are needed to investigate the effect of the plants' pharmacological active constituents on the treatment of life-threatening diseases in humans. The limitations of this study are the low quality and the limited number of clinical studies. Different administration methods of lavender are one of the limitations of this review.

Benefit of inhalation aromatherapy as a complementary treatment for stress and anxiety in a clinical setting – A systematic review

OBJECTIVE

The purpose of this systematic review is to ascertain the impact of inhalation aromatherapy on stress and anxiety in clinical settings.

METHODS

A search strategy was developed using various databases. Randomised Controlled Trials (RCTs) as well as single and double-blind pilot clinical studies (non-RCT) using inhalation aromatherapy with an essential oil blend or a single essential oil were examined. All studies included a control intervention and use of a validated measurement tool. The time period under review was years 2000-2021. Due to the high level of heterogeneity and element of bias, a narrative synthesis was conducted.

RESULTS

The search strategy initially retrieved 628 studies and through application of the selection criteria and the removal of duplicates, 76 studies were selected for review with a total of 6539 patients. In 42% of the RCTs, physiological measures including vital signs and/or salivary cortisol were used in addition to questionnaires. Over 70% of the studies reported a positive effect on anxiety levels in the aromatherapy intervention groups compared with the control. However, in many cases this is limited by the absence of safety data, imprecise reporting of plant species and dosage of essential oil.

CONCLUSION

Inhalation aromatherapy has the potential to reduce stress and anxiety with data emerging to further support this result across a wide modality of clinical treatments. However, there is a clear need for the development of standard protocols for research in this area, generating measurable results which will create the opportunity for more rigorous evidence-based outcomes.

Effects of linalyl acetate on oxidative stress, inflammation and endothelial dysfunction: can linalyl acetate prevent mild cognitive impairment?

Mild cognitive impairment (MCI) is a major public health challenge with an increasing prevalence. Although the mechanisms underlying the development of MCI remain unclear, MCI has been reported to be associated with oxidative stress, inflammatory responses, and endothelial dysfunction, suggesting that agents that reduce these factors may be key to preventing MCI. Currently, no agents have been approved for the treatment of MCI, with the efficacy of commonly prescribed cholinesterase inhibitors remaining unclear. Relatively safe natural products that can prevent the development of MCI are of great interest. Linalyl acetate (LA), the major component of clary sage and lavender essential oils, has been shown to have a variety of pharmacological effects, including anti-hypertensive, anti-diabetic, neuroprotective, anti-inflammatory, and antioxidant properties, which may have the potential for the prevention of MCI. The present review briefly summarizes the pathogenesis of MCI related to oxidative stress, inflammatory responses, and endothelial dysfunction as well as the benefits of LA against these MCI-associated factors. The PubMed and Google Scholar databases were used to search the relevant literature. Further clinical research may lead to the development of new strategies for preventing MCI, particularly in high-risk populations with oxidative stress, inflammatory responses, and endothelial dysfunction (e.g., patients with hypertension and/or diabetes mellitus).

Effects of the aroma of lemone verbena (Aloysia citriodora Paláu) essential oil on anxiety and the hemodynamic profile before cesarean section: A randomized clinical trial

Background

Aromatherapy is a noninvasive method used for alleviating anxiety. Lemon verbena (Aloysia citriodora Paláu, LV) has been frequently used in traditional medicine as an anxiolytic agent due to its pharmacological ingredients.

Objective

This randomized controlled trial aimed to assess the effects of inhaling essential oil of LV on the level of anxiety and subsequent hemodynamic changes before cesarean section.

Methods

The recent study was a randomized single-blind trial. Participants (n = 84) were randomly divided into two groups: LV essential oil (group A) and placebo (group B). The intervention group underwent aromatherapy using three drops of LV essential oil at a distance of 10 cm for 30 min. The placebo group received aromatherapy in a similar fashion. The State-Trait Anxiety Inventory of Spielberger questionnaire was administered before and 5 min after aroma inhalation. Vital signs were recorded before and after aromatherapy. Likewise, pain severity was assessed using the Numeric Rating Scale and vital signs were recorded. Data were analyzed using t-test, χ ², and the Kolmogrov-Smirnov test through SPSS21 software.

Results

Anxiety level was significantly attenuated in group A after aromatherapy. Heart rate, respiratory rate, and blood pressure decreased after inhalation; but no significant variation of pain scores was observed after inhalation in both groups.

Conclusion

We concluded that LV decreased preoperative anxiety in this recent study, therefore, aromatherapy with LV essential oil as a preemptive adjuvant to relieve anxiety before cesarean section is recommended by us; although more studies are required to endorse the results.

The Effects of Essential Oils on the Nervous System: A Scoping Review

Essential oils are a mixture of natural aromatic volatile oils extracted from plants. The use of essential oils is ancient, and has prevailed in different cultures around the world, such as those of the Egyptians, Greeks, Persians, and Chinese. Today, essential oils are used in traditional and complimentary medicines, aromatherapy, massage therapies, cosmetics, perfumes and food industries. The screening effect of essential oils has been studied worldwide. They demonstrate a range of biological activities, such as antiparasitic, antifungal, antibacterial, antiviral, antioxidant, anti-inflammatory, anticancer, antiaging, and neuroprotective properties. In this scoping review, we provide a 10-year updated comprehensive assessment of volatile oils and their effects on the nervous system. MEDLINE, Scopus, and Google Scholar were systematically and strategically searched for original studies investigating these effects from 2012 to 2022. Approximately seventy studies were selected as included studies. Among these studies, several outcomes were reported, including antistress, antianxiety, analgesic, cognitive, and autonomic effects. Some essential oils showed developmental benefits, with the potential to induce neurite outgrowth. The neurotransmitter receptor level can also be modified by essential oil application. Physiological and pathophysiological outcome measures were reported. For physiological outcomes, arousal, cognitive performance, circadian eating behavior, emotional modulation, consumer acceptance, preferences, and willingness to buy were investigated. For pathophysiological conditions, pain, depression, anxiety, stress, sleep disorder, mental fatigue, agitated behavior, and quality of life were measured. In conclusion, essential oils showed promising effects on the nervous system, which can be further applied to their use in functional foods, drinks, and alternative therapy.

Non-contact neuromodulation of the human autonomic nervous system function via different odors: Sex, menstrual cycle, and odor dose- and duration-specific effects

In recent decades, it has been uncovered that the autonomic nervous system (ANS) can be influenced using non-contact neuromodulation via odor stimulation. Increasing parasympathetic-vagal activation of the ANS is integral to improving the sympathovagal balance between the sympathetic- and parasympathetic nervous systems, which is often imbalanced in several chronic inflammatory disorders, such as rheumatoid arthritis and inflammatory bowel diseases. Although research into olfactory stimulation has been observed on the ANS, it is still lacking in the exploration of odor concentration and odor-specific effects. This is particularly the case as research has not utilized specified tools, such as the olfactometer to provide precise odor delivery. Furthermore, no research has compared the results in separate sex cohorts to investigate the role of sex or the menstrual stage on the subsequent interactions. In this study, we investigated the olfactory stimulation effects of four natural odors (mushroom, lavender, jasmine, and rose) in three concentrations (low, moderate, and high) on the ANS. To observe activity from the ANS, we used an electrocardiogram (ECG) based heart rate variability (HRV) and eye-tracker technology (pupil diameter). We found for the first time in literature that there were acute dose- and duration-specific odor effects of odors on the ANS. We also found sex and menstrual cycle effects in this interaction. Furthermore, there were stark distinctions in sympathovagal activity dependent ANS activation (HRV) in comparison to the oculomotor nerve-parasympathetic/cervical sympathetic nerves dependent ANS responses (pupil diameter). Sympathovagal activity dependent HRV showed odor, sex, and menstrual-stage interactions in both divisions of the ANS while the pupil responses only indicated increased sympathetic activation. These results shed light on the use of odor-specific stimulation to modulate the ANS activity in the context of sex and the menstrual stage. Future studies should be performed using a chronic odor delivery design to investigate the long-term effects of odors on the ANS.

The Impact of Aromatherapy with Citrus Aurantium Essential Oil on Sleep Quality in Pregnant Women with Sleep Disorders: A Randomized Controlled Clinical Trial

Background

Sleep disorders are so prevalent during pregnancy. The present study was conducted to investigate the impact of aromatherapy with Citrus aurantium essential oil on sleep quality in pregnant women with sleep disorders.

Methods

This randomized clinical trial study was conducted on 68 pregnant women in their 28-34 weeks of pregnancy who sufferred sleep disorders and referred to Jiroft health centers in 2021 (January-June). Those meeting the inclusion criteria were divided into the intervention and placebo groups, using random sequence generated through the randomization website. They were given five drops of Citrus aurantium essential oil and the placebo twice a day, every day for one month in the form of facemasks which they inhaled through normal breathing for 20 minutes. Sleep quality was assessed before the intervention and one month after the start of the intervention. The demographic questionnaire and Pittsburgh Sleep Quality Index (PSQI) were used for collecting the data. Data analysis was performed using SPSS 24 software. The Mann-Whitney-U, Wilcoxon and fisher exact tests were carried out. P-value<0.05 was considered statistically significant.

Results

Before the intervention, the mean and standard deviation scores of pregnant women's sleep quality in the intervention (9.89±3.00) and placebo (8.12±2.53) groups were not significantly different (P=0.10). One month after the intervention, the score was significantly lower in the intervention group (4.37±1.85) than the placebo group (8.48±2.62) (P<0.001).

Conclusion

Based on the results of the present study, it seems that aromatherapy with Citrus aurantium essential oil enhances the sleep quality in pregnant women with sleep disorders, so it can be used to diminish sleep disorders in these women.Trial Registration Number: IRCT20200512047414N1.

[Fatigue relief by aromatherapy use in prenatal and postnatal women: a systematic review and meta-analysis]

Purpose

The purpose of this systematic review was to examine aromatherapy interventions for prenatal and postnatal women, and to determine the effectiveness of these interventions on fatigue.

Methods

Six national and international databases were reviewed to retrieve and collect studies published up to September 7, 2021, describing randomized controlled trials and controlled clinical trials of aromatherapy interventions for prenatal and postnatal women's fatigue. Of the 323 articles initially identified, 64 duplicates were excluded and 259 were screened. After further excluding 216 articles not related to PICO framework, 10 were selected for review. Two reviewers independently selected studies and conducted data extraction and quality appraisal using Cochran's Risk of Bias and Risk of Bias Assessment Tool for Non-randomized Studies.

Results

The quality of the 10 selected studies was overall satisfactory. A meta-analysis of three studies showed that aromatherapy with lavender oil? produced a 0.75-point reduction in postnatal mothers' fatigue when compared to control groups. Sleep quality was also analyzed as a secondary outcome of fatigue. A meta-analysis of four studies using lavender and/or orange peel oil found that aromatherapy produced a 0.98-point improvement in postnatal mothers' quality of sleep. Although a meta-analysis could not be conducted to synthesize the findings for fatigue in pregnant women, inhalation and massage therapy using lavender oil showed positive effects on prenatal fatigue and sleep quality.

Conclusion

Aromatherapy using lavender oil and orange peel oil is effective in improving prenatal and postnatal fatigue and sleep quality.

Effectiveness of aromatherapy for intrapartum and postpartum emotional problems among parturient women: A meta-analysis of randomized controlled trials

AIM

Perinatal negative emotions are common in parturient women, but the problems are often ignored. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) that investigated the effectiveness of aromatherapy for intrapartum anxiety (IPA) and postpartum emotional symptoms (PES).

METHODS

We searched PubMed, Embase, Cochrane library, and ClinicalTrials.gov to identify suitable RCTs for analysis, and the study was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

RESULTS

Nine RCTs were included. The meta-analysis showed aromatherapy reduced IPA during the early to active phase (standardized mean difference [SMD]: -1.56 [-2.55, -0.61]) and during the transition phase (SMD: -3.30 [-4.97, -1.63]) when compared with controls. For the postpartum period, the meta-analyses showed a reduction of postpartum depression (PPD) at week 2 (SMD: -0.43 [-0.82, -0.03]), and a non-significant trend toward the reduction of PPD at weeks 4-6 (SMD: -0.70 [-1.40, 0.01]).

CONCLUSION

Our study found some evidence supporting the effectiveness of aromatherapy in reducing intrapartum anxiety and PES. We recommend the optional use of aromatherapy for intrapartum and postpartum care.

Aromatherapy in Obstetrics: A Critical Review of the Literature

Aromatherapy is the use of highly concentrated aromatic plant oils administered in various ways for a wide range of therapeutic indications. The purpose of this review is to present an overview of the evidence on aromatherapy during the perinatal period. There is research on the prenatal use of aromatherapy to treat nausea and vomiting, reduce stress, and support immune function; the intrapartum use of aromatherapy for labor pain/anxiety and labor progress; and the postpartum use of aromatherapy for postcesarean symptoms, perineal trauma, sleep, and symptoms of depression and anxiety. Overall, the evidence suggests that aromatherapy can be administered safely and effectively in obstetrics.

Is aromatherapy effective in obstetrics? A systematic review and meta-analysis

The aim of this systematic review is to collect clinical trials conducted using essential oils (EOs) in obstetric symptoms by evaluating if and in which context the aromatherapy practice is effective in obstetrics. The research was conducted by using the databases of EMBASE, Medline, Biosis and Toxcenter, PubMed, and Google Scholar search engine, selecting articles from January 2004 to July 2020. This study was performed according to the MOOSE and PRISMA guidelines. Only the randomized clinical trials were considered, and in cases of multiple publications, it was considered the most up to date information. Biases were highlighted. In the presence of homogeneous data, pooling statistics and meta-analysis were applied. The research led to 71 articles, 17 of which were eligible. Among the trials selected, eight investigated the effectiveness of EOs on anxiety, depression, and stress. Two concerned the treatment of nausea and vomiting, six evaluated the application of EOs on labor for pain treatment, and two showed the effectiveness in the treatment of episiotomy. The heterogeneity of works carried out so far has made it possible to develop a meta-analysis only in the field of pain treatment during childbirth, identifying the effectiveness of the EOs Lavandula spp. and Rosa damascena.

The Immediate Effects of Lavender Aromatherapy Massage versus Massage in Work Stress, Burnout, and HRV Parameters: A Randomized Controlled Trial

Background

Occupational stress is a common issue faced by workers in every discipline. Complementary and alternative medicine (CAM) therapies, such as aromatherapy massage or massage, have antistress effects in the literature. The purpose of this randomized clinical trial with triple blinds is to evaluate the immediate effects of lavender aromatherapy massage for improving work stress, burnout, and HRV parameters of female employees in a university.

Methods

A total of 53 subjects in experimental group whereas 57 subjects in control group completed interventions and measurement and led to power of 0.98. Inferential statistics, as independent t-test, paired t-test, and Chi-Square test, were performed to verify the expected relationships.

Results

The present study found that subjects in experimental group reported a lower role stress and less inclined to type A personality trait after aromatherapy massage with lavender. For control group, only less inclined to type A personality trait was reported after receiving massage. For burnout, a significant lower personal burnout and work-related burnout were reported after aromatherapy massage whereas only increased client-related burnout was reported in control group. For HRV, both the experimental and control groups reported higher SDNN and RMSSD in time domain after intervention. Contradictory HRT and PSI in time domain were significantly lower after intervention. In frequency domain of HRV, both groups reported significantly higher value in VLF and HF. In addition, the experimental group reported significantly higher value in TP and LF after intervention.

Conclusions

Both the lavender aromatherapy massage and massage did show immediate effect on different dimensions of work stress, burnout, and HRV. These two interventions can be applied as routine leisure activities by personal preference to reduce stresses occurring in work environment.

Ambient Scent as a Positive Distraction in Long-Term Care Units: Theory of Supportive Design

AIM

This study was designed to explore the associations between an ambient scent environment and residents' wellness in long-term care facilities.

BACKGROUND

The number of older adults living in an institutional setting has been steadily but slowly increasing. Because of a higher chance of having psychological disorders among people living in institutional settings than people living in noninstitutional settings, providing a supportive institutional setting is critical to enhance their wellness. The theory of supportive design suggests healthcare facilities can lower people's stress levels via three conditions (i.e., perceived control, social support, and positive distractions).

METHOD

A single-blind and placebo-randomized controlled study investigated the impacts of ambient scent environment, as a positive distraction, on residents' depression levels. The recruited residents (N = 58) were randomly assigned into either the intervention group, which received a 1% dilution of lavender scent for 2 weeks nearby their bedside or the placebo group, which received a nonscent for 2 weeks.

RESULTS

Their depression levels were measured by the Geriatric Depression Scale. Based on the t tests, both intervention and placebo groups had improvement in depression, indicating a placebo effect of lavender scent. Further regression analyses explored the interaction effects of built environments (e.g., building, distance to a ventilation system, and square footage). However, no statistically significant impact of the built environment was found.

CONCLUSION

Despite a placebo effect of ambient scent environment and nonsignificant built environment on depression, this study has valuable implications of being a positive distraction during the healing process as developed by the Theory of Supportive design.

Effects of lavender on anxiety: A systematic review and meta-analysis

BACKGROUND

Anxiety is one of the uprising psychiatric disorders of the last decades and lavender administration has been traditionally suggested as a possible treatment. The objective of this review is to assess the efficacy of lavender, in any form and way of administration, on anxiety and anxiety-related conditions.

METHODS

The PRISMA guidelines were followed. Retrieved data were qualitatively and quantitatively synthesized. Randomized Controlled Trials (RCTs) and Non-Randomized Studies (NRSs) which investigated the efficacy of lavender, in any form and way of administration, on patients with anxiety, involved in anxiety-inducing settings or undergoing anxiety-inducing activities, compared to any type of control, without language restrictions, were identified through electronic database searches. Medline via PubMed, Scopus, Web of Science, Cochrane Library, EMBASE, and Google Scholar were systematically searched. All databases were screened up to November 2018. Risk of bias was assessed with the Cochrane risk-of-bias tool and the following domains were considered: randomization, allocation sequence concealment, blinding, incomplete outcome data, selective outcome reporting, and other biases.

RESULTS

65 RCTs (7993 participants) and 25 NRSs (1200 participants) were included in the qualitative synthesis and 37 RCTs (3964 participants) were included in the quantitative synthesis. Overall, the qualitative synthesis indicated that 54 RCTs and 17 NRSs reported at least a significant result in favor of lavender use for anxiety. The quantitative synthesis showed that lavender inhalation can significantly reduce anxiety levels measured with any validated scale (Hedges' g = -0.73 [95% CI -1.00 to -0.46], p < 0.00001, 1682 participants), as well as state anxiety (Spielberger's state-trait anxiety inventory (STAI)-State mean difference = -5.99 [95% CI -9.39 to -2.59], p < 0.001, 901 participants) and trait anxiety (STAI-Trait mean difference = -8.14 [95% CI -14.44 to -1.84], p < 0.05, 196 participants). Lavender inhalation did not show a significant effect in reducing systolic blood pressure as a physiological parameter of anxiety. A significant effect in diminishing anxiety levels was also found in favor of the use of oral Silexan® 80 mg/die for at least 6 weeks (Hamilton Anxiety Scale mean difference = -2.90 [95% CI -4.86 to -0.95], p = 0.004, 1173 participants; Zung Self-rating Anxiety Scale mean difference = -2.62 [95% CI -4.84 to -0.39], p < 0.05, 451 participants) or of the administration of massage with lavender oil (Hedges' g = -0.66 [95% CI -0.97 to -0.35], p < 0.0001, 448 participants).

DISCUSSION

The most important limitation of this review is the low average quality of available studies on the topic. The majority of included RCTs were characterized by a high overall risk of bias. Another limitation regards the heterogeneity of study designs, especially with regard to non-oral ways of administration. Overall, oral administration of lavender essential oil proves to be effective in the treatment of anxiety, whereas for inhalation there is only an indication of an effect of reasonable size, due to the heterogeneity of available studies. Lavender essential oil administered through massage appears effective, but available studies are not sufficient to determine whether the benefit is due to a specific effect of lavender. Further high-quality RCTs with more homogeneous study designs are needed to confirm these findings. Available information outlines a safe profile for lavender-based interventions, although more attention should be paid to the collection and reporting of safety data in future studies. Considering these findings, since treatments with lavender essential oil generally seem safe, and, in the case of inhalation, also simple and inexpensive, they are a therapeutic option which may be considered in some clinical contexts.

OTHER

The present systematic review was not funded and was registered in PROSPERO under the following number: CRD42019130126.

Preterm Birth, Inflammation and Infection: New Alternative Strategies for their Prevention

BACKGROUND

Worldwide, the progress in reducing neonatal mortality has been very slow. The rate of preterm birth has increased over the last 20 years in low-income and middle-income countries. Its association with increased mortality and morbidity is based on experimental studies and neonatal outcomes from countries with socioeconomic differences, which have considered implementing alternative healthcare strategies to prevent and reduce preterm births.

METHODS

Currently, there is no widely effective strategy to prevent preterm birth. Pharmacological therapies are directed at inhibiting myometrial contractions to prolong parturition. Some drugs, medicinal plants and microorganisms possess myorelaxant, anti-inflammatory and immunomodulatory properties that have proved useful in preventing preterm birth associated with inflammation and infection.

RESULTS

This review focuses on the existing literature regarding the use of different drugs, medicinal plants, and microorganisms that show promising benefits for the prevention of preterm birth associated with inflammation and infection. New alternative strategies involving the use of PDE-4 inhibitors, medicinal plants and probiotics could have a great impact on improving prenatal and neonatal outcomes and give babies the best start in life, ensuring lifelong health benefits.

CONCLUSION

Despite promising results from well-documented cases, only a small number of these alternative strategies have been studied in clinical trials. The development of new drugs and the use of medicinal plants and probiotics for the treatment and/or prevention of preterm birth is an area of growing interest due to their potential therapeutic benefits in the field of gynecology and obstetrics.

The effect of aromatherapy on mental, physical symptoms, and social functions of females with premenstrual syndrome: A randomized clinical trial

Objective:

This study was designed to compare the effect of aromatherapy with Rosa Damascena and Citrus Aurantium blossom on psychological and physical symptoms and social functions of females with premenstrual syndrome.

Materials and Methods:

This double-blind clinical trial was conducted on 95 students. They were randomly divided into three aromatherapy groups (aromatherapy with 4% concentration of Rosa Damascena and 0.5% concentration of Citrus Aurantium blossom essential oil) and aromatherapy with sweet almond oil (as control group). Premenstrual Symptoms Screening Tool questionnaire (PSST) was completed before and during the first and second month of the intervention. Data were analyzed by SPSS software version 22.

Results:

After intervention, the scores of mental symptoms decreased in all three groups and this decrease was significant in both Citrus Aurantium (P = 0.004) and Rosa Damascena groups (P = 0.007). The score of physical symptoms was decreased in all three groups but it was significant only in the Rosa Demecensa group (P = 0.042). The reduction of effect of symptoms on social function was observed in two intervention groups which were significant only in Rosa Damascena group (P < 0.001).

Conclusion:

Essential oils of Rosa Damascena and Citrus Aurantium were both effective in improving the symptoms of premenstrual syndrome but the effect of Rosa Damascena, with regard to improvement of symptoms of premenstrual syndrome was more than that of Citrus Aurantium in all psychological, physical, and social aspects.

Essential oils disrupt steroidogenesis in a feto-placental co-culture model

We determined whether 5 common essential oils (basil, fennel seed, orange, black pepper and sage) interfered with feto-placental steroidogenesis in a co-culture model composed of fetal-like adrenocortical (H295R) and placental trophoblast-like (BeWo) cells. After a 24 h exposure, only basil and fennel seed oil significantly increased hormone concentrations of estradiol, estrone, dehydroepiandrosterone (DHEA), androstenedione, progesterone, and estriol. Basil and fennel seed oil were shown to significantly alter the expression of steroidogenic enzymes involved in cholesterol transport and steroid hormone biosynthesis, including StAR, CYP11A1, 3β-HSD1/2, SULT2A1, and HSD17β1, -4, and -5. Also, basil and fennel seed oil stimulated placental-specific promoter I.1 and pII-derived CYP19 mRNA in BeWo and H295R cells, respectively, as well as, increased CYP19 enzyme activity. Our results indicate that further study is necessary to determine the potential risks of using basil and fennel seed oils during pregnancy considering their potential to disrupt steroidogenic enzyme activity and expression in vitro.

Lavandula Essential Oils: A Current Review of Applications in Medicinal, Food, and Cosmetic Industries of Lavender

The global essential oil market has been steadily increasing in size over the past few years, and is estimated to reach ca. $7.5 billion USD per annum by 2018. Lavenders ( Lavandula; Lamiaceae) contribute significantly to this market, yielding ca. 1500 tons of essential oils which are primarily used in cosmetics, personal care products, and medicines. Recent literature indicates that these oils may also have applications in food preservation and pest control, among others. The medicinal and pharmaceutical properties of lavenders are chiefly due their essential oils, in particular the major essential oil constituents linalool and linalyl acetate, although certain activities have been attributed to the phenolic compounds. In addition, there is evidence that the major and minor essential oil constituents act synergistically to provide various biological effects. A substantial amount of current research focuses on evaluating the biological activities of lavender essential oils for potential use in traditional and complementary medicine, food systems, cosmetic and fragrance formulations, and insect control products. This review examines recent progress in these areas, and highlights the current and future implications for these economically and medicinally valuable plants.

Effects of Aromatherapy Massage on Pregnant Women's Stress and Immune Function: A Longitudinal, Prospective, Randomized Controlled Trial

OBJECTIVES

This study's aims are to examine the effects of aromatherapy massage on women's stress and immune function during pregnancy.

METHODS

This longitudinal, prospective, randomized controlled trial recruited 52 healthy pregnant women from a prenatal clinic in Taipei using convenience sampling. The participants were randomly assigned to the intervention (n = 24) or control (n = 28) group using Clinstat block randomization. The intervention group received 70 min of aromatherapy massage with 2% lavender essential oil every other week (10 times in total) for 20 weeks; the control group received only routine prenatal care. In both groups, participants' salivary cortisol and immunoglobulin A (IgA) levels were collected before and after the intervention group received aromatherapy massage (every month from 16 to 36 weeks gestation) and were analyzed using enzyme-linked immunosorbent assay.

RESULTS

The pregnant women in the intervention group had lower salivary cortisol (p < 0.001) and higher IgA (p < 0.001) levels immediately after aromatherapy massage than those in the control group, which did not receive massage treatment. Comparing the long-term effects of aromatherapy massage on salivary IgA levels between groups at different times, the study found that the pretest salivary IgA levels at 32 (p = 0.002) and 36 (p < 0.001) weeks gestational age (GA) were significantly higher than the pretest IgA at 16 weeks GA (baseline).

CONCLUSIONS

This study presented evidence that aromatherapy massage could significantly decrease stress and enhance immune function in pregnant women. The findings can guide clinicians or midwives in providing aromatherapy massage to women throughout the pregnancy.

Effects of prenatal yoga on women's stress and immune function across pregnancy: A randomized controlled trial

OBJECTIVE

The effects of prenatal yoga on biological indicators have not been widely studied. Thus, we compared changes in stress and immunity salivary biomarkers from 16 to 36 weeks' gestation between women receiving prenatal yoga and those receiving routine prenatal care.

DESIGN

For this longitudinal, prospective, randomized controlled trial, we recruited 94 healthy pregnant women at 16 weeks' gestation through convenience sampling from a prenatal clinic in Taipei. Participants were randomly assigned to intervention (n=48) or control (n=46) groups using Clinstat block randomization.

INTERVENTION

The 20-week intervention comprised two weekly 70-min yoga sessions led by a midwife certified as a yoga instructor; the control group received only routine prenatal care.

MAIN OUTCOME MEASURES

In both groups, participants' salivary cortisol and immunoglobulin A levels were collected before and after yoga every 4 weeks from 16 to 36 weeks' gestation.

RESULTS

The intervention group had lower salivary cortisol (p<0.001) and higher immunoglobulin A (p<0.001) levels immediately after yoga than the control group. Specifically, the intervention group had significantly higher long-term salivary immunoglobulin A levels than the control group (p=0.018), and infants born to women in the intervention group weighed more than those born to the control group (p<0.001).

CONCLUSION

Prenatal yoga significantly reduced pregnant women's stress and enhanced their immune function. Clinicians should learn the mechanisms of yoga and its effects on pregnant women. Our findings can guide clinicians to help pregnant women alleviate their stress and enhance their immune function.

Effects of Aroma Inhalation Therapy on Stress, Anxiety, Depression, and the Autonomic Nervous System in High-risk Pregnant Women

PURPOSE

The purpose of this study was to investigate the effect of aroma inhalation therapy on stress, anxiety, depression, and an autonomic nervous system reaction in high-risk hospitalized pregnant women.

METHODS

A quasiexperimental study used a non-equivalent control group non-synchronized design. Fifty high-risk hospitalized pregnant women were selected as participants on delivery room and maternity ward at university hospital. Twenty-five were selected for the experimental group while 25 were assigned to a control group. Neroli essential oil was used for aroma therapy and was already identified as not being hazard to pregnant women. It provided emotional stability from previous study. The participants inhaled Neroli 2 minutes, 3 times (9 am to 10 am, 4 pm to 5 pm, just before sleep) a day. A total of 15 sessions were held from the day of the preliminary investigation. Pre and post written survey and measuring an autonomic nervous system reaction were collected from both groups.

RESULTS

The data were analyzed by χ2 test, t-test, and paired t-test. There was a statistically significant difference in stress (t=-3.98, p<.001) between the experimental group and the control group.

CONCLUSION

These findings indicate that aroma inhalation therapy is effective as a nursing intervention for the stress relief of hospitalized high-risk pregnant women.

The Effectiveness of Aromatherapy for Depressive Symptoms: A Systematic Review

Background. Depression is one of the greatest health concerns affecting 350 million people globally. Aromatherapy is a popular CAM intervention chosen by people with depression. Due to the growing popularity of aromatherapy for alleviating depressive symptoms, in-depth evaluation of the evidence-based clinical efficacy of aromatherapy is urgently needed. Purpose. This systematic review aims to provide an analysis of the clinical evidence on the efficacy of aromatherapy for depressive symptoms on any type of patients. Methods. A systematic database search was carried out using predefined search terms in 5 databases: AMED, CINHAL, CCRCT, MEDLINE, and PsycINFO. Outcome measures included scales measuring depressive symptoms levels. Results. Twelve randomized controlled trials were included and two administration methods for the aromatherapy intervention including inhaled aromatherapy (5 studies) and massage aromatherapy (7 studies) were identified. Seven studies showed improvement in depressive symptoms. Limitations. The quality of half of the studies included is low, and the administration protocols among the studies varied considerably. Different assessment tools were also employed among the studies. Conclusions. Aromatherapy showed potential to be used as an effective therapeutic option for the relief of depressive symptoms in a wide variety of subjects. Particularly, aromatherapy massage showed to have more beneficial effects than inhalation aromatherapy.

Aromatherapy Improves Work Performance Through Balancing the Autonomic Nervous System

OBJECTIVE

This study analyzed the efficacy of aromatherapy in improving work performance and reducing workplace stress.

SUBJECTS

The initial sample comprised 42 administrative university workers (M_age = 42.21 years, standard deviation = 7.12; 10 male).

INTERVENTION

All sessions were performed in a university computer classroom. The participants were randomly assigned into an aromatherapy group (AG) and a control group (CG), and they were invited to participate in a specific session only once. They were seated in front of a computer. During the intervention period, some oil diffusers were switched on and were in operation throughout the session with petitgrain essential oil for AG sessions and a neutral oil (almond) for CG sessions. At the same time, participants completed a computer task on a specific Web site typing on their keyboard until they had finished it. The single times were different for all participants and were recorded on the Web site as "performance time."

OUTCOME MEASURES

Before and after the intervention, participants completed anxiety and mood state questionnaires (the Stait-Trait Anxiety Inventory [STAI] and the Profile of Mood States [POMS]). Heart-rate variability (HRV) was measured before (PRE), during (20-25 min), and after (POS) the intervention to analyze autonomic nervous system regulation.

RESULTS

The AG performed the Web site task 2.28 min faster than the CG (p = 0.05). The two groups showed differences in the following HRV parameters: low frequency (p = 0.05), high frequency (p = 0.02), standard deviation of all RR intervals (p = 0.05), and root mean square of differences (p = 0.02). All participants in all groups showed a decrease from PRE to POST for STAI (p < 0.001), Tension-POMS (p < 0.001), and Vigour-POMS (p = 0.01) scales.

CONCLUSIONS

Aromatherapy (inhaling petitgrain essential oil) can improve performance in the workplace. These results could be explained by an autonomic balance on the sympathetic/parasympathetic system through a combined action of the petitgrain main components (linalyl acetate, linalool, and myrcene). The final effect could be an improvement of the mental and emotional condition by a combination of reducing the stress level and increasing the arousal level of the participants in terms of attentiveness and alertness.

Yoga for Heart Rate Variability: A Systematic Review and Meta-analysis of Randomized Clinical Trials

The objective of this systematic review is to summarize and critically assess the effects of yoga on heart rate variability (HRV). Nine databases were searched from their inceptions to June 2014. We included randomized clinical trials (RCTs) comparing yoga against any type of control intervention in healthy individuals or patients with any medical condition. Risk of bias was assessed using the Cochrane criteria. Two reviewers performed the selection of studies, data extraction, and quality assessments independent of one another. Fourteen trials met the inclusion criteria. Only two of them were of acceptable methodological quality. Ten RCTs reported favourable effects of yoga on various domains of HRV, whereas nine of them failed to do so. One RCT did not report between-group comparisons. The meta-analysis (MA) of two trials did not show favourable effects of yoga compared to usual care on E:I ratio (n = 61, SMDs = 0.63; 95% CIs [-0.72 to 1.99], p = 0.36; heterogeneity: r(2) = 0.79, χ(2) = 5.48, df = 1, (p = 0.02); I(2) = 82%). The MA also failed to show statistically significant differences between the groups regarding the 30:15 ratio (n = 61, SMDs = 0.20; 95% CIs [-0.43 to 0.84], p = 0.53; heterogeneity: r(2) = 0.07, χ(2) = 1.45, df = 1, (p = 0.23); I(2) = 31%). The data from the remaining RCTs were too heterogeneous for pooling. These results provide no convincing evidence for the effectiveness of yoga in modulating HRV in patients or healthy subjects. Future investigations in this area should overcome the multiple methodological weaknesses of the previous research.

Association of Complementary and Alternative Therapies With Mental Health Outcomes in Pregnant Women Living in a Postdisaster Recovery Environment

PURPOSE

The objective of this study was to determine if complementary and alternative medicine therapies are associated with mental health in postdisaster environments.

DESIGN

Pregnant women (N = 402) were interviewed between 2010 and 2012 as part of a larger cross-sectional study on hurricane recovery and models of prenatal care.

METHODS

Symptoms of depression (Edinburgh Postnatal Depression Screen), prenatal anxiety (Revised Prenatal Distress Questionnaire), posttraumatic stress (PCL-S), and perceived stress (PSS) were examined. Logistic regression was used to adjust for income, race, education, parity, and age. The most commonly reported therapies were prayer, music, multivitamins, massage, and aromatherapy.

FINDINGS

Mental illness symptoms were common (30.7% had likely depression, 17.4% had anxiety, and 9.0% had posttraumatic stress). Massage was protective for depression (Edinburgh Postnatal Depression Index [EDSI] >8; adjusted odds ratio [aOR] = 0.6, 95% confidence interval [CI] = 0.3-0.9), while use of aromatherapy (aOR = 1.9, 95% CI = 1.1-3.2) and keeping a journal (aOR = 1.9, 95% CI = 1.1-3.2) were associated with increased odds of depression. Aromatherapy was associated with symptoms of pregnancy-related anxiety (aOR = 2.0, 95% CI = 1.1-3.8).

CONCLUSIONS

Symptoms of mental illness persist after disaster, when untreated. Nurses should consider assessing for complementary and alternative medicine utilization in pregnancy as a potentially protective factor for mental health symptoms.

The Outcomes of Complementary and Alternative Medicine Use among Pregnant and Birthing Women: Current Trends and Future Directions

Complementary and alternative medicine is used by a substantial number of pregnant women and maternity care providers are often faced with the task of ensuring women are using safe and effective treatments while respecting a woman's right to autonomous decision-making. In the era of evidence-based medicine maternity health professionals are expected to draw upon the best available evidence when making clinical decisions and providing health advice. This review will outline the current trends in research evidence associated with the outcomes of complementary and alternative medicine use amongst pregnant and birthing women as well as highlight some potential directions for future development in this important yet largely unknown topic in contemporary maternity care.

The physical effects of aromatherapy in alleviating work-related stress on elementary school teachers in taiwan

People use aromatherapy to relieve the symptoms of physical and psychological stress. However, previous studies have not precisely clarified a scientific basis for the beneficial effects of aromatherapy. Therefore, the overall purpose of this study was to elucidate the beneficial effect of aromatherapy in relieving work-related stress. Twenty-nine elementary school teachers from Taiwan participated in this study. The experimental procedures comprised 2 phases. First, we verified the effect of aromatherapy by conducting 2 blind tests. We used natural bergamot essential oil extracted from plants and synthesized a chemical essential oil as the placebo to do the aromatherapy. Second, we analyzed the performance of the aromatherapy treatment on the teachers who had various workloads. We measured the teachers' heart rate variability to evaluate their autonomic nervous system activity. The results show that only the natural bergamot essential oil had an effect and that the aromatherapy treatment relieved work-related stress of teachers with various workloads. However, the aromatherapy treatment had a weak effect on young teachers who had a heavy workload. Moreover, the aromatherapy treatment exhibited no effect on teachers who belong to the abnormal body mass index subgroup having a heavy workload.

Does lavender aromatherapy alleviate premenstrual emotional symptoms?: a randomized crossover trial

Background

A majority of reproductive-age women experience a constellation of various symptoms in the premenstrual phase, commonly known as premenstrual syndrome (PMS). Despite its prevalence, however, no single treatment is universally recognized as effective, and many women turn to alternative approaches, including aromatherapy, a holistic mind and body treatment. The present study investigated the soothing effects of aromatherapy on premenstrual symptoms using lavender (Lavandula angustifolia), a relaxing essential oil, from the perspective of autonomic nervous system function.

Methods

Seventeen women (20.6 ± 0.2 years) with mild to moderate subjective premenstrual symptoms participated in a randomized crossover study. Subjects were examined on two separate occasions (aroma and control trials) in the late-luteal phases. Two kinds of aromatic stimulation (lavender and water as a control) were used. This experiment measured heart rate variability (HRV) reflecting autonomic nerve activity and the Profile of Mood States (POMS) as a psychological index before and after the aromatic stimulation.

Results

Only a 10-min inhalation of the lavender scent significantly increased the high frequency (HF) power reflecting parasympathetic nervous system activity in comparison with water (aroma effect: F = 4.50, p = 0.050; time effect: F = 5.59, p = 0.017; aroma x time effect: F = 3.17, p = 0.047). The rate of increase in HF power was greater at 10–15 min (p = 0.051) and 20–25 min (p = 0.023) in the lavender trial than in the control trial with water. In addition, POMS tests revealed that inhalation of the aromatic lavender oil significantly decreased two POMS subscales—depression–dejection (p = 0.045) and confusion (p = 0.049)—common premenstrual symptoms, in the late-luteal phase, as long as 35 min after the aroma stimulation.

Conclusions

The present study indicated that lavender aromatherapy as a potential therapeutic modality could alleviate premenstrual emotional symptoms, which, at least in part, is attributable to the improvement of parasympathetic nervous system activity. This study further implies that HRV could evaluate the efficacy of aromatherapy using various fragrances to relieve premenstrual symptoms, and ultimately, support the mind and body health of women.