Scenting Relief-Aromatherapy for alleviating Primary Dysmenorrhea in Adolescents and Young Women: A systematic review and meta-analysis

Hasan Nawaz Tahir^1*Naureen Rehman^2*Mursala Tahir³Nemer Alotaibi¹Mohammed Saleh Al-Dhubaibi¹Noureldaim Elnoman Elbadawi Mohamed¹Imran Zaheer¹Yousaf Ali¹

• ¹Shaqra University, Shaqra, Saudi Arabia
• ²Aga Khan University Hospital, Pakistan, Karachi, Pakistan
• ³Jinnah Sindh Medical University, Karachi, Pakistan

Background: Primary dysmenorrhea (PD) is prevalent among adolescents and young women, significantly impacting their quality of life. Aromatherapy has emerged as a promising non-pharmacological intervention for managing PD, but its age-specific efficacy, mode of application, and type of aroma oils remain underexplored. Thus, this systematic review evaluate aromatherapy's effectiveness in alleviating PD symptoms among adolescents and young women aged 10-24. Methods: Data were sourced from PubMed, Google Scholar, ScienceDirect, Cochrane, Bielefeld Academic Search Engine (BASE), and through cross-referencing. Results were synthesized by conducting meta-analysis using random-effects models, and assessing heterogeneity using I² statistics. Quality assessment of the included studies was also carried out. Results: A total of 15 studies were included for meta-analysis of which 4 were Randomized controlled trials (RCTs) and 11 were non-RCTs. Aromatherapy significantly reduced PD pain score across studies, with a standardized mean difference (SMD) of -3.19 (CI -5.09, -1.28; I² = 98%) and -0.98 (CI-1.40, -0.57; I² = 64%) in quasi-experimental studies and RCTs, respectively. In addition, moderate to severe pain was measured categorically (RR: 0.39; CI 0.25, 0.60; I² = 36%).. Adolescents exhibited the most significant benefit (SMD: -3.64; CI - 6.24, -1.03; I² 98%; RR: 0.39; CI 0.25, 0.60; I² = 36%), compared to young women (SMD: - 1.04; CI -1.35, -0.72; I² 53%). Inhalation aromatherapy (SMD -3.09; CI -5.06, -1.12; I² 98%) showed superior efficacy over massage (SMD -1.20; CI -1.45, -0.96; I² 7%). Rose essential oil, cinnamon, and peppermint oil demonstrated significant efficacy, while lavender and lemon oils showed varying outcomes. 3 Conclusion: This study supports aromatherapy's effectiveness in reducing PD symptoms, particularly among adolescents. Standardized protocols and well-designed trials are needed to optimize aromatherapy's therapeutic potential for managing menstrual pain across diverse age groups, addressing current gaps in research methodology and oil-specific efficacy. Trial Registration: The study protocol was registered in the International Prospective Register of Systematic Reviews. Registration Number: CRD42024552178.