Can massage therapy and aromatherapy massage alleviate the symptoms of menopause?

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 non-hormonal 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 menopausal 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 massages, 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 geranium, 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 translated from English into Farsi, and the translation validated in a pilot study of 50 women
who were demographically similar to the participants.

The Results
No statistically significant differences were observed among the three groups in terms of age, age at
menopause or body mass index. The baseline scores for menopausal symptoms 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.

References
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.