Mona Najaf Najafi - Clinical Research Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Farnaz Hadavi - Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Shima Vazirinasab Kermani - Department of Obstetrics and Gynecology, Kerman University of Medical Sciences, Kerman, Iran.
Fahime Vafisani - MSc of Nutrition, Medicine Faculty, Mashhad University of Medical Sciences, Mashhad, Iran.

Background: Primary dysmenorrhea is painful bleeding in the absence of any confirmed pelvic disorder, which is often accompanied by nausea, vomiting, and headache. The tendency of patients to use herbal and alternative medicine is more than the past. Regarding the fact that no meta-analytical study has been done to evaluate aromatherapy with Iranian herbal medicines, this study was conducted to evaluate the effect of aromatherapy with different herbs on premenstrual syndrome andprimary dysmenorrhea. Materials and Methods: English and Persian electronic databases were systematically searched without any time limit until May 5, 2019. The references of review articles and clinical trials were also reviewed. Two authors independently reviewed the titles and abstracts, if the subject of the article was relevant, the full article was extracted and criticized. Comprehensive Meta-Analysis software was used to conduct meta-analysis. Results: Finally, 14 studies were entered into a meta-analysis. The mean standard difference between two groups of aromatherapy with different plants and control group was -1.06 (95%CI: -1.33 to -0.848; p<0.001). Aromatherapy with roses (SMD=-1.35; 95%CI= -0.01 to -2.69; p=0.048), and aromatherapy with lavender (SMD= -1.08; 95% CI: -0.73 to -1.43; p<0.001) compared to the control group had better effect in reduction of pain severity. According to three studies, aromatherapy with Geranium 2% essential oil, Citrus aurantium blossom essential oil, and Rosa damascena were more effective than control group regarding mental and physical signs. Conclusion This meta-analysis showed that aromatherapy with different Iranian herbs such as lavender and rose could significantly reduce primary dysmenorrhea and premenstrual syndrome. This treatment can be used specifically in patients who cannot tolerate conventional treatments.

Aromatherapy, Dysmenorrhea, Herbal medicines, Iran, Premenstrual Syndrome