Sleep Journal Club: Aromatherapy for PMS

Here’s one for the ladies with PMS!

Sure, there are tons of tips and tricks out there for better sleep, but scientists and doctors rely on randomized, placebo-controlled trials to back up their advice. Sleep, like many body functions and symptoms, is highly susceptible to the placebo effect. That’s why studies that randomly assign participants to either an active treatment or placebo group are the gold standard, ideally with neither the participants nor the researchers knowing who’s receiving what.

There’s a general dearth of high quality research on natural treatments for sleep, so I was delighted to come across a clinical trial* that looked at PMS, essential oils, and (of course) sleep. This study, published in BMC Complementary Medicine and Therapies, was from a team in Turkey.

99 women age 18–45 years were enrolled, and of those, 90 were randomly assigned to one of three groups (30 per group): placebo (sweet almond oil), bergamot essential oil, or grapefruit essential oil. The main outcome was the Premenstrual Syndrome Scale (PMSS), a 44-item questionnaire with a max score of 220, with higher scores meaning worse symptoms. To be included in the study, the participants had to have a score of >110, and have regular periods.

Here’s how they did it: in a “bright and odorless” ventilated room, participants placed three drops of their assigned essential oil on a cotton ball, and inhaled the aromas while holding the cotton ball about 15 cm (6 inches) away, for 30 minutes. They did this aromatherapy three times a day, for four consecutive days during the luteal phase (the seven days before menstruation), repeated over three menstrual cycles. (So, a total of 36 sessions totaling 18 hours!)

And now for the results… 🥁🥁🥁

The total PMSS score improved significantly in both the bergamot and grapefruit groups, while it actually increased (got worse) in the placebo group. Looking specifically at the sleep-related sub-score, the grapefruit group showed significant improvement. The bergamot group didn’t see a notable sleep change, and the placebo group’s sleep score worsened.

In short: this is high-quality evidence that aromatherapy with bergamot or grapefruit essential oils, used three times daily, can help improve PMS symptoms. Grapefruit essential oil, in particular, helps with sleep problems occuring as part of PMS.

A couple important notes: 1) The aromatherapy wasn’t done at bedtime or during sleep. 2) The study excluded anyone with respiratory conditions like asthma or bronchitis, anosmia (inability to smell), pregnancy or suspected pregnancy, allergies to aromatherapy, abnormal uterine bleeding, use of contraceptives, use of other complementary therapies, fibroids, polycystic ovaries, use of analgesics, use of hormone medications, diabetes, and hypertension. 3) The study was not blinded, ie the women knew which group they were in, as they could obviously smell which group they were assigned to.

Not into essential oils? Fun fact: bergamot is featured in Earl Grey and Lady Grey tea. (Fun opinion: Earl Grey is the best caffeinated tea!)

*Özer E, Döner Şİ, Dağ Tüzmen H. The effect of aromatherapy intervention with Bergamot and Grapefruit essential oils on premenstrual syndrome and menstrual symptoms: a randomized controlled trial. BMC Complement Med Ther. 2025 May 1;25(1):162. doi: 10.1186/s12906-025-04857-3. PMID: 40312670; PMCID: PMC12044709. Full text