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- Clary Sage (Salvia sclarea) Essential Oil
- Lavender (Lavandula angustifolia) Essential Oil
- Blood Pressure
- Incontinence
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Date:
04-15-2013 | HC# 031361-470
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Re: Clary Sage Essential Oil, but Not Lavender Essential Oil, Reduces Stress during Urodynamic Examinations
Seol GH, Lee YH, Kang P, You JH, Park M, Min SS. Randomized controlled
trial for Salvia sclarea or Lavandula angustifolia: Differential
effects on blood pressure in female patients with urinary incontinence
undergoing urodynamic examination. J
Altern Complement Med. January 29, 2013; [epub ahead of print]. doi: 10.1089/acm.2012.0148.
Incontinence,
or uncontrolled bladder activity, can be very disruptive; this condition in
women may be due to problems in childbirth, aging, or infection, among other
causes. Diagnoses of incontinence are made by utilizing urodynamic measurements
(a variety of methods estimating bladder and urinary function). As this testing
is intimate and can be embarrassing and uncomfortable, it can increase patient
stress, interfering with the testing process.
Previous
studies have reported that lavender (Lavandula
angustifolia) essential oil promotes muscle relaxation and attenuates
anxiety in vivo. Linalool, a compound found in lavender, is reported to
modulate signaling upstream of muscle movement. In addition, clary sage (Salvia sclarea) essential oil has been
shown to attenuate both depression and stress either in vivo or clinically.
This double-blind, randomized, controlled trial investigated the potential
effects of the inhalation of lavender, clary sage, or almond oil (control) on
stress alleviation in women undergoing urodynamic assessment.
Patients (n=45) were randomly
assigned to receive either 5% volume/volume lavender or clary sage essential
oil in an almond (Prunus dulcis) carrier
oil, or almond oil alone (control). Patient dropouts included n=5 from the
control group and n=3 from both the lavender and clary sage groups. No reasons were
given for the dropouts. This resulted in a total of n=12 for both the lavender
and clary sage groups and n=10 in the control group. Included patients were
diagnosed with incontinence and undergoing urodynamic examination; were >20
years of age; and had a fully functional sense of smell and no allergies to the
treatments. They also were not being treated for any psychiatric disturbances,
were not smokers or alcohol-drinkers, and had no chronic illnesses. If patients
were "examined" longer or shorter than 1 hour, they were excluded.
Almond
oil and both the clary sage and lavender essential oils (produced from flowers)
were provided for the study by Aromarant Co. Ltd.; Röttingen, Germany.
Compounds in both treatment oils were detected by gas chromatography-mass
spectrometry (GC-MS). Major volatile compounds of lavender oil were linalyl
acetate (38.5%), linalool (33.3%), and terpinen-4-ol (2.1%). In clary sage oil,
linalyl acetate (63.7%), linalool (17.7%), and α-terpineol (2.5%) were the
major volatile components.
For
the study, 2 ml of oils were placed on pads, and patients inhaled while pads
were kept 30 cm from the nose. Inhalation continued for 60 minutes, concurrent
with the urodynamic assessment. A questionnaire was used to assess stress, both
physical and psychological. In addition, blood pressure, pulse, and respiratory
rates were evaluated both prior to and following urodynamic assessment. Measurements
of salivary cortisol were also taken at the same time of day prior to and after
the urodynamic exam.
Patients
(all female) were an average age of 56.2 years. Urge urinary incontinence (UUI)
was diagnosed in n=6 patients, with n=13 patients suffering from stress urinary
incontinence (SUI). A mix of incontinence types were found in n=15 patients. No
significant differences were reported between groups for baseline stress
scores, blood pressure, or pulse and respiratory rates.
As
compared to baseline, the clary sage group had significantly decreased systolic
blood pressure (SBP) (4.7%, 117.0 ± 12.73 mmHg vs. 111.2 ± 11.30 mmHg, P=0.019)
after 60 minutes of inhalation. SBP of the clary sage group was also
significantly less than that of the control group and the lavender group after
the study (P=0.048 and P=0.026, respectively).
Additionally,
diastolic blood pressure (DBP) was significantly decreased in the clary sage
group from baseline (5.1%, 77.6 ± 5.18 mmHg vs. 73.6 ± 5.74 mmHg, P<0.016).
DBP of this group was also significantly less than those in the lavender group
(P<0.034). In comparison to the control group, respiratory rates of those in
the lavender and clary sage groups were significantly less (P=0.045 and
P<0.01, respectively). There were no significant differences detected in
pulse rates or salivary cortisol concentrations across the study.
In
summary, patients who inhaled clary sage essential oil were found to have
decreases in multiple stress parameters. Also, those in the lavender group
experienced decreased respiratory rates. While both contain linalyl acetate, it
is detected in the largest amount in clary sage essential oil, and may act on
smooth muscles in the vasculature to decrease blood pressure. The lack of
effect of lavender oil may be due to its diuretic actions, which may have
caused bladder sensitivity and therefore increased levels of stress during
urodynamic examination. The authors also note that clary sage essential oil may
be acting on dopamine pathways. Due to the limited bioactivity observed with
inhalation of lavender essential oil, it is posited that this oil may not be
useful for blood pressure reduction during urodynamic assessment. In
conclusion, the inhalation of 5% clary sage essential oil is potentially useful
in mitigating stress caused by urodynamic exams in those suffering from
incontinence.
—Amy C. Keller,
PhD
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