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As defined by the World Health Organization (WHO), sexual health is a state of physical, mental and social well-being related to sexuality. Sexual dysfunction in postmenopausal women is defined as any disorder related to sexual desire, orgasm or arousal phase, which can affect the quality of life (2). The prevalence of sexual dysfunction in postmenopausal women is 4 times more than reproductive-age women (3). The risk of sexual dysfunction in older age women has increased and sexual satisfaction decreased which can be due to the postmenopausal hormonal changes (4). After menopause orgasm, arousal and lubrication are decreased with age; low estrogen and androgen levels, reduced blood flow to the vulva, vaginal dryness, dyspareunia reduce mentalsexual energy (5). Dennerstein et al indicated sexual dysfunction about 42% after one year and 88% after 8 years from menopause which was definitely associated with menopause (6). In Iran, several studies have also reported decreased libido and increased sexual dysfunction in postmenopausal women (7-9). Estrogen can treat these disorders and improve sexual function, but studies are needed to determine the minimum effective treatment dose with the best results (10,11). Prescribing exogenous estrogen has complications such as stroke, pulmonary embolism and breast cancer (11,12). Over the past decade, the use of complementary medicine instead of hormone therapy has increased and more women are looking for natural alternative treatments to relieve menopausal symptoms (13). The use of alternative medicine has increased not only due to its low cost and proven effectiveness but also due to the recommended holistic care theory and various nursing theories (14). Ginkgo biloba is a phytoestrogen that contains flavone glycosides (15,16). It facilitates blood flow and has relaxant effect on smooth muscle tissues (17,18). A number of studies have shown improvement in sexual function after taking this plant (19,20). The possible side effects of this Abstract Objectives: Due to enhanced life expectancy and an increasing elderly population, sexual and physical problems related to menopause are essential from the health point of view. This study was performed to evaluate the effect of Ginkgo biloba tablet and aromatherapy inhaler combination (lavender, fennel and geranium and rose) in decrement of sexual dysfunction in postmenopausal women. Materials and Methods: This double blind randomized clinical trial was performed on 180 postmenopausal women with age range of 45-55 years referring to health care centers in Ardabil University of Medical Sciences, Iran. The participants were randomly divided into 3 groups of 60 subjects: Ginkgo biloba tablet and placebo aroma solution users, aroma solution with placebo Ginkgo biloba users, and placebo aroma with placebo Ginkgo biloba users who received 40 mg Ginkgo biloba either in tablet or placebo and 2-3 drops of aroma solution or placebo on the skin, 3 times a day for 6 weeks. The tool for collecting data was a questionnaire encompassed questions on the socio-demographical features and female sexual function index (FSFI). The primary outcome was the sexual function mean score after intervention in the research groups. The analysis was conducted according to intention-to-treat. Results: The mean (SD) scores of total sexual function at baseline in aromatherapy, Ginkgo biloba and placebo groups were 18.4 (5.4), 17.5 (6.8) and 15.8 (5.7) that enhanced to 22.9 (3.3), 21.6 (4.5) and 17.2 (4.2) in the mentioned groups respectively after intervention. Analysis of covariance (ANCOVA) test indicated significant discrepancy after intervention in total (P < 0.001) and all sub-domains scores of sexual function (P < 0.003) with the exception of pain in Ginkgo biloba and aromatherapy groups compared to placebo with controlling of confounding factors. Conclusion: Aromatherapy inhaler combination and Ginkgo biloba tablet improved sexual function in postmenopausal women.

international journal of women's health and reproduction sciences

The Impact of Ginkgo biloba Tablet and Aromatherapy Inhaler Combination on Sexual Function in Females During Postmenopausal Period: A Double-Blind Randomized Controlled Trial