Linalool and linalyl acetate aromatherapy for labor pain management: A narrative review of evidence for integration into midwifery practice

Dwi Pratiwi Kasmara, Yulinda Aswan

Abstract

Labor pain is a complex physiological and emotional experience, leading many women to seek nonpharmacological relief alongside standard analgesia. Linalool and linalyl acetate—major monoterpenes in lavender and clary sage—exhibit sedative, anxiolytic, antinociceptive, and smooth-muscle relaxant properties. This narrative review evaluates their pharmacological mechanisms, clinical efficacy, and integration into midwifery practice. Literature searches across six major databases identified 12 core studies. Evidence demonstrates modest but consistent reductions in pain intensity and maternal anxiety during the first stage of labor, with excellent safety profiles. Key mechanisms include GABAA modulation, TRPA1 and voltage-gated Ca2+ channel inhibition, endogenous opioid release, and myometrial relaxation. Linalool- and linalyl acetate–rich aromatherapy offers a safe, feasible adjunct to intrapartum care. Midwives should implement standardized protocols for inhalation and topical massage to enhance maternal comfort. Linalool and linalyl acetate aromatherapy for labor pain management: A narrative review of evidence for integration into midwifery practice

Full Text:

PDF

References

Coviello A, Iacovazzo C, Frigo MG, Ianniello M, Cirillo D, Tierno G, Siena AU, Buonanno P, Servillo G. Technical aspects of neuraxial analgesia during labor and maternity care: an updated overview. J Anesth Analg Crit Care 2025; 5(1): 224.

Kazeminia M, Abdi A, Vaisi-Raygani A, Jalali R, Shohaimi S, Daneshkhah A, Salari N, Mohammadi M. The effect of lavender (Lavandula stoechas L.) on reducing labor pain: A systematic review and meta-analysis. Evid Based Complement Alternat Med 2020; 2020: 4384350.

Kasmara DP, Abdullah E, Harun Z, Sari FN, Abd Rashid N, Teoh SL. Mini review of plant products as food supplement against MSG-induced liver injury: antioxidant, oxidative stress and histological prospects. Front Pharmacol 2025; 16: 1512345.

Koulivand PH, Khaleghi Ghadiri M, Gorji A. Lavender and the nervous system. Evid Based Complement Alternat Med 2013; 2013: 681304.

Hashimoto M, Takahashi K, Ohta T. Inhibitory effects of linalool, an essential oil component of lavender, on nociceptive TRPA1 and voltage-gated Ca2+ channels in mouse sensory neurons. Biochem Biophys Rep 2023; 34: 101468.

Tabatabaeichehr M, Mortazavi H. The effectiveness of aromatherapy in the management of labor pain and anxiety: A systematic review. Ethiop J Health Sci 2020; 30(3): 449-58.

Kaya A, Yeşildere Sağlam H, Karadağ E, Gürsoy E. The effectiveness of aromatherapy in the management of labor pain: A meta-analysis. Eur J Obstet Gynecol Reprod Biol X 2023; 20: 100234.

Movahedi M, Ebrahimian M, Saeedy M, Tavoosi N. Comparative study of transcutaneous electrical nerve stimulation, the aromatherapy of Lavandula and physiologic delivery without medication on the neonatal and maternal outcome of patients. Int J Physiol Pathophysiol Pharmacol 2022; 14(3): 206-10.

Muna S, Wahyuni S. The effectiveness of lavender aromatherapy in adolescent girls. Sci Midwifery 2019; 13(2): 45-50.

Karatopuk S, Yarıcı F. Determining the effect of inhalation and lavender essential oil massage therapy on the severity of perceived labor pain in primiparous women: A randomized controlled trial. Explore (NY) 2023; 19(1): 107-14.

Ghiasi A, Bagheri L, Haseli A. A systematic review on the anxiolytic effect of aromatherapy during the first stage of labor. J Caring Sci 2019; 8(1): 51-60.

Bilgiç FŞ, Yıldız Karaahmet A. The effect of aromatherapy on labor pain, duration of labor, anxiety and Apgar score outcome: a systematic review and meta-analysis. Eur Res J 2023; 9(5): 1258-70.

Suzuki H, Kato M, Shimozaki K, Lopes KS, Ota E. Systematic review of the effectiveness of aromatherapy in labor. J Pediatr Infants 2021; 4(1): 1-12.

Liao CC, Lan SH, Yen YY, Hsieh YP, Lan SJ. Aromatherapy intervention on anxiety and pain during first stage labour in nulliparous women: a systematic review and meta-analysis. J Obstet Gynaecol 2021; 41(1): 21-31.

Karataş Okyay E. Biologically based complementary methods used in the control of labor pain: Aromatherapy and phytotherapy. Socrates J Interdiscip Soc Res 2022; 8(14): 77-84.

Salh RFM, Zaki NH, Essa RM, Lamadah SM. Effect of aromatherapy back massage versus acupressure San Yin Jiao (Sp6) on labor pain intensity and duration among primigravidas. Alexandria Sci Nurs J 2024; 26(4): 407-19.

Maedeh S, Ronak S, Bijan N, Asrin K, Karim N, Shahgheibi S, Fariba R. Comparison of the effect of entonox gas and aromatherapy with lavender on the severity of labor pain. Health Aging Res 2019; 8(1): 1-5.

Khadijah S. The effect of Cinnamomum burmannii aromatherapy as nonpharmacological intervention for labor pain. Indones J Midwifery 2020; 3(1): 1-6.

Poyton C, Manchadi ML, Cheesman M, Lavidis N. Effects of lavender and linalool on neurotransmission and contraction of smooth muscle. Pharmacogn Commun 2015; 5(3): 217-25.

Nöldner M, Germer S, Koch E. Pharmacokinetics of linalool and linalyl acetate, the two main constituents of Silexan, an essential oil from Lavandula angustifolia flowers, in rats. Planta Med 2011; 77(12): 1345.

Phuong TNT, Jang SH, Rijal S, Jung WK, Kim J, Park SJ, Han SK. GABA- and glycine-mimetic responses of linalool on the substantia gelatinosa of the trigeminal subnucleus caudalis in juvenile mice: Pain management through linalool-mediated inhibitory neurotransmission. Am J Chin Med 2021; 49(6): 1437-48.

Sadraei H, Asghari G, Rahmati M. Study of antispasmodic action of Lavandula angustifolia Mill hydroalcoholic extract on rat ileum. J Herbmed Pharmacol 2019; 8(1): 56-63.

Sun L, Liu LN, Li JC, Lv YZ, Zong SB, Zhou J, Wang ZZ, Kou JP, Xiao W. The essential oil from the twigs of Cinnamomum cassia Presl inhibits oxytocin-induced uterine contraction in vitro and in vivo. J Ethnopharmacol 2017; 206: 107-14.

Agustin CS, Ferina. Linalool in lavender aromatherapy reduce labor pain. SEAJOM Southeast Asia J Midwifery 2022; 8(2): 67-74.

Hashimoto M, Takahashi K, Ohta T. Analgesic effects of linalyl acetate via nociceptive TRPV1 inhibition in mice. Biomed Res 2024; 45(6): 217-30.

Api AM, Bartlett A, Belsito D, Botelho D, Bruze M, Bryant-Freidrich A, Burton GA Jr, Cancellieri MA, Chon H, Dagli ML, Dekant W, Deodhar C, Farrell K, Fryer AD, Jones L, Joshi K, Lapczynski A, Lavelle M, Lee I, Moustakas H, Muldoon J, Penning TM, Ritacco G, Sadekar N, Schember I, Schultz TW, Siddiqi F, Sipes IG, Sullivan G, Thakkar Y, Tokura Y. Update to RIFM fragrance ingredient safety assessment, linalyl acetate, CAS registry number 115-95-7. Food Chem Toxicol 2024; 192(S1): 114805.

Tadokoro Y, Horiuchi S, Takahata K, Shuo T, Sawano E, Shinohara K. Changes in salivary oxytocin after inhalation of clary sage essential oil scent in term-pregnant women: a feasibility pilot study. BMC Res Notes 2017; 10(1): 717.

Fung TKH, Lau BWM, Ngai SPC, Tsang HWH. Therapeutic effect and mechanisms of essential oils in mood disorders: Interaction between the nervous and respiratory systems. Int J Mol Sci 2021; 22(9): 4844.

Schaeuble D, Myers B. Cortical-hypothalamic integration of autonomic and endocrine stress responses. Front Physiol 2022; 13: 820398.

Leistner C, Menke A. Hypothalamic-pituitary-adrenal axis and stress. Handb Clin Neurol 2020; 175: 55-64.

Hinds JA, Sanchez ER. The role of the hypothalamus–pituitary–adrenal (HPA) axis in test-induced anxiety: Assessments, physiological responses, and molecular details. Stresses 2022; 2(1): 146-55.

Chen SF, Wang CH, Chan PT, Chiang HW, Hu TM, Tam KW, Loh EW. Labour pain control by aromatherapy: A meta-analysis of randomised controlled trials. Women Birth 2019; 32(4): 327-35.

Kashiwadani H, Higa Y, Sugimura M, Kuwaki T. Linalool odor-induced analgesia is triggered by TRPA1-independent pathway in mice. Behav Brain Funct 2021; 17(1): 3.

Mirzaiinajmabadi K, Makvandi S, Mirteimoori M, Sadeghi R. An update on the effect of massage and inhalation aromatherapy with lavender on labor pain relief: A systematic review and meta-analysis. J Obstet Gynecol Cancer Res 2018; 3(1): 29-37.

Refbacks

  • There are currently no refbacks.