Peppermint oil in menstrual disorders and menopausal symptoms: a research progress review

Globally, approximately 80-95% of women of reproductive age are affected by premenstrual syndrome and menstrual-related symptoms, which significantly impair their quality of life. Although non-steroidal anti-inflammatory drugs and hormonal therapies are considered first-line treatment options, they are limited by adverse effects and restrictions on applicable populations. Peppermint oil is a natural plant extract. Its primary bioactive component, menthol, exhibits significant antioxidant, anti-inflammatory, and smooth muscle relaxant pharmacological activities. It has shown preliminary application potential in the management of menstrual disorders and menopausal symptoms, yet it is still in the early stage of research. This review synthesizes current research progress on peppermint oil in the management of menstrual disorders and menopausal symptoms, with a focus on its pharmacological basis, clinical application evidence, and existing controversies and research gaps. Available evidence indicates that peppermint oil exerts preliminary efficacy in alleviating primary dysmenorrhea and improving genitourinary symptoms of menopause. These effects are mediated by multi-target mechanisms, including ion channel modulation, inhibition of inflammatory pathways, and regulation of the neuroendocrine network. However, current research faces key bottlenecks, including fragmented clinical evidence, unclear mechanisms of action, lack of product quality standardization, and insufficient long-term safety data. To address these challenges, future efforts should prioritize large-scale, standardized randomized controlled trials. In parallel, future research may also integrate multi-omics technologies to elucidate its molecular mechanisms and develop novel drug delivery systems to enhance bioavailability. We hypothesize that this pathway holds promise for moving peppermint oil from traditional experience toward evidence-based medicine, though the precision medicine framework remains an exploratory direction given the current state of evidence.