However, we acknowledge that our study has several limitations, such as non-randomized design and the lack of an equivalent-treatment control group to estimate the superior effectiveness of aromatherapy massage. Therefore, it is not clear whether the positive effects were due to the aromatherapy, the massage or both (e.g. identical results may have been achieved by using only massage, or by using aromatherapy and massage). Further randomized studies should be carried out that include more objective measures, such as hormonal changes associated with climacteric women, to explain the possible mechanism of reduction in menopausal symptoms.