Introduction

ccording to World Health Organization (WHO), the sexual health is defined as integration and harmony between thought, emotion, and body which directs social, and rational aspects of the human towards promoting his /her personality and leads to relationship and love [1].

One of the differences between human and animals is the tendency towards sexual activity without reproduction purpose.

Human considers sexual relationships as a means of communication and a way to express different kinds of emotions like the intimacy, love, anger, and aggression [5]. In the past years, a high percentage of divorces which happened in family courts with different reasons were due to sexual issues; the real statistics seems to be more than real one, because various factors like shame often prevents presenting the sex issues as a reason for divorce.

Communication problems and dissatisfaction with the marital relationship are affected by various factors such as daily positive interactions, the degree of love between the couple, conflict resolution, aggressiveness, sexual factors, and life events, that among these components, the marital satisfaction is strongly related to sexual activity and satisfaction, so that the marital satisfaction in couples who are sexually satisfied, despite of the communication problems between them will be higher than that of the couples who  do not have sexual satisfaction [6].

According to Mazur et al. (2005), these pieces of evidence show the importance of sexual satisfaction in marital life and if the couples, due to some reasons such as emergence of sexual disorders in one of them, do not have enough sexual satisfaction, their marital satisfaction will be impaired accordingly. The sexual action disorders have several effects on couple’s sexual relationships such as violence towards spouse, development of conflicts in couple’s roles, and decrease in attractiveness of spouses from other spouse view which decreases the sexual desire and avoiding sexual intercourse [7].

Different studies have shown that satisfaction from interpersonal relationships is correlated with their sexual satisfaction [4] and low sex satisfaction anticipates reduction in communication of men and not women (2).

On the other hand, today, the use of traditional medicine and complementary medicine has found global expansion [1]. The term of complementary medicine or alternative method, refers to a group of treatments and prevention practices that their effectiveness and method vary from traditional medicine or conventional biochemical treatments [8]. One of the complementary or alternative medicines is aromatherapy (9). Aromatherapy is the technique of using volatile plant oils, including essential oils, for inducing psychological and physical health [10]. Aromatherapy is the therapeutic use of essential oils derived from plants (11-13) that its effect is through the skin and the olfactory system (14). The use of aromatherapy can have a positive impact on human emotions [15]. Aromatherapy is used to relief pain, anxiety, depression, insomnia, fatigue, asthma, and even building confidence, success and creativity (16). Essential oils can have antibacterial and sedative effects, reduce depression, improve memory and maintain the work efficiency (17-19). It has effect on the immune system, and also improves the temperament (20).

Studies have shown that the use of bergamot oil in inhalation aromatherapy would reduce symptoms of anxiety, mood disorders, behavioral disorders, chronic pain and cancer pain [21].

It is believed that the smell of fragrances activates olfactory nerve cells, resulting in the stimulation of the limbic system. Depending on the type of aroma, neurons and neurotransmitters are released differently. These neurotransmitters include enkephalins, endorphins, adrenaline and serotonin [6]. Aromatherapy runs through bathing, inhalation, and massage [5]. Essential oils used in aromatherapy are divided into stimulant and sedative essential oil groups. Stimulating essential oils such as peppermint and eucalyptus are used to improve focus and eliminate lethargy. Essential oils such as lavender and valerian through calming effect on the nervous system and its relaxation effects can eliminate the anxiety (3).

Research Method

The present study is a quasi-experimental research with pre-test and post-test and the control group. The study population consisted of all married men and women attending the counseling clinics whose marriage was more than 4 years old. In this study, the sample was taken by a convenience method from counseling clinics of Sirjan city and selected subjects were divided into two groups of control and experiment. Sample was consisted of 30 couples (30 men and 30 women). The tool used in this study was the short form of sex Enrich Marital Satisfaction Questionnaire subscales. At first, the Enrich Marital satisfaction questionnaire were given to 100 spouses and then from those whose subscales grades were one standard deviation lower than mean, were asked to take part in this research. Couples were divided into two groups of 30 and one group served as the control group and the other group as the experiment one.

The experiment group was given the Jasmine essential oil and were asked to use it for ten days, at night before sleep and every morning before leaving the house. They should put two drops of the fragrance on the paper and rub it to the hands and other parts of the body that are involved in sexual activity such as the neck, and smell it for 2 to 3 minutes, but the control group was not given any fragrance. After ten days, the couples were asked to complete questionnaires.

Research Instruments

Enriched marital satisfaction questionnaire is used to assess marital satisfaction. Each of the scales of the questionnaire is related to one of the most important aspects of married life. Assessment of these aspects within a marital relationship could explain the potential problems of couples or specifies their strong points and enhancements. This instrument is also used for couples searching for marital counseling or seeking to strengthen their marital relationship (5). In this study, the 47-item form of Enrich is used which was used by Soleimanian (1994) and its α coefficient was 95% and Forghany (2003) reported the reliability of the questionnaire by 86%. α coefficient of the Enrich questionnaire in Olson, Fournier and Drakmn (1989) regarding the subscales of sex relationship was 0.76. Sex subscales assess the personal feelings and concerns about sexual and emotional relationship with the spouse. The items reflect the satisfaction from presenting emotions and degree of relaxation in discussing about sex and sexual relationship subjects.  Low score shows satisfaction from expression of emotions and having positive attitude towards the role of sex issues in marriage and or disagreement about decisions related to avoiding pregnancy. Questions that measure this scale include 10,17,27,36,44.

Data Analysis

In this research, to analyze the data and study of their effectiveness in increasing sexual relationship, we used descriptive statistics, including mean, standard deviation, highest and lowest score, frequency, and percentile. Also, we used inferential statistics to calculate univariate covariance (ANCOVA). All calculation was performed using SPSS 16 software.

Table 1. Mean, Standard Deviation, Highest and Lowest Score of Sexual Relationship in Pre-test Stage in control and Experimental Groups

Table 2. Mean, Standard Deviation, Highest and Lowest Score of Sexual Relationship in Post-test Stage in control and Experimental Groups

Results

To test the hypothesis and determine significant differences between the control and experimental groups with regard to the study variable (sexual relationship), univariate analysis of covariance (ANCOVA) was used. In this method, pre-test was controlled to nullify its effect on the results of the study.

 Table 3. The results of analysis of covariance on the mean of sexual relationship scores in the experiment and control groups