Peppermint: benefits, dosage, contraindications
Scientific name(s)
Mentha × piperita
Family or group:
Plants
Active ingredients:
Eucalyptol
Carvone
Menthol
Pulegone
Menthone
Indications
Scoring methodology
EFSA approval.
Irritable bowel syndrome ✪✪✪✪✪
Irritable bowel syndrome (IBS) is characterized by abnormal contractions of the intestinal muscles, causing pain, bloating, and changes in bowel habits such as diarrhea or constipation. This condition can be exacerbated by stressors and is often associated with inappropriate eating habits and intestinal dysbiosis. According to a meta-analysis, peppermint oil administered in capsule form has demonstrated significant efficacy in treating IBS symptoms, including abdominal pain and distension. These capsules release the oil directly into the small intestine, minimizing side effects such as reflux by avoiding excessive relaxation of the lower esophageal sphincter. The study also notes that benefits are generally achieved after two weeks of treatment, although long-term effects remain uncertain, as the included studies did not exceed 12 weeks. Most studies used 1 to 2 enteric-coated peppermint oil capsules orally two to four times a day. Each capsule provides about 0.2 ml of peppermint oil, or 180–225 mg of peppermint oil. In addition to its use as monotherapy, peppermint oil has been tested in combination with other herbs in products such as Iberogast (including lemon balm, milk thistle, cumin, chamomile, licorice, and others), and another product, Atrantil, which combines peppermint with red quebracho extract and horse chestnut, showing a reduction in constipation and bloating symptoms in patients with constipation-predominant IBS. Although the American College of Gastroenterology's recommendations are cautious due to the limited quality of the evidence, they acknowledge the therapy's effectiveness for short-term relief. Similarly, the British Society of Gastroenterology assesses peppermint oil as a potentially effective treatment for overall symptoms and the abdominal pain associated with IBS. However, they note that long-term efficacy has not been established and mention gastroesophageal reflux as a common side effect.
Posologie
Orally
0.6 - 1.2 mL
infusion, essential oil, Atrantil, capsules, Iberogast
Synergies
Systematic review and meta-analysis: efficacy of peppermint oil in irritable bowel syndrome
Efficacy and Safety of Peppermint Oil in a Randomized, Double-Blind Trial of Patients With Irritable Bowel Syndrome
Bulking agents, antispasmodics and antidepressants for the treatment of irritable bowel syndrome
Response of irritable bowel syndrome with constipation patients administered a combined quebracho/conker tree/M. balsamea Willd extract
ACG Clinical Guideline: Management of Irritable Bowel Syndrome
Peppermint Oil Treatment for Irritable Bowel Syndrome: A Randomized Placebo-Controlled Trial
E/S/C/O/P: 2nd Edition of the ESCOP Monographs
British Society of Gastroenterology guidelines on the management of irritable bowel syndrome
Digestive disorders, Digestive spasms ✪✪✪✪✪
Clinical research suggests that peppermint oil, in combination with caraway oil, can significantly improve quality of life and reduce symptoms of dyspepsia, such as a feeling of fullness, pain, and mild gastrointestinal spasms. These results were obtained with specific products such as Enteroplant and Menthacarin, administered two to three times daily at doses of 90 mg peppermint oil and 50 mg caraway oil, over a period of 4 weeks. This combination was compared and found to be as effective as cisapride, a medication previously used to treat dyspepsia symptoms. Furthermore, the product Iberogast, which includes peppermint leaf extract and other herbs such as lemon balm and chamomile, taken at 1 mL three times daily, demonstrated a significant reduction in the severity of dyspepsia symptoms in a meta-analysis of clinical studies. This treatment helps relieve symptoms such as acid reflux, epigastric pain, cramps, nausea, and vomiting.
Posologie
Oral administration
50 mg
infusion, essential oil, Carmenthin®, Iberogast
A randomized placebo-controlled trial on the effects of Menthacarin, a proprietary peppermint- and caraway-oil-preparation, on symptoms and quality of life in patients with functional dyspepsia
European Union herbal monograph on Mentha x piperita L., folium
Menthacarin, a Proprietary Peppermint Oil and Caraway Oil Combination, Improves Multiple Complaints in Patients with Functional Gastrointestinal Disorders: A Systematic Review and Meta-Analysis
A Combination of Peppermint Oil and Caraway Oil for the Treatment of Functional Dyspepsia: A Systematic Review and Meta-Analysis
Treatment of functional dyspepsia with a herbal preparation. A double-blind, randomized, placebo-controlled, multicenter trial
Migraine ✪✪✪✪✪
Peppermint, applied topically, has been shown to be effective in relieving tension headaches. In one study, a 10% solution of peppermint oil in ethanol was applied to the forehead and temples, showing a significant reduction in headache intensity within 15 minutes, comparable to the effect of a 1000 mg dose of acetaminophen. An additional study examined the effect of menthol, an active component of peppermint, found in topical treatments for migraine without aura. Topical application of 10% menthol produced a significant effect on pain, outperforming placebo and also improving associated symptoms such as nausea and sensitivity to light and sound. Preliminary research also shows that intranasal peppermint oil at 1.5% may be as effective as intranasal lidocaine 4% in reducing migraine intensity, with effects felt in as little as 5 minutes for some patients. These results suggest that peppermint oil could offer a natural and fast alternative for treating migraine and headache symptoms.
Posologie
Topical, nasal, oral
2 drops
essential oil
Comparing the Effect of Intranasal Lidocaine 4% with Peppermint Essential Oil Drop 1.5% on Migraine Attacks: A Double-Blind Clinical Trial
E/S/C/O/P: 2nd Edition of the ESCOP Monographs
Effect of peppermint and eucalyptus oil preparations on neurophysiological and experimental algesimetric headache parameters
Nausea and vomiting ✪✪✪✪✪
Peppermint oil shows promising results for the treatment of nausea from various causes. In cases of chemotherapy-induced nausea, the addition of 40 drops of peppermint oil to 20 mL of water every 8 hours was effective in reducing the severity of nausea and vomiting. For postoperative nausea, inhalation of peppermint oil vapors also demonstrated significant benefits by reducing nausea in gynecological patients. In addition, a study in children with acute leukemia used diffusion of essential oils with 2 drops of peppermint oil and 3 drops of lemon oil, effectively reducing the severity of treatment-associated nausea and vomiting. However, a Cochrane review on aromatherapy for postoperative nausea found no reliable evidence of the effectiveness of peppermint oil, highlighting the need for more rigorous research to validate these results.
Posologie
By inhalation
2 drops
essential oil
The Effects of Peppermint Oil on Nausea, Vomiting and Retching in Cancer Patients Undergoing Chemotherapy: An Open Label Quasi-Randomized Controlled Pilot Study
The Effect of Combined Inhalation Aromatherapy with Lemon and Peppermint on Nausea and Vomiting of Pregnancy: A Double-Blind, Randomized Clinical Trial
The Effect of Peppermint (Mentha piperita) Extract on the Severity of Nausea, Vomiting and Anorexia in Patients with Breast Cancer Undergoing Chemotherapy: A Randomized Controlled Trial
Infant colic ✪✪✪✪✪
In a double-blind crossover study, 1 drop/kg of body weight of peppermint was compared with simethicone in 30 infants suffering from colic. After 14 days of treatment, a reduction in the frequency and duration of colic episodes was observed in both groups, indicating that peppermint may be as effective as simethicone. These encouraging results call for further clinical trials.
Posologie
Orally
1 1 drop/kg
essential oil
Ear, nose and throat infections ✪✪✪✪✪
Peppermint oil and menthol are traditionally used in the treatment of respiratory infections. Balms containing menthol are commonly applied to relieve bronchitis. Moreover, menthol inhalation, although it does not affect the temperature of the nasal mucosa or nasal airflow, directly stimulates cold receptors, thereby inducing a cooling sensation that can give the impression of clearing the nasal passages. For symptoms of cold and cough, the use of menthol-based nasal ointments (1-5 %) is also a traditional remedy approved to relieve these conditions according to the EMA.
Posologie
By inhalation, nasal, topical, oral
2 drops
infusion, essential oil, ointment, balm
Muscle pain ✪✪✪✪✪
Peppermint essential oil is traditionally used to relieve localized muscle pain according to the EMA.
Posologie
Topical use
2 drops
essential oil, ointment
Insect bites, Itching ✪✪✪✪✪
Preliminary clinical studies suggest that topically applied peppermint oil may improve itching of various origins. For itching related to renal, hepatic, or diabetic problems, the topical application of a 5% peppermint solution in petroleum jelly twice daily for two weeks showed an improvement in symptoms compared with petroleum jelly alone. Another study demonstrated that applying a gel containing 3.6% peppermint oil, 1.4% menthol, and 2.5% methyl salicylate significantly reduced the severity of itching due to burn scars for up to seven days after application. Peppermint oil is recognized as a traditional medicinal product for the symptomatic relief of localized pruritic conditions on intact skin.
Posologie
Topical use
2 drops
gel, essential oil
The effect of peppermint oil on symptomatic treatment of pruritus in pregnant women
Effective symptomatic treatment for severe and intractable pruritus associated with severe burn-induced hypertrophic scars: A prospective, multicenter, controlled trial
https://www.ema.europa.eu/en/documents/herbal-monograph/european-union-herbal-monograph-mentha-x-piperita-l-aetheroleum-revision-1en.pdf
E/S/C/O/P: 2nd Edition of the ESCOP Monographs
Properties
Antispasmodic
The antispasmodic effect of peppermint is mainly due to its active component, menthol, which acts on the transient receptor potential melastatin 8 (TRPM8) channels in sensory neurons. Activation of these channels allows the entry of Ca2+ ions into cells, thereby modulating the activity of gastrointestinal smooth muscle. nnStudies have shown that peppermint essential oil, applied topically or ingested, relaxes these muscles and reduces intragastric pressure. These properties make it an effective remedy for spasms and digestive pain, notably used in the treatment of irritable bowel syndrome.nn
Usages associés
Digestive effect
Peppermint is recognized for its carminative activity, which consists of relaxing the gastrointestinal sphincters, thus facilitating belching and the passage of gas. This mechanism helps relieve symptoms of bloating and flatulence. nnIn addition to its carminative effects, peppermint oil is used to treat irritable bowel syndrome (IBS) because of its antispasmodic properties. It slows the natural movement of the intestine, thereby helping to relax the smooth muscles of the gastrointestinal tract. This is due in part to the action of menthol, which may block calcium channels. Menthol also acts as an agonist of kappa opioid receptors and has serotonergic antagonist properties, contributing to the prevention of excessive contractions often observed in patients with IBS.nnPreliminary studies indicate that peppermint oil, administered in capsules combined with caraway oil, can reduce gastroduodenal motility and decrease excessive stomach sensitivity, which plays a role in the development of symptoms related to functional gastrointestinal disorders. nn
Usages associés
Antimicrobial
Peppermint oil and its main constituent, menthol, have demonstrated significant antibacterial and antifungal properties. They also potentiate the effect of certain antibiotics such as oxytetracycline. Peppermint oil has shown the ability to inhibit various pathogenic bacteria such as Helicobacter pylori, Staphylococcus aureus, Escherichia coli, and multidrug-resistant strains of Shigella sonnei. In addition to its antibacterial activity, peppermint oil has been shown to be effective against pathogenic fungi such as Candida albicans and Trichophyton mentagrophytes, even rivaling commercial fungicides. The combined use of peppermint oil with antibiotics has revealed synergistic effects, notably by increasing the susceptibility of Escherichia coli to antibiotic treatments and by significantly reducing the minimum inhibitory concentrations of the drugs.
Usages associés
Antioxidant
The polyphenolic compounds of peppermint, such as luteolin-7-O-rutinoside, eriocitrin, and rosmarinic acid, demonstrate significant antioxidant activity. Peppermint essential oil and its constituents, menthone and isomenthone, also possess antioxidant properties. By comparison, peppermint and lemon balm stand out for their strong antioxidant and free radical–scavenging effects, surpassing other plant extracts such as caraway, German chamomile, and angelica.
Choleretic
Peppermint essential oil and peppermint tea, as well as their flavonoids, exhibit choleretic activity, promoting bile secretion. Aqueous extracts of peppermint leaves also have choleretic effects. Peppermint oil relaxes the gallbladder and the small intestine, modulating transit time and increasing bile acid secretion while reducing cholesterol in bile, by upregulating genes related to bile acid synthesis.
Usages associés
Analgesic
Peppermint oil has demonstrated a significant analgesic effect, notably reducing pain sensitivity in controlled studies. Menthol, one of its active components, plays a key role by modulating GABA receptors and sodium ion channels, thereby contributing to its analgesic action. When applied topically, menthol also acts on kappa-opioid receptors, reducing the perception of pain and itch. Furthermore, inhalation of peppermint essential oil can relieve chronic pain by promoting relaxation through a parasympathetic response stimulated by touch and smell.
Usages associés
Neurological
L-menthol, a component of peppermint, increases the perception of cold and reduces that of heat by stimulating cold receptors, useful for relieving respiratory discomfort. Inhalation of menthol also enhances the sensation of nasal airflow and provides a cool feeling in the nasal cavity, influencing the greater palatine nerve. Furthermore, studies in mice show that peppermint oil stimulates motor activity, linked to an effect of mental stimulation, by inhibiting dopamine uptake, potentially via the action of menthone.
Safe dosage
Adult from 16 years: 3 g - 6 g (infusion)
- Infusion: 3 g to 6 g per 150 mL of water, steep for 10 minutes, several times a day. - Essential oil capsules: Most studies report doses of about 0.2–0.5 mL two to four times a day. - Inhalation: 3–4 drops added to hot water. - Tincture (1:5, 45% ethanol): 2 to 3 mL, 3 times a day. - External use (analgesic or irritations): 0.1% to 16% of the preparation. - Tension headaches: 10% solution applied to the skin of the forehead and temples.
Child from 4 to 16 years: 3 g - 6 g (infusion)
Children aged 4 years and older, daily infusion dose: - 4–10 years, 3–5 g - 10–16 years, 3–6 g For digestive disorders, adult proportions are adjusted to the child’s weight.
Interactions
Médicaments
CYTOCHROME P450 1A2: weak interaction
Research shows that peppermint oil and leaves inhibit the enzyme CYP1A2, which is responsible for the metabolism of many drugs. Drugs affected by this enzyme include clozapine (an antipsychotic) and theophylline (an asthma treatment). Medical monitoring is recommended to adjust dosages if necessary.
Cytochrome P450 3A4: moderate interaction
Peppermint oil at 600 mg inhibits the enzyme CYP3A4, increasing the effect of felodipine, a drug in this class. Affected drugs also include statins such as atorvastatin, certain sedatives such as midazolam, and anti-HIV drugs such as ritonavir. Medical consultation is recommended to adjust doses if necessary.
Precautions
Pregnancy: use with caution
Insufficient data; consult a healthcare professional
Breastfeeding: use with caution
Insufficient data; consult a healthcare professional
