Benefits
Menopausal symptom scores, studied in a three-herb combination
Most human menopause evidence tests this root inside a standardized three-herb product that also contains Phlomis umbrosa and Angelica gigas. In a 12-week placebo-controlled trial, women on the combination had larger drops in a menopause symptom index than those on placebo. A later single-arm study reported improvement but had no placebo group. These results belong to the combination, not the root alone.
Total and LDL cholesterol in adults with higher starting levels
Two small Korean placebo-controlled trials tested a standardized extract of the root by itself, at 300 or 600 mg a day for 8 weeks, in adults with raised cholesterol. Total and LDL cholesterol fell by a few percent more than on placebo, with the clearest changes in those whose LDL started highest. The reductions were small and not dose-dependent, and both trials were short and small.
Estrogen-receptor-beta signaling in laboratory and animal studies
A water-soluble polysaccharide fraction from the root eased menopause-like changes in ovariectomized mice, such as uterine shrinkage and bone loss, and did so by switching on estrogen receptor beta rather than estrogen receptor alpha, without raising blood estradiol. Cell studies of root extracts also point to weak estrogen-like activity. This is laboratory and animal work, not evidence of an effect in women.
Hot flush markers in ovariectomized animal models
In a rat model of menopausal hot flushes, where tail-skin temperature rises after the ovaries are removed, a water extract of the root lowered that temperature rise over a week of dosing, without changing blood estradiol. The study was brief and measured a surrogate marker in animals, and the authors called for longer work at higher doses. It does not show relief of hot flashes in people.
Mechanism of action
Weak estrogen-receptor activity
Root extracts and an isolated polysaccharide bind and activate estrogen receptors in laboratory tests, with a preference for estrogen receptor beta over alpha. This weak, selective estrogen-like action is the proposed reason for effects on menopause-related measures, and the reason caution is advised in hormone-sensitive conditions.
Root constituents
The dried root supplies C21 steroidal glycosides, acetophenones and water-soluble polysaccharides. These are the compounds credited with its activity in laboratory work, and the steroidal-glycoside and genetic marker profiles are also what analysts use to tell the true root from its look-alike.
Symptom effects without a change in estrogen levels
In animal studies the root eased menopause-like signs without raising measured blood estradiol, which suggests it acts at estrogen receptors and downstream signaling rather than by adding estrogen to the body. The same pattern is reported for several menopause botanicals.
Clinical trials
Randomized, double-blind, placebo-controlled 12-week trial of a standardized three-herb extract containing this root, in pre-, peri- and postmenopausal women (Chang et al. 2012, Phytother Res)
64 pre-, peri- and postmenopausal women in the United States (31 combination, 33 placebo).
The Kupperman menopause index fell from about 29.5 to 11.3 on the combination versus 29.2 to 23.7 on placebo, a significant difference, with improvement in vasomotor symptoms, insomnia, fatigue and vaginal dryness and no weight gain or serious side effects. The product is a three-herb mixture, so the result cannot be attributed to this root alone.
Prospective, single-center, single-arm 12-week study of the same standardized three-herb combination, with no placebo group (Kirubamani et al. 2023, J Midlife Health)
60 Indian women with confirmed menopause and moderate-to-severe symptoms.
Somatic, urogenital and psychological scores on the Menopause Rating Scale improved from baseline at 6 and 12 weeks, and most women reported satisfaction, with no side effects recorded and no change in blood pressure or body mass index. With no placebo arm and a maker-affiliated author team, the improvement cannot be separated from natural change or expectation.
Randomized, double-blind, placebo-controlled 8-week trial of a standardized root extract at two doses in adults with elevated total cholesterol (Shin et al. 2020, Phytother Res)
96 Korean adults with total cholesterol 200 to 240 mg/dL (32 each at 300 mg/day, 600 mg/day and placebo).
Total cholesterol fell about 4% and LDL cholesterol about 6% more than placebo at both doses, with no clear dose-response and no serious side effects reported. This is a small, short single trial in people with modestly raised cholesterol.
Double-blind, randomized, placebo-controlled 8-week parallel trial of an ethanol root extract at 300 or 600 mg a day in adults with high LDL cholesterol (Youn et al. 2019, Nutrients)
84 adults with elevated LDL cholesterol; a subgroup of 33 had LDL at or above 150 mg/dL.
Very-low-density lipoprotein and triglycerides were lower at the 300 mg dose than placebo. In the higher-LDL subgroup, total cholesterol and apolipoprotein B dropped at both doses. The primary outcomes were mixed and the clearest effects were in a subgroup, so the finding is preliminary.
Laboratory and animal study of a water-soluble polysaccharide fraction from the root in ovariectomized mice and in cell assays (Lee et al. 2020, Int J Biol Macromol)
Ovariectomized mice plus cell-based estrogen-receptor assays; not a human study.
The polysaccharide eased ovariectomy-induced uterine atrophy and bone loss and normalized follicle-stimulating hormone, alkaline phosphatase and osteocalcin, acting through estrogen receptor beta without changing plasma estradiol. These are animal and cell findings only.