Benefits
Helps reduce menopausal hot flashes
Standardized rhubarb root extract has been shown in placebo-controlled trials in perimenopausal women to help lower the frequency and severity of hot flashes and night sweats as measured by the Menopause Rating Scale over twelve weeks of daily use.
Supports overall menopausal symptom relief
Daily use is associated with improvements in composite menopausal symptom scores covering vasomotor, psychological, and somatic complaints, supporting comfort during the perimenopausal transition without relying on hormone therapy.
Helps maintain mood and emotional balance
Trial data indicate improvements in subscales relating to anxiety, irritability, and depressed mood in perimenopausal women, helping support emotional well-being during a phase of fluctuating hormones.
Promotes better sleep quality during perimenopause
By reducing night sweats and overall climacteric symptom burden, the extract is associated with improvements in self-reported sleep quality and reductions in sleep disturbance scores in perimenopausal users.
Supports non-estrogenic hormonal balance
As a selective ER-beta-preferring botanical that does not measurably activate ER-alpha in standard assays, it offers menopausal symptom support without the endometrial proliferation associated with estrogenic stimulation of the uterus.
Mechanism of action
Selective ER-beta activation
The hyperestrolide aglycones rhapontigenin and desoxyrhapontigenin preferentially bind and transactivate estrogen receptor beta in cellular reporter assays while showing essentially no transactivation of ER-alpha, mimicking the receptor profile thought to mediate central menopausal symptom relief.
Modulation of hypothalamic thermoregulation
ER-beta activation in hypothalamic neurons is implicated in stabilizing the thermoregulatory set point, which is hypothesized to underlie the observed reductions in hot flash frequency and night sweats with ERr 731 supplementation.
Lack of uterotrophic ER-alpha signaling
Because the extract does not transactivate ER-alpha, preclinical and clinical safety data show no endometrial thickening or proliferation, distinguishing it from classical estrogen-containing menopause therapies.
Serotonergic and mood-related signaling
ER-beta signaling influences serotonergic neurotransmission relevant to mood and anxiety, providing a plausible mechanism for improvements in irritability, depressed mood, and anxiety subscales reported in trials.
Clinical trials
Multicenter, randomized, double-blind, placebo-controlled trial; one enteric-coated ERr 731 tablet daily for 12 weeks.
109 perimenopausal women with climacteric complaints (Menopause Rating Scale II baseline).
ERr 731 produced significantly greater reductions in total MRS II score, in number and severity of hot flashes, and in individual symptom subscales compared with placebo. The extract was rated effective and well tolerated, with no estrogenic effects on the endometrium observed.
Multicenter, randomized, double-blind, placebo-controlled confirmatory trial; one ERr 731 tablet daily for 12 weeks.
112 perimenopausal women with menopausal symptoms.
Compared with placebo, ERr 731 significantly reduced the MRS total score and the number and severity of hot flashes, confirming efficacy for menopausal symptom management. The extract was well tolerated by the majority of women and no relevant safety signals were identified.
Two consecutive 48-week prospective observational extensions following the initial RCT, totaling up to 96 weeks of ERr 731 exposure.
Perimenopausal women previously enrolled in the 12-week RCT who continued with open-label ERr 731.
Continued improvements in MRS II total and subscale scores were observed across the 96-week period, with sustained reductions in hot flashes and mood-related complaints and no adverse events linked to long-term use of the standardized rhubarb extract.