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Siberian Rhubarb Extract Alleviates Menopausal Symptoms in Indian Women

Hormone replacement therapy (HRT) is a mainstay for treating menopause, but more and more women are searching for non-hormonal therapies. An extract from Siberian Rhubarb (latin name Rheum rhaponticum) has been in use treating menopause for decades, and is now gaining popularity in more markets worldwide. Recently (2021) another clinical trial demonstrated the efficacy and safety of this extract, ERr-731, in treating menopause in Indian women.1 In this Indian trial researchers found a 4 mg once daily dose led to an overall 68% reduction in menopausal symptoms across all subscales (somatic, urogenital, and psychological).1 Some of the greatest score improvements were with sleep (70%), depressive mood (73%), and hot flushes (75%).1  Reassessments at weeks 4, 8, and 12 showed progressive improvements, with maximum benefits observed in the last measurements.1

In this Indian trial researchers found a 4 mg once daily dose led to an overall 68% reduction in menopausal symptoms across all subscales (somatic, urogenital, and psychological).1

This most recent study was 12 weeks in duration, used an open-label design, and expands on the diversity of patient population that ERr-731 may be effective for.1 This study included perimenopausal women from 45-55 years old with a Menopause Rating Scale score of >18, which is a lower threshold than some previous clinical trials.1-4

In this study done in India researchers also discovered a modest improvement in fasting and postprandial blood sugar levels, though participants were non-diabetic patients.1 The researchers also looked at blood pressure, lipid, and hsCRP levels, which were not significantly changed throughout the trial.1

This study does have limitations, it was based on a relatively small sample size (129 women were screened, 104 entered, and 70 completed the trial), conducted as open-label trial and only 12 weeks in length.1 However, it builds on good evidence from previous randomized placebo-controlled studies, which demonstrated longer term efficacy and safety.2-4 Those other published trials were studied in Ukraine and Germany, so presumptively this trial has demonstrated ERr-731’s ability to perform for menopausal women across various populations with distinct genetics and cultural/lifestyle practices.2-4

To learn more about ERr-731, a non-hormonal therapy for menopause, check out our in-depth Research Review of ERr-731 here.

Key Clinical Takeaways:

    • ERr-731 can be dosed once daily at 4 mg to effectively relieve many of the symptoms associated with menopause.
    • Generally patients see progressive improvements, with maximal benefit at 12 weeks.
    • ERr-731 has a demonstrated safety record and may provide a modest improvement in blood sugar levels.


  1. Shah J et al. Evaluation of the Efficacy and Safety of Rheum rhaponticum Root Extract (ERr 731) for Menopausal Symptoms in Perimenopausal Indian Women: An Interim Analysis. J Midlife Health. 2021;12(2):108-115.
  2. Kaszkin-Bettag M et al. The special extract ERr 731 of the roots of Rheum rhaponticum decreases anxiety and improves health state and general well-being in perimenopausal women. 2007;14(2):270-283.
  3. Kaszkin-Bettag M et al. Confirmation of the efficacy of ERr 731 in perimenopausal women with menopausal symptoms. Altern Ther Health Med. 2009;15(1):24-34.
  4. Hasper I et al. Long-term efficacy and safety of the special extract ERr 731 of Rheum rhaponticum in perimenopausal women with menopausal symptoms. Menopause. 2009;16:117–131.

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