An extract derived from the roots of the rhubarb plant has been shown in a randomized, placebo-controlled trial to provide relief of vasomotor symptoms in peri- and postmenopausal women, Dr. David S. Riley said at the annual meeting of the North American Menopause Society.
The trial, which was conducted at University Hospital, Frankfurt, Germany, showed that women who consumed one tablet containing 4 mg of the extract Rheum rhaponticum, or ERr 731, every day for 12 weeks had a significant reduction in the number and severity of hot flashes, compared with women who took placebo.
Although ERr 731 has been available in Germany for several years, it is still relatively unknown on this side of the Atlantic, Dr. Riley of the University of New Mexico, Albuquerque, explained in a telephone interview. As a consultant to the German researchers, he thought it would be interesting to present their data to clinicians in the United States.
“This is a substance that has been on the market in Germany since 1993, and the research was done in order to reregister it as an herbal medication,” said Dr. Riley, also editor-in-chief of Explore, The Journal of Science and Healing.
Hormone therapy, the standard for relieving vasomotor symptoms of menopause, can have unwanted side effects; other therapies, which do not have troublesome side effects, are of questionable efficacy, he said.
In this study, 112 perimenopausal women were randomized to 4 mg per day of ERr 731 or to placebo for 12 weeks. At the beginning of the trial, all of the women had a menopause rating scale (MRS) score of at least 18, which meant that their menopausal symptoms were moderate to severe.
Factors rated in the MRS score included hot flashes and sweating, heart complaints, sleep disturbances, depressive mood, irritability, anxiety, physical and mental exhaustion, sexual problems, urinary tract complaints, vaginal dryness, and joint and muscle complaints.
The women rated their symptoms on a scale from 0 (no symptoms) to 4 (very severe symptoms). The maximum attainable MRS score was 44 points, Dr. Riley explained.
After 12 weeks of treatment, there was a significant reduction in MRS score in the women taking the extract; 46 of the 56 (82%) women randomized to ERr 731 had a decrease of at least 10 points in their MRS score, compared with 2 (4%) of the women randomized to placebo.
ERr 731 was associated with a significant reduction in hot flashes, compared with placebo, from 11 per day at baseline, to 4 per day at 12 weeks, Dr. Riley said.
The compound was safe and was associated with no breast tenderness or increase in endometrial thickness as assessed on ultrasound and biopsies, no changes in liver enzymes, no changes in blood pressure, no changes in weight, no increase in estradiol or progesterone, and no enhanced bone turnover, he added.
“Women are looking for safe and natural alternatives to hormones to relieve their menopausal symptoms, especially hot flashes, which appear to be the most annoying. This compound is exciting and shows promise, and hopefully we can generate some interest on this side of the Atlantic,” he said.
An extract derived from the roots of Rheum rhaponticum, shown here, has been on the market in Europe since 1993. Courtesy Mueller-Goeppingen