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Efficacy of the Special Extract ERr 731 from Rhapontic Rhubarb for Menopausal Complaints: A 6-month Open Observational Study

Marietta Kaszkin-Bettag, PhD; Sabine Beck, PhD; Andy Richardson, PhD; Peter W. Heger; André-Michael Beer, MD

Abstract
The most frequently occurring symptoms of menopause are hot flushes and psychosomatic complaints, followed by vaginal dryness, and they all exert a profound impact on the quality of life of sufferers. The special extract ERr 731 (trade name Phyto-Strol® and Phyto-Strol Loges®, Chemisch-Pharmazeutische Fabrik Göppingen, Carl Müller, Apotheker, GmbH & Co KG, Göppingen, Germany) has been an established treatment for menopausal symptoms in women in Germany since 1993.1 ERr 731 is derived from the roots of rhapontic rhubarb (Rheum rhaponticum), also known as Siberian rhubarb. The constituents of the standardized extract ERr 731 (drug:extract ratio 16-26:1,extraction solvent calcium oxide: water, 1:38 [mass/mass]) are rhaponticin, desoxyrhaponticin, rhapontigenin, and desoxyrhapontigenin. They are all-natural hydroxystilbenes and are structurally related to resveratrol, which is found in red wine.2 One tablet of Phyto-Strol 400 mg contains 4 mg of ERr 731.

ERr 731 is well known as an effective and safe medication for the treatment of menopausal symptoms. The recently published results from a 12-week multicenter, prospective, randomized, double- blind, placebo-controlled, clinical trial with 109 perimenopausal women showed that ERr 731 alleviates menopausal symptoms in perimenopause quickly and effectively.1 At the end of the trial, endometrial biopsies, bleeding, body weight, blood pressure, pulse, and laboratory parameters revealed no significant differences among the treatment groups, and there were no adverse events associated with the intake of ERr 731. Importantly, an excellent long-term efficacy, tolerability, and safety profile has been demonstrated in a subsequent open-label observational study with ERr 731 intake over 48 and 96 weeks.3

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