Siberian Rhubarb Has Four Human Trials for Menopausal Symptoms

The Oasis Health Journal · Submitted July 24, 2026 · 5:14 PM ET

Rhubarb is mostly known as a pie ingredient that needs a lot of sugar to cooperate. There is also a Siberian kind, and its root has been in four human studies for menopausal symptoms. The pie is unrelated.

What ERr 731 actually is

The studies do not use rhubarb from the garden. They use a standardized extract from the root of Rheum rhaponticum, called ERr 731. It is the active ingredient in Estrovera. It is a plant extract, not hormone therapy, and not a drug. The garden variety is a separate plant, and its leaves are high in oxalic acid, which is why nobody eats them.

The first trial

In a 2006 randomized, double-blind, placebo-controlled trial, 109 perimenopausal women took either one ERr 731 tablet or a placebo daily for 12 weeks. The main measure was the Menopause Rating Scale II, which is a symptom questionnaire. By 12 weeks the score dropped more in the ERr 731 group than in the placebo group. The number and severity of hot flashes were lower starting at week 4. It was one trial, and it was small.

The confirmation trial

A second randomized, placebo-controlled trial, published in 2009, enrolled 112 perimenopausal women for 12 weeks. The Menopause Rating Scale total fell from about 27 to about 12 in the ERr 731 group. In the placebo group it went from about 27 to about 24. The gap between those two numbers was the point of the study. Same extract, same dose, a different set of women.

Anxiety and general well-being

A 2007 analysis from the first trial looked at anxiety using the Hamilton Anxiety Scale. Scores fell from roughly 27 to 9 in the women taking ERr 731, and from roughly 25 to 22 on placebo. People taking it also reported better general well-being. Menopausal symptoms, sleep, and mood tend to travel together, so the overlap is less surprising than it sounds. If the hot flash nights are the problem, that is part of why.

What happens past 12 weeks

Most of these trials ran 12 weeks, which is short. A longer follow-up published in 2009 tracked women for up to 96 weeks. Symptom scores kept drifting down slowly, and by the end the group averaged fewer than 1.4 mild hot flashes per day. No adverse events were tied to long-term use in that report. It was an open-label follow-up, not a placebo comparison, so it reads as a durability-and-safety note rather than proof.

The catch

All four studies share overlapping authors and are connected to the same research network behind the extract. That does not make the numbers fake, but independent replication from unrelated labs is thin. The women were perimenopausal, not postmenopausal, so the results do not automatically transfer. And this is one specific standardized extract, not rhubarb in general. The kind at the grocery store will not do this, and it was never going to.

Where it sits

Siberian rhubarb extract is one of several plant options women weigh during the menopause transition, alongside the more familiar names. It has more placebo-controlled data than most of them. Most of that data comes from one team. Both of those things are true at the same time.

This article is for education, not medical advice. Talk with your clinician before starting a new supplement, especially if you are pregnant, nursing, or taking medication.

Sources

1. Heger M, Ventskovskiy BM, Borzenko I, Kneis KC, Rettenberger R, Kaszkin-Bettag M, Heger PW. Efficacy and safety of a special extract of Rheum rhaponticum (ERr 731) in perimenopausal women with climacteric complaints: a 12-week randomized, double-blind, placebo-controlled trial. Menopause, 2006;13(5):744-759. PubMed
2. Kaszkin-Bettag M, Ventskovskiy BM, Kravchenko A, Rettenberger R, Richardson A, Heger PW, Heger M. The special extract ERr 731 of the roots of Rheum rhaponticum decreases anxiety and improves health state and general well-being in perimenopausal women. Menopause, 2007;14(2):270-283. PubMed
3. Kaszkin-Bettag M, Ventskovskiy BM, Solskyy S, Beck S, Hasper I, Kravchenko A, Rettenberger R, Richardson A, Heger PW. Confirmation of the efficacy of ERr 731 in perimenopausal women with menopausal symptoms. Altern Ther Health Med, 2009;15(1):24-34. PubMed
4. Hasper I, Ventskovskiy BM, Rettenberger R, Heger PW, Riley DS, Kaszkin-Bettag M. Long-term efficacy and safety of the special extract ERr 731 of Rheum rhaponticum in perimenopausal women with menopausal symptoms. Menopause, 2009;16(1):117-131. PubMed