4.6

CiteScore

2.2

Impact Factor
  • ISSN 1674-8301
  • CN 32-1810/R
Vishal P. Dubey, Varun P. Sureja, Dharmeshkumar B. Kheni. Efficacy evaluation of standardized Rheum rhaponticum root extract (ERr 731®) on symptoms of menopause: A systematic review and meta-analysis study[J]. The Journal of Biomedical Research, 2024, 38(3): 278-286. DOI: 10.7555/JBR.37.20230219
Citation: Vishal P. Dubey, Varun P. Sureja, Dharmeshkumar B. Kheni. Efficacy evaluation of standardized Rheum rhaponticum root extract (ERr 731®) on symptoms of menopause: A systematic review and meta-analysis study[J]. The Journal of Biomedical Research, 2024, 38(3): 278-286. DOI: 10.7555/JBR.37.20230219

Efficacy evaluation of standardized Rheum rhaponticum root extract (ERr 731®) on symptoms of menopause: A systematic review and meta-analysis study

More Information
  • Corresponding author:

    Vishal P. Dubey, Department of Scientific and Medical Affairs, Sundyota Numandis Probioceuticals Pvt. Ltd., Prahladnagar, Ahmedabad, Gujarat 380015, India. E-mails: vishal.d@sundyotanumandis.com and rx.vishaldubey@gmail.com

  • Received Date: September 14, 2023
  • Revised Date: January 15, 2024
  • Accepted Date: January 21, 2024
  • Available Online: January 23, 2024
  • Published Date: April 17, 2024
  • Menopause is characterized by various physical, mental and emotional symptoms. ERr 731® is a standardized extract from Rheum rhaponticum root and has been clinically studied for its role in reducing menopausal symptoms. The current systematic review and meta-analysis aimed to evaluate the efficacy of ERr 731® supplementation in alleviating the severity of menopausal symptoms. In this review, we searched across three online databases up to March 2023, evaluated the quality of the included studies by the Physiotherapy Evidence Database scale, and assessed the risk of bias by the Cochrane Risk of Bias tool. We then performed a meta-analysis using RevMan software to estimate the pooled mean difference (MD). The study protocol was registered in the Prospective Register of Systematic Reviews (CRD42023416808). After screening and evaluation, we included four high-quality studies (a total of 390 participants; the ERr 731® group: 193 participants; the control group: 197 participants) in the meta-analysis. The results showed that ERr 731® supplementation significantly reduced the Menopause Rating Scale score (MD: –15.12; P < 0.001), compared with control therapy. Sensitivity analysis revealed no effect of individual studies on the overall pooled estimate or overall observed heterogeneity. The current review provides evidence that ERr 731® supplementation is effective in reducing menopause symptoms. Potential bias and high heterogeneity in the results warrant further clinical studies.

  • This work received no funding from any source.

    None.

    CLC number: R711, Document code: A

    The authors reported no conflict of interests.

  • [1]
    Cengiz H, Kaya C, Caypinar SS, et al. The relationship between menopausal symptoms and metabolic syndrome in postmenopausal women[J]. J Obstet Gynaecol, 2019, 39(4): 529–533. doi: 10.1080/01443615.2018.1534812
    [2]
    Kaya C, Cengiz H, Yeşil A, et al. The relation among steroid hormone levels, lipid profile and menopausal symptom severity[J]. J Psychosom Obstet Gynecol, 2017, 38(4): 284–291. doi: 10.1080/0167482X.2017.1321633
    [3]
    Nelson HD. Menopause[J]. Lancet, 2008, 371(9614): 760–770. doi: 10.1016/S0140-6736(08)60346-3
    [4]
    Kalhan M, Singhania K, Choudhary P, et al. Prevalence of menopausal symptoms and its effect on quality of life among rural middle aged women (40-60 years) of Haryana, India[J]. Int J Appl Basic Med Res, 2020, 10(3): 183–188. doi: 10.4103/ijabmr.IJABMR_428_19
    [5]
    Shah J, Chandanani S, Reddy 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]. J Midlife Health, 2021, 12(2): 108–115. https://pubmed.ncbi.nlm.nih.gov/34526744/
    [6]
    Marjoribanks J, Farquhar C, Roberts H, et al. Long term hormone therapy for perimenopausal and postmenopausal women[J]. Cochrane Database Syst Rev, 2012, (7): CD004143. https://pubmed.ncbi.nlm.nih.gov/22786488/
    [7]
    Glazier MG, Bowman MA. A review of the evidence for the use of phytoestrogens as a replacement for traditional estrogen replacement therapy[J]. Arch Intern Med, 2001, 161(9): 1161–1172. doi: 10.1001/archinte.161.9.1161
    [8]
    Mehta J, Kling JM, Manson JE. Risks, benefits, and treatment modalities of menopausal hormone therapy: current concepts[J]. Front Endocrinol, 2021, 12: 564781. doi: 10.3389/fendo.2021.564781
    [9]
    Vollmer G, Papke A, Zierau O. Treatment of menopausal symptoms by an extract from the roots of rhapontic rhubarb: the role of estrogen receptors[J]. Chin Med, 2010, 5: 7. doi: 10.1186/1749-8546-5-7
    [10]
    Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews[J]. BMJ, 2021, 372: n71. doi: 10.1136/bmj.n71
    [11]
    Higgins JPT, Thomas J, Chandler J, et al. Cochrane handbook for systematic reviews of interventions[M]. Hoboken: John Wiley & Sons, 2019: 156–167.
    [12]
    Dixon A, Robertson K, Yung A, et al. Efficacy of probiotics in patients of cardiovascular disease risk: a systematic review and meta-analysis[J]. Curr Hypertens Rep, 2020, 22(9): 74. doi: 10.1007/s11906-020-01080-y
    [13]
    Aguiar AF, Casonatto J. Effects of citrulline malate supplementation on muscle strength in resistance-trained adults: a systematic review and meta-analysis of randomized controlled trials[J]. J Diet Suppl, 2022, 19(6): 772–790. doi: 10.1080/19390211.2021.1939473
    [14]
    Sterne JAC, Savović J, Page MJ, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials[J]. BMJ, 2019, 366: l4898. https://pubmed.ncbi.nlm.nih.gov/31462531/
    [15]
    Yagiz G, Akaras E, Kubis HP, et al. The effects of resistance training on architecture and volume of the upper extremity muscles: a systematic review of randomised controlled trials and meta-analyses[J]. Appl Sci, 2022, 12(3): 1593. doi: 10.3390/app12031593
    [16]
    Heger M, Ventskovskiy BM, Borzenko I, et al. 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[J]. Menopause, 2006, 13(5): 744–759. doi: 10.1097/01.gme.0000240632.08182.e4
    [17]
    Kaszkin-Bettag M, Ventskovskiy BM, Solskyy S, et al. Confirmation of the efficacy of ERr 731 in perimenopausal women with menopausal symptoms[J]. Altern Ther Health Med, 2009, 15(1): 24–34. https://pubmed.ncbi.nlm.nih.gov/19161045/
    [18]
    Hasper I, Ventskovskiy BM, Rettenberger R, et al. Long-term efficacy and safety of the special extract ERr 731 of Rheum rhaponticum in perimenopausal women with menopausal symptoms[J]. Menopause, 2009, 16(1): 117–131. doi: 10.1097/gme.0b013e3181806446
    [19]
    Thiemann E, Heger PW, Chang JL, et al. The special extract ERr 731® is save in acute and long-term treatment of climacteric complaints in perimenopausal women[C]//Proceedings of the International Conference on Science and Society: Biopiracy and Phytomedicine. Mainz, Germany: ICSS, 2017: 49.
    [20]
    Jia M, Dahlman-Wright K, Gustafsson JÅ. Estrogen receptor alpha and beta in health and disease[J]. Best Pract Res Clin Endocrinol Metab, 2015, 29(4): 557–568. doi: 10.1016/j.beem.2015.04.008
    [21]
    Paterni I, Granchi C, Katzenellenbogen JA, et al. Estrogen receptors alpha (ERα) and beta (ERβ): subtype-selective ligands and clinical potential[J]. Steroids, 2014, 90: 13–29. doi: 10.1016/j.steroids.2014.06.012
    [22]
    Chen GG, Zeng Q, Tse GMK. Estrogen and its receptors in cancer[J]. Med Res Rev, 2008, 28(6): 954–974. doi: 10.1002/med.20131
    [23]
    Brown M, Cato L, Jeselsohn R. Hormone-Responsive Cancers[M]//Strauss III JF, Barbieri RL. Yen & Jaffe's Reproductive Endocrinology. 8th ed. Amsterdam: Elsevier, 2019: 717–741. e8.
    [24]
    Wober J, Möller F, Richter T, et al. Activation of estrogen receptor-β by a special extract of Rheum rhaponticum (ERr 731®), its aglycones and structurally related compounds[J]. J Steroid Biochem Mol Biol, 2007, 107(3-5): 191–201. doi: 10.1016/j.jsbmb.2007.04.002
    [25]
    Kaszkin-Bettag M, Ventskovskiy BM, Kravchenko A, 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[J]. Menopause, 2007, 14(2): 270–283. doi: 10.1097/01.gme.0000251932.48426.35
    [26]
    Möller F, Richter T, Unger C, et al. Activation of estrogen receptor-ß by a special extract of Rheum rhaponticum (ERr 731®), its aglycones and structurally related compounds[J]. Zeitschrift für Phyther (in German), 2006, 27: 26. https://www.err731.com/?page_id=271
    [27]
    Papke A, Möller F, Rettenberger R, et al. The special extract of Rheum rhaponticum (ERr 731®) does not stimulate uterine growth and proliferation in ovariectomized wistar rats[J]. Zeitschrift für Phyther (in German), 2008, 29(S1): 28. doi: 10.1055/s-2008-1047875
    [28]
    Papke A, Kretzschmar G, Zierau O, et al. Effects of the special extract ERr 731® from Rheum rhaponticum on estrogen-regulated targets in the uterotrophy model of ovariectomized rats[J]. J Steroid Biochem Mol Biol, 2009, 117(4-5): 176–184. doi: 10.1016/j.jsbmb.2009.09.011
    [29]
    Keiler AM, Papke A, Kretzschmar G, et al. Long-term effects of the rhapontic rhubarb extract ERr 731® on estrogen-regulated targets in the uterus and on the bone in ovariectomized rats[J]. J Steroid Biochem Mol Biol, 2012, 128(1-2): 62–68. doi: 10.1016/j.jsbmb.2011.08.016
    [30]
    Kaszkin-Bettag M, Richardson A, Rettenberger R, et al. Long-term toxicity studies in dogs support the safety of the special extract ERr 731 from the roots of Rheum rhaponticum[J]. Food Chem Toxicol, 2008, 46(5): 1608–1618. doi: 10.1016/j.fct.2007.12.026
    [31]
    Kaszkin-Bettag M, Beck S, Richardson A, et al. Efficacy of the special extract ERr 731 from rhapontic rhubarb for menopausal complaints: a 6-month open observational study[J]. Altern Ther Health Med, 2008, 14(6): 32–38. https://pubmed.ncbi.nlm.nih.gov/19043936/
    [32]
    Chang JL, Montalto MB, Heger PW, et al. Rheum rhaponticum extract (ERr 731): Postmarketing data on safety surveillance and consumer complaints[J]. Integr Med, 2016, 15(3): 34–39. https://pubmed.ncbi.nlm.nih.gov/27547165/
  • Related Articles

    [1]Liping Cheng, He Jin, Tianheng Xiao, Xiaoyu Yang, Tingting Zhao, Eugene Yujun Xu. Human circBOULE RNAs as potential biomarkers for sperm quality and male infertility[J]. The Journal of Biomedical Research, 2024, 38(5): 473-484. DOI: 10.7555/JBR.37.20230296
    [2]Zhang Weifeng, Chen Han, Zhang Guoxin, Jin Guangfu. A nomogram for predicting lymph node metastasis in superficial esophageal squamous cell carcinoma[J]. The Journal of Biomedical Research, 2021, 35(5): 361-370. DOI: 10.7555/JBR.35.20210034
    [3]He Xi, Xie Wenxiu, Li Huiling, Cui Yiqiang, Wang Ya, Guo Xuejiang, Sha Jiahao. The testis-specifically expressed gene Trim69 is not essential for fertility in mice[J]. The Journal of Biomedical Research, 2021, 35(1): 47-60. DOI: 10.7555/JBR.34.20200069
    [4]Huang Lei, Lu Qun, Du Jiangbo, Lv Hong, Tao Shiyao, Chen Shiyao, Li Xiuzhu, Han Xiumei, Zhou Kun, Xu Bo, Liu Xiaoyu, Ma Hongxia, Xia Yankai, Jin Guangfu, Shen Hongbing, Ling Xiufeng, Hu Zhibin, Tan Jichun, Diao Feiyang. Cumulative live birth rates of in vitro fertilization/intracytoplasmic sperm injection after multiple complete cycles in China[J]. The Journal of Biomedical Research, 2020, 34(5): 361-368. DOI: 10.7555/JBR.34.20200035
    [5]Slimen Itaf Ben, Boubchir Larbi, Seddik Hassene. Epileptic seizure prediction based on EEG spikes detection of ictal-preictal states[J]. The Journal of Biomedical Research, 2020, 34(3): 162-169. DOI: 10.7555/JBR.34.20190097
    [6]Wang Le Yi, McKelvey George M., Wang Hong. Multi-outcome predictive modelling of anesthesia patients[J]. The Journal of Biomedical Research, 2019, 33(6): 430-434. DOI: 10.7555/JBR.33.20180088
    [7]Young-Joo Yi, S. Kamala-Kannan, Jeong-Muk Lim, Byung-Taek Oh, Sang-Myeong Lee. Effects of difructose dianhydride (DFA)-IV on in vitro fertilization in pigs[J]. The Journal of Biomedical Research, 2017, 31(5): 453-461. DOI: 10.7555/JBR.31.20160115
    [8]Anna Karolina Zuk, Xuesong Wen, Stephen Dilworth, Dong Li, Lucy Ghali. Modeling and validating three dimensional human normal cervix and cervical cancer tissues in vitro[J]. The Journal of Biomedical Research, 2017, 31(3): 240-247. DOI: 10.7555/JBR.31.20160150
    [9]Seo-jin Park, Kyoung-Ha So, Sang-Hwan Hyun. Effect of zeaxanthin on porcine embryonic development during in vitro maturation[J]. The Journal of Biomedical Research, 2017, 31(2): 154-161. DOI: 10.7555/JBR.31.20160079
    [10]Eliza Shrestha, Yuebo Yang, Xiaomao Li, Yu Zhang. Successful conservative management with methotrexate and mifepristone of cervical pregnancy[J]. The Journal of Biomedical Research, 2011, 25(1): 71-73. DOI: 10.1016/S1674-8301(11)60009-2
  • Other Related Supplements

Catalog

    Figures(5)  /  Tables(4)

    Article Metrics

    Article views (466) PDF downloads (262) Cited by()
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return