If you’ve sampled the seemingly endless menu of cooking shows on TV, then undoubtedly you’ve seen some clever things you can do with rhubarb. Perhaps there was a dramatic scene in which the master Italian chef tastes the apprentice’s strawberry dessert sauce and with a perplexed look on his face says, “It needs something…something…yes, that’s it – rhubarb!” The apprentice quickly adds some chopped rhubarb stalks and stirs the new culinary concoction; the mentor then takes a quick taste and shouts, “Yes! That’s it – buonissimo!” Although rhubarb-seasoned strawberry sauce probably won’t make you a reality TV star, the benefits of rhubarb are priceless.

Often mistaken for a fruit, rhubarb is in fact a vegetable. The plant can grow several feet tall, and the edible stalks can grow up to 18 inches (45 cm) in length and two inches (5 cm)  in diameter. The green leaves of the rhubarb plant, which contain oxalic acid, are poisonous and can cause swelling of the tongue and throat and can interfere with breathing. Going back as early as 2700 BCE, rhubarb was used in China for medicinal uses, particularly for its “purgative qualities.” Rhubarb was brought to Britain and the US in the 18th century, primarily for its taste.

Nutritionally, rhubarb is high in fiber (hence its purgative qualities) and vitamin C, but it has many other valuable qualities. Since 1993 it has been used in Germany to treat menopausal symptoms. The specific type of product used in Germany for this purpose is called ERr 731 and is made from a Siberian rhubarb root (Rheum rhaponticum L.). Trade names for it include Phyto-Strol® and Phyto-Strol Loges®. The product comes in a pink and white box with a rather amusing  drawing of a woman dancing in front of the moon.

The Science of ERr 731
To determine the effectiveness and safety of ERr 731 for use by menopausal women, a study of 363 women with menopausal symptoms was conducted among 70 German gynecological practices. The study lasted six months. After the women visited the practices for a baseline assessment, they had follow-up visits after three months and six months. Here is the citation for the study: Kaszkin-Bettag M, Beck S, Richardson A, Heger PW, Beer AM, “Efficacy of the Special Extract ERr 731 from Rhapontic Rhubarb for Menopausal Complaints: A 6-Month Open Observational Study,” Alternative Therapies, Nov/Dec 2008, Vol. 14, No. 6.

Regarding safety, the authors of the study reported the following: “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.” And in a study on ERr 731 that lasted 96 weeks and appeared in the January 2009 issue of , the authors made the following conclusions about safety: “There was no clinically relevant change in safety parameters, and no adverse events were observed with relation to the long-term use of ERr 731.”

These findings are important, as there can be significant risks associated with using hormone replacement drugs to treat menopausal symptoms – such as an increased risk of developing breast cancer. In fact, in June 1998 the National Cancer Institute issued the following statement in their journal: “Hormones may act to promote the late stages of carcinogenesis among postmenopausal women and to facilitate the proliferation of malignant cells. Strategies that do not cause breast cancer are urgently needed for the relief of menopausal symptoms….”

Although 363 women were enrolled in the study, by the end of the study the number of subjects had been reduced to 252 due to protocol deviations, such as pregnancy or simultaneous treatment of menopausal symptoms with other nutriceuticals (including soy, red clover and black cohosh) or medicines.

The study was observational, in that conclusions (hypotheses) were based upon observing the subjects’ responses. To measure the responses, the researchers used the Menopause Rating Scale (MRS), which consists of rating 11 symptoms on a scale of 0-4 (0 = none, 1 = mild, 2 = moderate, 3 = severe, 4 = severe). The total score ranges from 0 to 44, with the lower score representing less severe menopausal symptoms, although each of the 11 symptoms could also be tracked.

As a way of classifying the effects of rhubarb, each of the 11 symptoms were placed into one of three categories, or subscales. These subscales are as follows:

Psychological: Depressive mood, irritability, anxiety, physical and mental exhaustion
Somatic: Hot flushes/sweating, heart discomfort, sleep problems, joint and muscular discomfort
Urogenital: Sexual problems, urinary tract complaints, vaginal dryness

Upon evaluating the results, the researchers found a significant reduction in menopausal symptoms. The average MRS total score was 14.7 points at baseline and 6.9 points after six months. In other words, during the study the average score decreased from 33.4 percent to 15.68 percent.

In looking at the 11 symptoms, the researchers noted that the most “pronounced effect” occurred during the first three months but that improvements continued to be made in all 11 symptoms for the final three months. The most pronounced improvements were observed for the symptoms of hot flushes/sweating, irritability, sleep problems, depressive mood, and physical and mental exhaustion.

The Siberian rhubarb root used in this impressive study is the primary ingredient in Rhubarb Px. Although a doctor’s prescription is not needed to purchase Rhubarb Px, this product is contraindicated for women who are pregnant or nursing or who have a suspected estrogen-dependent cancer; also, if you are taking any medications, you should consult with your healthcare practitioner before use.

The recommended dosage of Rhubarb Px is just one tablet per day (much more convenient than preparing daily meals using rhubarb stalks!), although some women have gotten faster results by using up to 4 tablets per day at first. Most women notice results in about 1-2 weeks, but as this study found, improvements can continue to occur even when the product is taken daily for at least six months.

Although using a tasty vegetable to resolve undesirable menstrual symptoms might seem too good to be true, scientific research has proven that rhubarb is an effective and safer alternative to drugs.