Menopause Relief e Breast Cancer Risk: What a Big Study Says About ERr 731

Navigating Menopause: The Search for Safe Relief

Okay, let’s talk about menopause. If you’re a woman, or know one, you’re probably familiar with the rollercoaster it can be. Hot flashes that hit out of nowhere, mood swings that make you feel like a teenager again, sleepless nights, and even worries about bone health. Millions of us around the world deal with these symptoms, and finding relief is a big deal.

For a long time, hormone replacement therapy (HRT) has been the go-to. And sure, it can be effective for many symptoms. But here’s the rub – there have always been concerns about potential risks, especially when it comes to things like breast cancer and heart issues. Because of this, lots of women (and maybe you’re one of them!) are looking for other options, something non-hormonal that feels safer but still works.

Enter ERr 731: A Plant-Based Player

This is where a plant called Rheum rhaponticum, or rhapontic rhubarb, comes into the picture. People have used it in traditional medicine for ages. And for over 30 years, a special extract from its roots, known as ERr 731, has been prescribed in Germany specifically for menopausal symptoms. You might know it by brand names like Phytoestrol N or femiLoges. It’s even mentioned in official guidelines for managing menopause symptoms.

Now, researchers have looked into this extract quite a bit. They know what’s in it (mostly something called rhaponticin), how it might work (it seems to interact with a specific estrogen receptor, ERβ, which is different from the one often linked to breast tissue growth, ERα), and smaller studies have suggested it’s pretty safe and can help with symptoms like hot flashes. They’ve also seen that it doesn’t seem to cause concerning changes in things like the uterine lining.

The Big Question: Breast Cancer Risk?

Even with promising smaller studies, a big question has lingered: what about the long-term safety, particularly regarding breast cancer risk? We’ve seen the concerns with HRT, so it’s natural to wonder about any therapy aimed at menopausal symptoms, even a plant-based one. Until now, we haven’t had a large-scale study looking at this in a real-world setting – you know, using data from actual doctors seeing actual patients over many years.

So, a recent study set out to do just that. They wanted to see if women who were prescribed ERr 731 were more likely to be diagnosed with breast cancer later on, compared to women who didn’t use it, and also compared to women who used HRT.

How the Study Worked (Keeping it Simple)

Think of this study like looking back through tons of medical records. Researchers in Germany got data from hundreds of gynecologists’ offices, covering prescriptions given between 1993 and 2022. This is ‘real-world’ data, not a controlled trial where everyone is monitored super closely. It gives us a snapshot of what happens in everyday practice.

They created two main comparisons:

• Group 1: Women who got an ERr 731 prescription versus women who didn’t get ERr 731 (but might have used other things).
• Group 2: Women who got an ERr 731 prescription versus women who got an HRT prescription.

To make the comparisons fair, they used a clever statistical method called ‘matching’. They paired up women in each group who were similar in age, health insurance, and had similar health issues (like obesity, menopausal disorders, or breast conditions) and even past HRT prescriptions before the study started. This helps make sure they’re comparing apples to apples as much as possible.

They looked at data from thousands of women – over 5,000 ERr 731 users matched with over 17,000 non-users for the first comparison, and over 2,600 ERr 731 users matched with over 7,800 HRT users for the second. They then tracked these women over time to see who was diagnosed with breast cancer.

The Results: Good News for ERr 731 Users?

So, what did they find? The big news is pretty straightforward:

• When they compared ERr 731 users to women who didn’t use it, there was no increased risk of being diagnosed with breast cancer. The numbers were practically identical (around 3.5 cases per 1,000 women per year for ERr 731 users vs. 3.4 for non-users).
• When they compared ERr 731 users to women using HRT, again, there was no increased risk associated with ERr 731. The incidence rates were very close (3.6 cases per 1,000 for ERr 731 vs. 3.7 for HRT).

These findings held true even when they looked specifically at different age groups or women who definitely had menopausal symptoms. It seems the association (or lack thereof!) stayed consistent.

Why Might This Be? (A Little Science)

The researchers suggest this fits with what we know about how ERr 731 works. Remember how I mentioned it mainly interacts with ERβ receptors? Well, unlike ERα receptors which are more commonly linked to promoting breast cancer cell growth, ERβ activation isn’t thought to have the same effect, and some studies even suggest it might be protective. The components in ERr 731, like rhaponticin, seem to be selective for ERβ, which could explain why it doesn’t appear to increase breast cancer risk.

What This Means for You

These results are pretty important, especially if you’re looking for ways to manage menopausal symptoms without using traditional HRT, perhaps because you’re concerned about breast cancer risk or have other reasons to avoid hormones. This large, real-world study provides strong evidence suggesting that ERr 731 isn’t associated with a higher chance of getting breast cancer compared to either not using it or using HRT.

Given its track record for helping with symptoms like hot flashes and its apparently favorable safety profile regarding breast and uterine tissue (based on previous studies), ERr 731 looks like a really promising alternative. This is particularly good news for women who might be at higher risk of breast cancer and are usually advised against HRT.

A Few Caveats (Because Science Isn’t Perfect)

Now, while this study is big and uses real-world data, it’s important to remember a few things:

• It shows association, not causation: This type of study can tell us if two things happen together (like using ERr 731 and having a certain risk), but it can’t definitively say that one *causes* the other.
• Data limitations: The study used prescription data. After 2005, ERr 731 became available over-the-counter in Germany, so women buying it without a prescription wouldn’t be included. This means they couldn’t track the total duration of use for everyone. Also, the database relies on doctor’s diagnostic codes, which might not capture every detail or misclassify some cases.
• Missing lifestyle factors: Things like diet, exercise, smoking, and family history can all affect breast cancer risk. The database didn’t have information on these, which could potentially influence the results, although the matching process helps to balance groups on known factors like obesity.

The Takeaway

Despite these limitations, this study is a significant step forward. It provides solid evidence from a large group of women in a real-world setting over many years. The finding that ERr 731 use is not associated with an increased risk of breast cancer diagnosis, compared to both non-users and HRT users, is reassuring.

For women navigating the challenges of menopause and looking for effective, non-hormonal options, ERr 731 appears to be a viable and safe choice, particularly if breast cancer risk is a primary concern. Of course, talking to your doctor about your individual situation and treatment options is always the best approach.

Source: Springer