Estrovera 30 Tablets

• Clinically shown to dramatically reduce the number of daily menopausal hot flashes♦
• Clinically demonstrated to relieve a wide range of other menopausal symptoms including:♦
  - Sleep disturbances
  - Poor mood, irritability, and anxiety
  - Physical and emotional exhaustion
  - Heart complaints (e.g., racing)
  - Joint and muscle complaints
  - Urinary tract symptoms
  - Vaginal dryness and sexual problems
• No reported changes in safety parameters or serious adverse events in clinical studies lasting up to 2 years♦
• Clinically effective dose in just 1 tablet daily♦

Other Ingredients: Microcrystalline cellulose, stearic acid, croscarmellose sodium, silica, and enteric coating (deionized water, cellulose acetate phthalate, glycerol triacetate, ammonium hydroxide, hypromellose, maltodextrin, and polyethylene glycol).

Caution: Do not use if pregnant or nursing, or if you have endometriosis. This product is contraindicated for individuals with known or suspected hormone-sensitive cancer(s). If taking medication(s), consult your healthcare practitioner before use.

†Also known as special extract ERr 731 of Siberian rhubarb root.

How do I order Metagenics nutritional products?
Metagenics formulas are only available through licensed healthcare practitioners.

What is Estrovera?
Estrovera is a nutraceutical that contains a unique phytoestrogenic extract of a garden rhubarb species that has been recommended in Germany for menopausal complaints since 1993. This extract, referred to in research as ERr 731®, was introduced in 2009 to the United States and is available exclusively from Metagenics. Estrovera contains the first phytonutrient compound shown in well-designed clinical studies to offer effective hot flash reduction similar to conventional hormones therapies, but without the associated risks or other serious adverse events. Estrovera's main active ingredient has also demonstrated significant improvements in common menopausal complaints—such as poor mood, anxiety, and sleep quality—as well as additional measures of quality of life and general health and well-being.♦

Will Estrovera relieve my menopausal hot flashes? And how does it compare to hormone therapies (HT)?
Estrovera offers fast and effective hot flash relief with only 1 tablet daily. Estrovera's active ingredient (ERr 731) is perhaps the only natural approach shown to provide consistent and significant symptom reduction comparable to conventional HT—without the associated risk of serious adverse effects. In a double-blind, placebo-controlled clinical study of perimenopausal women, ERr 731 was shown to relieve moderate and severe hot flashes after only 4 weeks (a study measurement point); the frequency and intensity of hot flashes were further decreased at 8 and 12 weeks. In another double-blind, placebo-controlled clinical study, the efficacy of ERr 731 was confirmed with a statistically significant, average reduction in hot flash frequency from 12 to 2 daily. A comparison of hot flash weekly weighted scores from this study suggests that the effectiveness of ERr 731 is comparable to that of an ultra low dose of HT.♦

How does Estrovera compare to other natural approaches for menopausal hot flash relief?
Due to a lack of well-controlled studies for many natural approaches, including other phytoestrogens, it's difficult to make a comparison. ERr 731 appears to represent a more effective approach than soy, black cohosh, red clover, hops, and flax lignans (to name just a few) that are currently recommended for hot flash relief. Research to date suggests that ERr 731 may be the first phytoestrogen extract to transcend the placebo effect in clinical studies with menopausal women to offer a higher degree of effectiveness with minimal safety concerns for long-term use.♦

What makes Metagenics different from most nutritional supplement companies?
A lot of things make us stand above other companies—a focus on patient health, quality manufacturing, ingredient testing, safety reviews, clinical testing, scientific research, unique formulas, and more.

Does Estrovera help mood or sleep quality?
Estrovera's phytoestrogenic extract has been clinically demonstrated to significantly improve measures of common menopausal symptoms: heart complaints (e.g., racing), sleep problems, poor mood, irritability, anxiety, physical/mental exhaustion, sexual problems, bladder problems,
vaginal dryness, and joint/muscle discomfort. It has also been shown to improve other measures of anxiety, menopause-specific quality of life, and general women's health and well-being.♦

Is Estrovera use recommended for perimenopausal and postmenopausal women?
Yes. Unlike conventional hormone therapies, Estrovera's main ingredient has been demonstrated as a safer approach for perimenopausal women. The predicted safety profile for ERr 731 suggests safe use through postmenopause until symptoms dissipate.♦

How do I take Estrovera?
Take 1 tablet daily with breakfast and a glass of water or as directed by your health care practitioner.

Do I need a stronger dose for more severe symptoms?
Because positive clinical outcomes have been seen at varying intensities of hot flashes at the 4 mg dose, higher doses are not recommended. In fact, women with greater symptomatology in clinical studies reported the greatest benefit, yet did not exceed the recommended dosage. Follow all health care provider recommendations for the dosage of any product, natural or otherwise.♦

How quickly will I notice improvement?
It may take up to 4 weeks for you to notice sustained improvement. Daily supplementation with Estrovera for a minimum of 3 months is suggested to ensure better outcomes, or as your practitioner recommends. You may also benefit from keeping a weekly hot flash diary to help them track Estrovera's effectiveness, as well as to identify eating and lifestyle habits that may also trigger symptoms (e.g., spicy foods, vigorous exercise, heated rooms, and stressful situations).♦

What makes Estrovera unique?
Estrovera contains a novel extract from the root of rhapontic or Siberian rhubarb (Rheum rhaponticum L.). This extract contains natural bioflavonoid compounds (primarily rhaponticin) that are similar to resveratrol and may work collectively to offer menopausal symptom relief. The effectiveness of this extract has been confirmed with well-designed, placebo-controlled clinical studies.♦

How does Estrovera work?
Like many popular approaches for menopausal symptom relief, the exact mechanism of action is not yet clear. (And neither is the exact cause of hot flashes.) ERr 731 has been shown in vitro to exhibit selective estrogen receptor modulator (SERM) properties, primarily as an agonist of estrogen receptor-β, which has been suggested as a possible mechanism of action for observed menopausal symptom relief. Furthermore, the root of Rheum rhaponticum naturally contains significant amounts of the antioxidant flavonoid quercetin, which suggests that ERr 731 may also protect against oxidative stress that contributes to menopause and other age-related complaints.♦

Are Estrovera's ingredients safe?
Estrovera's novel rhubarb extract has an excellent predicted safety profile. ERr 731 has been reviewed by the FDA as a new dietary ingredient and has been dispensed in Germany since 1993 with over 60 million doses to date. ERr 731 and its individual components have been evaluated via in vitro to exhibit predictably safe activity in endometrial and bone cell lines. In vivo toxicity studies have demonstrated no significant effects in clinical observations, blood tests, microscopic findings, and other standard toxicology measures (including those of the uterus). Safety has been further demonstrated through well-designed clinical studies with over 400 patients that include 1- and 2-year evaluations for long-term efficacy. These clinical studies have shown no clinically relevant changes in endometrial biopsies, bleeding, weight, blood pressure, pulse, or other standard laboratory parameters. No serious adverse events associated with ERr 731 use have been reported to date.♦

Does Estrovera have any serious adverse events?
Estrovera's active ingredient, ERr 731, is well tolerated. There have been no serious reported adverse effects associated with ERr 731 supplementation in clinical studies (lasting up to 2 years), in vivo studies, and clinical experience with more than 60 million doses since 1993. Mild and transient symptoms suspected to be related to ERr 731 (e.g., headache) intake have been observed to dissipate after discontinuation.♦

Why is there a laxative warning on the label in California?
This label warning is required by California state law only and does not appear outside the state. Labeling requirements mandate a warning on all dietary supplements containing any amount of herbs known to have a laxative effect, including rhubarb. Although ERr 731 is established in humans to have no laxative effect (unlike some medicinal rhubarb species), there are no exceptions to the labeling requirement and any rhubarb-containing product sold in California must carry this warning.♦

Who should NOT take Estrovera?
Due to lack of safety studies, Estrovera supplementation is not recommended for use during pregnancy, if you are planning to get pregnant, or while nursing. Like other supplements containing natural selective estrogen receptor modulator (SERM) compounds (phytoestrogens), Estrovera should be avoided if you have a known or suspected estrogen-dependant cancer(s), as the effects on cell lines are not known.

Should Estrovera be combined with any other therapy to see positive results?
Because lifestyle factors (e.g., diet, exercise, stress, smoking, alcohol, caffeine, body mass index) can increase the intensity of symptoms, health authorities suggest that a healthier lifestyle greatly contributes to the success of any menopausal approach. Your doctor may recommend Estrovera as part of a comprehensive lifestyle protocol specific to menopausal women. Furthermore, in addition to mineralization support for bone protection (e.g., calcium, magnesium, and other minerals), postmenopausal women may also need nutritional support for bone remodeling, which is also influenced by estrogen decline.♦

Are there benefits to taking Estrovera long term?
Estrovera's phytoestrogenic extract has been investigated in 4 published clinical studies lasting up to 2 years that demonstrate continuing benefit with regular use. Because the extract components are rapidly metabolized within hours of intake, they do not stay in the body to offer residual benefits after intake is halted or missed. Symptoms such as hot flashes reportedly increase a few days after discontinuation, suggesting that daily intake is crucial for sustained relief.♦

Why does Estrovera need to be enteric-coated?
The bioflavonoid compounds in Estrovera break down rapidly. The enteric coating therefore prevents the tablet from premature breakdown in the stomach, ensuring that all the potentially active ingredients are delivered to the small intestine for optimal use. The inactive ingredients used in the enteric coating are approved for use in dietary supplement manufacturing and enhance the delivery of Estrovera's natural active ingredients without compromising its predicted safety profile.♦

In order to ensure proper use of our high-quality nutritional supplements, Metagenics only sells to licensed healthcare practitioners. The products listed in this online catalog are available in the United States and may not be available in other countries. In addition, certain formulas may be slightly different outside the US.

♦ These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any diseases.