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In the Siberian Rhubarb and Menopause Research Review, the natural transition period of perimenopause and associated physiological changes are examined, with a focused look at vasomotor symptoms like hot flushes. Pharmacologic and natural treatments for menopausal symptoms are detailed, including the safety and efficacy research that spans 30+ years for a unique phytoestrogen extract from the roots of Siberian rhubarb (Rheum rhaponticum L.) called ERr 731®, a non-hormonal therapy.