Pause menopause with Rhodiola rosea, a natural selective estrogen receptor modulator Original paper

What was studied?

This study explored the potential of Rhodiola rosea (R. rosea), a natural selective estrogen receptor modulator (SERM), as a treatment for menopause symptoms and health risks. The authors reviewed molecular mechanisms by which R. rosea could mitigate cognitive decline, mood disturbances, cardiovascular disease, osteoporosis, and cancer associated with estrogen decline during menopause. Emphasis was placed on the neuroprotective, cardioprotective, anti-inflammatory, and anti-oxidative properties of R. rosea extracts, particularly focusing on the bioactive constituent salidroside and its interaction with estrogen receptors. The paper also presented a clinical case illustrating improvements in cognitive function and mood with R. rosea treatment in a menopausal woman.

Who was studied?

The study synthesized findings from in vitro, animal, and limited human clinical studies examining R. rosea extracts and salidroside effects on estrogen receptor modulation and menopause-related pathologies. These included ovariectomized rodent models simulating estrogen deficiency, human clinical trials assessing cognitive and mood improvements in stressed or fatigued adults, and case reports from menopausal women. The study focused on women in menopausal transition and postmenopause, at increased risk for neurocognitive, cardiovascular, and bone-related disorders due to estrogen decline.

Most important findings

Rhodiola rosea acts as a natural SERM with tissue-specific modulation of estrogen receptors, showing agonistic effects on brain, bone, and cardiovascular tissues while lacking uterotrophic or pro-carcinogenic activity. Salidroside demonstrated neuroprotective effects by enhancing synaptic function, memory, and executive function, partly via ERβ activation and anti-inflammatory pathways such as NF-κB inhibition. Cardiovascular benefits arose from improved endothelial nitric oxide synthase (eNOS) activity, enhanced nitric oxide production, and antioxidant protection reducing oxidative stress. Osteoprotective effects included inhibition of oxidative stress-induced osteoblast dysfunction, preventing bone loss in estrogen-deficient models. Importantly, R. rosea showed anti-cancer potential by inhibiting proliferation and inducing apoptosis in estrogen receptor-positive and -negative breast cancer cell lines without stimulating tumor growth. Clinically, R. rosea improved cognitive function, reduced anxiety, depression, and fatigue in menopausal and stressed individuals with minimal side effects, suggesting a favorable safety profile compared to synthetic SERMs and hormone replacement therapy (HRT).

Key implications

This review highlights Rhodiola rosea as a promising natural alternative to conventional HRT and synthetic SERMs for managing menopause-associated cognitive decline, mood disorders, cardiovascular risk, osteoporosis, and cancer risk. Its multi-targeted estrogen receptor modulation and anti-inflammatory, antioxidant mechanisms address critical pathways affected by estrogen loss. Unlike HRT, R. rosea may confer these benefits without increasing risks of cancer or thrombosis. However, clinical trials specifically in menopausal women are necessary to validate efficacy, optimal dosing, and long-term safety. The compound’s favorable side effect profile and neuroprotective properties make it a potential adjunct or alternative therapy, aligning well with growing patient interest in botanical and non-hormonal menopause treatments.