by JANE ALLIN
October is National Breast Cancer Month. What better opportunity to remind women of the dangers posed by the use of HRT and the inherent cruelty foisted upon the innocent mares and their foals by the PMU industry?
Despite advances in medical technology over the years, Pfizer continues to promote their conjugated equine estrogen drugs (e.g. Premarin, Prempro, Duavee) based on antiquated science – science that has since been proven to be flawed.
In fact, the findings of the WHI study was listed as one of the top ten medical advances of the decade in an article published in 2009; “The Top 10 Medical Advances of the Decade: From genome to hormones, doctors pick the top medical advances of the decade.” 
“And then the world changed, the National Heart Lung and Blood Institute, which was sponsoring a placebo-controlled trial of hormone replacement therapy in more than 161,000 healthy women, announced that it was shutting down the study because HRT increased the risk of heart attack, stroke, blood clots, and breast cancer.
It was the “oops” heard round the world.” 
Why are these drugs still here 14 years after the fact? Why haven’t the FDA and other drug agencies around the world pulled these from the market?
Time and again the antagonistic effects of conjugated equine estrogens have proven to be potent carcinogens that give rise to a variety of cancers and other life-threatening diseases, breast cancer included.
The FDA and other governing bodies such as the European Commission in the EU continue to endorse these drugs as safe therapies for women of menopausal and post-menopausal age despite the unequivocal dire warnings on the packaging cautioning women of substantial risks that should, in any dutiful context, prevent these drugs from being marketed.
And not to forget the pitiful existence of the mares and their by-products – the innocent foals born into a precarious world where their fate is sealed if there are no takers. Now of course, this malevolent industry has moved across the globe to countries where animal welfare is decidedly worse than the loathsome state of affairs in North America.
But there are of course options – alternatives to the use of drugs containing equine-derived hormones. The Horse Fund has compiled a list of such options (see http://horsefund.org/pmu-alternatives-to-cee-drugs.php) as well as the safety aspects of FDA-approved prescription versions of HRT that are not derived from pregnant mare’s urine. 
One natural alternative that crops up (pun intended) on occasion, yet is not mentioned in either of these articles, is “rhubarb”.
Rhubarb is said to be a very “old” plant, meaning that documented knowledge of the plant goes back as far as 2,700 years in China. The roots were said to have medicinal value and were a prized commodity for treating a variety of ailments. 
In many cultures, herbs and foods that contain so-called phytoestrogens have been used to treat symptoms of climacteric complaints – that is, complaints associated with the transition between premenopause, perimenopause and early postmenopausal stages. Examples include black cohosh, soy and red clover; rhubarb is also classified as a phytoestrogen.
Phytoestrogens are known to have distinct actions on what are known as estrogen receptors (ERs) which are activated by the hormone estrogen. As an example, estrogen receptors are over-expressed in around 70% of breast cancer cases, referred to as “ER-positive”, which can lead to proliferation of mammary cells. Moreover, estrogen metabolism creates genotoxic waste – chemical agents that damage the genetic information within a cell causing mutations which may lead to cancer.
There is growing evidence that phytoestrogens could have a protective effect on the initiation or progression of breast cancer by inhibiting pathways important for cell growth and proliferation. The characterized mode of phytoestrogen action is estrogen receptor (ER) binding which effectively blocks estrogen from binding to the ER and reduces the risk of cell propagation. Their metabolic actions are much more complicated than this simple explanation and the science behind their effectiveness is challenging to address. 
Essentially this is what a SERM’s (Selective Estrogen Receptor Modulator) function is.
Several reports have indicated that experimental data supports the theory that ERr from the rhubarb plant and/or its constituents do in fact exhibit(s) SERM-like properties. 
SERMs block the effects of estrogen in the breast tissue, for example, as well as other tissues in the body that have estrogen receptors (e.g. bones, uterus). Recall that the bazedoxifene component of Duavee is a SERM, although it is not naturally derived, nor has it been officially approved by the FDA as a stand alone drug.
Several scholarly articles can be found online that describe the efficacy and safety profile of rhubarb extracts in the treatment of menopausal symptoms such as hot flashes, sweating, sleep disturbances, and mood swings.
In each of these, a pill containing the extract (ERr) significantly reduced vasomotor and other menopausal symptoms. ERr was first introduced to treat menopausal symptoms in 1993 and has had no severe adverse effects reported with its use.
In an article published in Menopause in 2006 “Efficacy and safety of a special extract of Rheum rhaponticum (ERr 731 – trade name Phytoestrol N) in perimenopausal women with climacteric complaints: a 12-week randomized, double-blind, placebo-controlled trial.” Authored by Heger et al, the effectiveness of the rhubarb extract ERr 731 to treat menopausal symptoms was validated by a multicenter, prospective, randomized, double-blind, placebo-controlled, clinical trial on 109 women with climacteric complaints receiving either a daily dose of 4 mg of ERr 731 or a placebo. 
The primary outcome criterion for the efficacy of ERr 731 was the change of the Menopause Rating Scale II (MRS II) total score compared to the placebo after 12 weeks. The MRS II is a health-related quality of life developed in the early 1990’s that measures the severity of age-/menopausal-related complaints by rating a profile of 11 different symptoms. 
These symptoms include; hot flashes/flushes, heart discomfort, sleep problems, depressive mood, irritability, anxiety, physical and mental exhaustion, sexual problems, bladder problems, dryness of vagina and joint and muscular discomfort. 
Additionally, the MRS II score was accompanied by secondary outcome criteria which included physical examinations to assess the safety of ERr 731 (e.g. vaginal smear, pap smear, transvaginal ultrasound, endometrial biopsy, breast palpitation, body weight).
The treatment outcome after the intake of ERr 731 or placebo for 12 weeks was assessed by both the investigators and participants according to the Integrative Medicine Outcome Scale (IMOS) – a 4-point (investigator) and 5-point (patient) verbal rating scale ( complete recovery (patient-only), major improvement, moderate change, no change, and deterioration). Results are shown in the figure below.
More detailed results, including the MRS II scores, are shown in the paper. 
Clearly the rhubarb ERr 731 extract is effective in significantly reducing symptomatic climacteric complaints when compared to the placebo.
Throughout the trial no abnormalities in breast tissue were observed which support those of long-term treatment with ERr 731 in everyday practice.
Moreover, women who took the ERr 731 experienced no vaginal bleeding and spotting which are common side effects due to an estrogen-dependent stimulation of the endometrium, nor was there any evidence of endometrial hyperplasia in the treated women.
Neither clinical nor experimental results detected any adverse effects of ERr 731 (e.g. uterine and endometrial growth and proliferation) which suggests that ERr 731 exerts SERM-like activites.
Overall, the trial results show that ERr 731 is a highly effective, well-tolerated, and safe herbal medicinal product in the treatment of climacteric complaints in the transition through the various stages of menopause as an alternative to traditional HRT. 
The demand for safe and effective estrogen-free medications is ever-increasing given the risks associated with conventional HRT, particularly those derived from conjugated equine estrogens.
In the end what matters most is that women become informed from a health and risk perspective with the realization that there is no need for PMU farming operations, whether that be here in North America or on the fledgling farms in lands far away.
PFIZER MARCHES ON
Unfortunately Pfizer, and now their counterparts in foreign jurisdictions, continue to deceitfully market these drugs as the panacea to every woman’s natural menopausal transition.
Sadly, those farms in China, India and other places where they may exist, are, in general, without the same level of oversight from advocates of animal welfare, unlike here in North America where the plight of animals, whether that be livestock or the use of animals for other human profit, such as the PMU horses, has an ever-increasing base of concerned citizens.
Foremost because the industry outside of North America is, relatively speaking, new, secondly because animal welfare issues appear to be less front and center and last, but not least, because many people in these countries are likely unaware of the risks associated with these drugs derived from pregnant mare’s urine.
This of course is changing as time progresses.
At one point North America, and the EU for example, were in the same position. It took decades for the truth to surface and yet Pfizer still manages to market these drugs, considered carcinogens, to physicians and their patients alike without moral compass from all perspectives – horse or human.
After all, to Big Pharma it is all about corporate welfare and shareholder satisfaction no matter what the cost.
Save a horse – go out and eat some rhubarb, just don’t eat the leaves. 
 http://www.rhubarbinfo.com/history and http://www.botanical.com/botanical/mgmh/r/rhubar14.html
© THE HORSE FUND
“The Health Benefits of Rhubarb“, Livestrong.com.
• A Look at a PMU Farm in China and It’s Not all About Pfizer; Tuesday’s Horse
• Premstoppers Campaign; The Horse Fund