Background: Hormonal therapy for menopause has been found to be the most efficacious treatment, but it may be associated with adverse effects in some of the women. Rheum rhaponticum root extract (”ERr 731”), which is available worldwide, is a natural, reliable, effective, and well-tolerated remedy for women in perimenopausal women with menopausal symptoms (MSs), but there is no Indian study demonstrating its efficacy, safety, and tolerability till date. Objective: This study aimed to evaluate the efficacy and safety of ERr 731 in alleviating MSs in perimenopausal Indian women. Patients and Methods: In this open-labeled prospective study, 129 perimenopausal women were treated with tablet containing 4 mg of Rr dried root extract once daily for 12 weeks. The Menopause Rating Scale (MRS) II score, endometrial thickness (ET), blood pressure, glycemic status, lipid profile, and high-sensitivity C-reactive protein (hs-CRP) level were periodically assessed and compared. Results: A significant reduction (67% by 12 th week) in the mean MRS II score was observed from baseline till the end of 12 weeks (18.1; 95% confidence interval [CI]: 17.0–19.2; P < 0.001). A monotonic reduction in the mean total MRS II score over time was found (1.51 units/week; 95% CI: 1.42–1.60 units/week; P < 0.001) noticeable. There was a reduction in the mean ET from baseline till the end of 12 weeks, although the change was not significant. There were significant reductions in the mean fasting (6.3 mg/dl; 95% CI: 1.7–11.0 mg/dl; P = 0.008) and postprandial (6.3 mg/dl; 95% CI: 1.0–11.7; P = 0.021) blood glucose levels and glycated hemoglobin level (0.30%; 95% CI: 0.085–0.520; P = 0.007) at 12 weeks. No significant changes were noted in terms of blood pressure, lipid profile, and hs-CRP level. The drug was found to be safe. Conclusion: ERr 731 was well tolerated and was found to be efficacious and safe in alleviating MSs in Indian perimenopausal women.

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Aim:The primary objective of this consensus document is to develop evidence-based consensus recommendations on the use of the levonorgestrel-releasing intrauterine system (LNG-IUS) for contraception in the Indian setting. Background: The unintended pregnancy rate in India is among the highest in the world. Current contraceptive options for women in India include combined or progesterone-only contraceptive pills, vaginal ring, depot medroxyprogesterone acetate, copper intrauterine devices, LNG-IUS, and implants. However, currently, there are no India-specific guidelines/recommendations on the use of LNG-IUS in women. Therefore, an expert panel meeting was convened to arrive at practical recommendations for clinicians on the appropriate use of LNG-IUS. Review results: The panel comprising 15 obstetrics and gynecology experts from India discussed appropriate patient profiles for LNG-IUS and available evidence for the general population and women with comorbidities. The panel thoroughly reviewed the existing literature on contraception and put forth definitive recommendations to be followed on the use of LNG-IUS in the Indian setting. Consensus-based clinical recommendations were developed to serve as a reference for clinicians, regarding the use of LNG-IUS in the general population and women with comorbidities. Conclusion:The use of the LNG-IUS in selected population can ensure contraception and also enhance treatment outcomes. The consensus recommendations given in this document can guide clinicians toward the same in Indian settings. Clinical significance: The LNG-IUS, while being effective for contraception, offers several advantages in terms of reversibility, reduced pelvic infections, etc. Clinicians should carefully select the specific patient profiles/subgroups who would benefit from the use of LNG-IUS.