How Rose grades evidence
Every supplement, symptom, and treatment page on Rose carries an evidence grade. Here is exactly what each grade means and how we decide.
Rose
"The most important thing I do on this site is tell you when the evidence is weak. I spent too long reading breathless wellness content that made everything sound certain. It is not. The What We Do Not Know section on every page is not a disclaimer. It is the most honest part."
Strong evidence
Multiple well-designed randomised controlled trials (RCTs) showing consistent results. Ideally in menopausal women specifically. Supported by meta-analyses and systematic reviews. The finding has been replicated across independent research groups.
Examples on Rose: Vitamin D3 for bone density. Omega-3 for cardiovascular health. HRT for hot flash relief. CBT-I for insomnia.
Examples on Rose: Vitamin D3 for bone density. Omega-3 for cardiovascular health. HRT for hot flash relief. CBT-I for insomnia.
Mixed evidence
Some positive studies but results are inconsistent across trials. May include good mechanistic evidence but insufficient clinical trials. Studies may exist but not specifically in menopausal women. Results vary significantly between individuals in trials.
Examples on Rose: Black cohosh for hot flashes. Ashwagandha for stress and mood. Acupuncture for vasomotor symptoms.
Examples on Rose: Black cohosh for hot flashes. Ashwagandha for stress and mood. Acupuncture for vasomotor symptoms.
Weak evidence
Limited clinical trials. Studies are small, short-term, or methodologically limited. Evidence is primarily observational, traditional use, or animal/in vitro studies. Clinical benefit has not been reliably demonstrated in rigorous trials.
Examples on Rose: Evening primrose oil for hot flashes. Sage for night sweats. Many herbal combinations marketed for menopause.
Examples on Rose: Evening primrose oil for hot flashes. Sage for night sweats. Many herbal combinations marketed for menopause.
Insufficient evidence
Not enough research exists to draw any meaningful conclusion. The intervention may be promising or it may be ineffective — we simply do not have enough data to say. Rose is honest about this rather than filling the gap with enthusiasm.
Our sources
Rose draws primarily on: PubMed and Cochrane for peer-reviewed research. Menopause Society, British Menopause Society, and International Menopause Society guidelines. NICE guidelines (UK). Major systematic reviews and meta-analyses. We prioritise randomised controlled trials and systematic reviews over observational studies and case reports. We prioritise studies in menopausal women over general adult populations.
What Rose does not do
Rose does not cite studies without reading them. Rose does not upgrade evidence grades because a finding is positive. Rose does not downgrade evidence grades because a finding is inconvenient. Rose does not omit negative studies. Rose does not receive funding from supplement companies, pharmaceutical companies, or any commercial interest. Rose has no financial reason to tell you anything other than the truth.