Benign Prostatic Hypertrophy (BPH) (also known as Enlarging Prostate, or EP) is a thickening of the prostate tissue surrounding the urethra in older men that is associated with problems with urination. It is a part of normal aging, and with time some men are affected more than others. Many men don’t want to go to the doctor and get into the cycle of prescription medications. Is there a way they can use alternative or natural options and avoid the doctor? The most commonly promoted natural and herbal alternative is Saw Palmetto. But does it really work?
Saw Palmetto is a supplement derived from the fruit of Serenoa repens or Sabal serrulatum, or the American Dwarf Palm, native to the Southeast US. Saw Palmetto is marketed for the treatment of benign prostatic hypertrophy (BPH), a hardening of the prostate gland that is associated with problems with urination, and is used by 2 million men in the US for that purpose. Saw Palmetto is often mixed with nettle root in a formulation for the prostate. It is promoted as having anti-inflammatory properties, as well as blocking conversion of testosterone to dihydrotestosterone, with resultant shrinkage of the prostate tissue. The primary side effect is stomach upset, which can be reduced by taking it with food.
Saw Palmetto was shown in an initial controlled trial to be efficacious in the treatment of BPH. However a more recent double blind placebo controlled trial failed to show any effects of Saw Palmetto on symptoms of BPH, objective measures of BPH, or quality of life. I think in earlier trials of saw palmetto that patients may have been able to smell the saw palmetto thus breaking the blind. I therefore do not think that saw palmetto is very helpful for BPH, although it is free of risk and if you want to try it you are free to do so.