Diet & Fitness

In many parts of Europe, herbal supplements are considered standard medical treatment for BPH. Although herbs for BPH are available without prescription, men wishing to take them should be monitored by a physician.

The fat-soluble (liposterolic) extract of the saw palmetto berry has become the leading natural treatment for BPH. This extract, when used regularly, has been shown to help keep symptoms in check.^8,9 Saw palmetto appears to inhibit 5-alpha-reductase, the enzyme that converts testosterone to its more active form, dihydrotestosterone (DHT). Saw palmetto also blocks DHT from binding in the prostate.¹⁰ Studies have used 320 mg per day of saw palmetto extract that is standardized to contain approximately 80 to 95% fatty acids.

A three-year preliminary study in Germany found that 160 mg of saw palmetto extract taken twice daily reduced nighttime urination in 73% of patients and improved urinary flow rates significantly.¹¹ In a double-blind trial at various sites in Europe, 160 mg of saw palmetto extract taken twice per day treated BPH as effectively as finasteride without side effects, such as loss of libido.¹² A one-year dose-comparison study found that 320 mg once per day was as effective as 160 mg twice per day in the treatment of BPH.¹³ A review of double-blind trials concluded that saw palmetto is effective for treatment of men with BPH and is just as effective as, with fewer side effects than, the drug finasteride.¹⁴ However, two double-blind trials have found saw palmetto to be ineffective as a treatment for BPH.^15,16 The reason that different studies have had different results is not clear.

Saw palmetto, known more for its use in BPH, has also been used historically for symptoms of prostatitis.¹⁷ According to laboratory studies, saw palmetto contains constituents that act to reduce swelling and inflammation.¹⁸ However, there is no scientific research evaluating the effects of saw palmetto in men with prostatitis.