Saw Palmetto May Improve Prostate Condition
Taking a daily, standardized extract of saw palmetto (Serenoa repens) may improve symptoms of benign prostatic hyperplasia (BPH), according to a new controlled study in Urology.1 Symptoms associated with BPH include increased urinary urgency and frequency, straining while urinating, and a sensation of incomplete voiding after urination.
The study included 85 men over the age of 45, who scored greater than 8 on the International Prostate Symptom Score (IPSS) and had no evidence of prostate cancer. The IPSS is a questionnaire used to determine the severity of urinary blockage and symptoms in men with BPH, with scores of 0 to 7 indicating minimal to no obstruction, 8 to19 signifying mild to moderate obstruction, and 20 to 35 denoting severe obstruction. All participants received a placebo for one month. Then, for the next six months, 41 men received 320 mg per day of a standardized extract of saw palmetto (containing 85% to 95% fatty acids and sterols) and 44 men received a placebo. In addition to the IPSS, measurements of sexual function, urinary flow rate, and side effects of treatment were assessed.
In those taking saw palmetto the IPSS decreased 2.2 points more than it did in the placebo group, a statistically significant difference. However, there were no significant differences in sexual function, urinary flow rate, or side effects between the two groups.
One possible weakness of the study is that the pretreatment IPSS was slightly higher (worse) in the saw palmetto group than in the placebo group. With a higher initial score, it is possible that some of the improvement seen in the saw palmetto group was a statistical artifact, rather than an effect of the treatment. Nevertheless, the results of this study are consistent with those of previously published trials demonstrating that saw palmetto is an effective treatment for the symptoms of BPH,2 3 4 although its mechanism of action remains unknown.
An advantage of saw palmetto over conventional medications is that it has fewer reported side effects, which may improve quality of life. One study found saw palmetto to be as effective as finasteride (Proscar®) in reducing urinary symptoms in men with mild to moderate BPH.5 Men taking 320 mg per day of saw palmetto for six months had a 6% improvement in sexual function, while those taking 5 mg per day of finasteride had a 9% decrease. Additionally, finasteride significantly lowered PSA, a marker for prostate cancer, whereas saw palmetto had no effect on PSA. Because saw palmetto does not lower PSA levels, it seems that taking this herb would not be likely to mask the diagnosis of prostate cancer.
1. Gerber GS, Kuznetsov D, Johnson BC, Burstein JD. Randomized, double-blind, placebo-controlled trial of saw palmetto in men with lower urinary tract symptoms. Urology 2001;58:960–5.
2. Carraro JC, Raynaud JP, Koch G, et al. Comparison of phytotherapy (Permixon®) with finasteride in the treatment of benign prostatic hyperplasia: A randomized international study of 1,098 patients. Prostate 1996;29:231–42.
3. Champault G, Patel JC, Bonnard AM. A double-blind trial of an extract of the plant Serenoa repens in benign prostatic hyperplasia. Br J Clin Pharmacol 1984;18:461–2.
4. Descotes JL, Rambeaud JJ, Deschaseaux P, et al. Placebo-controlled evaluation of the efficacy and tolerability of Permixon® in benign prostatic hyperplasia after exclusion of placebo responders. Clin Drug Invest 1995;9:291–7.
5. Carraro JC, Raynaud JP, Koch G, et al. Comparison of phytotherapy (Permixon®) with finasteride in the treatment of benign prostatic hyperplasia: A randomized international study of 1,098 patients. Prostate 1996;29:231–42.
Darin Ingels, ND, MT (ASCP), received his bachelor’s degree from Purdue University and his Doctorate of Naturopathic Medicine from Bastyr University in Kenmore, WA. Dr. Ingels is the author of Garlic and Cholesterol: Everything You Need to Know (Prima, 1999) and Natural Treatments for High Cholesterol (Prima, 2000). He currently is in private practice in Westport, CT, where he specializes in environmental medicine and allergies. Dr. Ingels is a regular contributor to Healthnotes and Healthnotes Newswire.
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