Saw palmetto (Serenoa repens/Sabal serrulata) is a palm like plant with berries that were a staple food and medicine for the Native Americans of the southeastern United States. In the early 1900s, men used the berries to treat urinary tract problems, and even to increase sperm production and boost libido. Today, the primary use of saw palmetto is to treat benign prostatic hyperplasia (BPH), a noncancerous enlargement of the prostate gland. Researchers aren't sure exactly how saw palmetto works, but it contains plant-based chemicals that may be effective for BPH. Researchers think that saw palmetto may affect the level of testosterone in the body, and perhaps reduce the amount of an enzyme that promotes the growth of prostate cells. Saw palmetto is often combined with nettle extract to treat BPH.
Benign Prostatic Hyperplasia (BPH)
Evidence is mixed about whether saw palmetto works to treat BPH. Several studies suggest that the herb is effective for treating symptoms, including too frequent urination, having trouble starting or maintaining urination, and needing to urinate during the night. The urethra, the tube that empties urine from the body, runs through the prostate gland in men; when the prostate gland is enlarged, men may have trouble urinating.
Some studies show that saw palmetto is as effective in treating symptoms as finasteride (Proscar) without side effects, such as loss of libido. Other studies suggest that saw palmetto may actually shrink the size of the prostate gland. Due to the short duration (usually less than 3 months) of these studies, it is not possible to say for sure whether saw palmetto is truly effective for preventing complications of BPH. In fact, a well-conducted study published in the New England Journal of Medicine found that saw palmetto was no better than placebo in relieving the signs and symptoms of BPH.
It is important to receive a proper diagnosis of BPH from your health care provider to rule out prostate cancer.
Animal studies show that saw palmetto inhibits the growth of tumor cells, indicating that it may be helpful in the treatment of prostate cancer. Other studies show that saw palmetto improves urinary tract symptoms related to BPH. While these studies are promising, more research is needed to determine whether saw palmetto is effective for these conditions.
Agbabiaka TB, Pittler MH, Wider B, Ernst E. Serenoa repens (saw palmetto): a systematic review of adverse events. Drug Saf. 2009;32(8):637-47.
Bent S, Kane C, Shinohara K, et. al. Saw Palmetto for Benign Prostatic Hyperplasia. NEJM. 2006; 354:557-566.
Blumenthal M, Goldberg A, Brinckmann J. Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Integrative Medicine Communications; 2000:335-340.
Bone K, Mill S, eds. Principles and Practices of Phytotherapy, Modern Herbal Medicine. London: Churchill Livingstone; 2000:523-532.
Boyle P, Robertson C, Lowe F, Roehrborn C. Updated meta-analysis of clinical trials of Serenoa repens extract in the treatment of symptomatic benign prostatic hyperplasia. BJU International. 2004;93(6):751-756.
Braeckman J. The extract of Serenoa repens in the treatment of benign prostatic hyperplasia: A multicenter open study. Curr Therapeut Res. 1994;55:776–785.
Carraro JC, Raynaud JP, Koch G, Chisholm GD, Di Silverio F, Teillac P et al. Comparison of phytotherapy (Permixon) with finasteride in the treatment of benign prostate hyperplasia: a randomized international study of 1,098 patients. Prostate. 1996;29(4):231-242.
Dedhia RC, McVary KT. Phytotherapy for lower urinary tract symptoms secondary to benign prostatic hyperplasia. J Urol. 2008;179(6):2119-25.
De La Taille A, Buttyan R, Hayek O, et al. Herbal therapy PC-SPES: In vitro effects and evaluation of its efficacy in 69 patients with prostate cancer. J Urol. 2000;164:1229-1234.
Di Silverio F, D'Eramo G, Lubrano C, et al. Evidence that Serenoa repens extract displays an antiestrogenic activity in prostatic tissue of benign prostatic hypertrophy patients. Eur Uro.1992;21:309-314.
Dull P, Reagan RW Jr, Bahnson RR. Managing benign prostatic hyperplasia. American Family Physician. 2002;66(1):77-84 and 87-88.
Engelmann U, Walther C, Bondarenko B, Funk P, Schläfke S. Efficacy and safety of a combination of sabal and urtica extract in lower urinary tract symptoms. A randomized, double-blind study versus tamsulosin. Arzneimittelforschung. 2006;56(3):222-229.
Ernst E. The risk-benefit profile of commonly used herbal therapies: Ginkgo, St. John's Wort, Ginseng, Echinacea, Saw Palmetto, and Kava. Ann Intern Med. 2002;136(1):42-53.
Gerber GS. Saw palmetto for the treatment of men with lower urinary tract symptoms. J Urol. 2000;163(5):1408-1412.
Gerber GS, Fitzpatrick JM. The role of a lipido-sterolic extract of Serenoa repens in the management of lower urinary tract symptoms associated with benign prostatic hyperplasia. BJU International. 2004;94(3):338-344.
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(6):960-965.
Goepel M, Hecker U, Krege S. Saw palmetto extracts potently and noncompetitively inhibit human a1-adrenoceptors in vitro. Prostate. 1998;38(3):208-215.
Hong H, Kim CS, Maeng S. Effects of pumpkin seed oil and saw palmetto oil in Korean men with symptomatic benign prostatic hyperplasia. Nutr Res Pract. 2009;3(4):323-7.
Izzo AA, Ernst E. Interactions between herbal medicines and prescribed drugs: a systematic review. Drugs. 2001;61(15):2163-2175.
Koch E. Extracts from fruits of saw palmetto (Sabal serrulata) and roots of stinging nettle (Urtica dioica): viable alternatives in the medical treatment of benign prostatic hyperplasia and associated lower urinary tracts symptoms. Planta Med. 2001;67(6):489-500.
Marks LS, Partin AW, Epstein JI, et al. Effects of saw palmetto herbal blend in men with symptomatic benign prostatic hyperplasia. J Urol. 2000;163(5):1451-1456.
Miller LG. Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions. Arch Intern Med. 1998;158(20):2200-2211.
Miller: Miller's Anesthesia, 7th ed. Philadelphia, PA. Churchill Livingstone. 2009.
Pittler MH. Complementary therapies for treating benign prostatic hype.rplasia. FACT. 2000;5(4):255-257.
Pytel YA, Vinarov A, Lopatkin N, Sivkov A, Gorilovsky L, Raynaud JP. Long-term clinical and biologic effects of the lipidosterolic extract of Serenoa repens in patients with symptomatic benign prostatic hyperplasia. Advanced Therapy. 2002;19(6):297-306.
Rakel: Integrative Medicine, 2nd ed. Philadelphia, PA: Saunders Elsevier Inc.; 2007.
Rotblatt M, Ziment I. Evidence-Based Herbal Medicine. Philadelphia, Penn: Hanley & Belfus, Inc.; 2002:327-331.
Small EJ, Frohlich MW, Bok R, et al. A prospective trial of the herbal supplement PC-SPES in patients with progressive prostate cancer. J Clin Oncol. 2000;18(21):3595-3603.
Sultan C, Terraza A, Devillier C, et al. Inhibition of androgen metabolism and binding by a liposterolic extract of "Serenoa repens B" in human foreskin fibroblasts. J Steroid Biochem. 1984;20(1):515-519.
Willetts KE, Clements MS, Champion S, Ehsman S, Eden JA. Serenoa repens extract for benign prostate hyperplasia: a randomized controlled trial. BJU International. 2003;92(3):267-270.
Wilt TJ, Ishani A, Rutks I, MacDonald R. Phytotherapy for benign prostatic hyperplasia.Public Health Nutr. 2000;3(4A):459-472.
Wilt TJ, Ishani A, Stark G, MacDonald R, Lau J, Mulrow C. Saw palmetto extracts for treatment of benign prostatic hyperplasia: a systemic review. JAMA. 1998;280(18):1604-1609.
Wolverton: Comprehensive Dermatologic Drug Therapy, 2nd ed. 2007.
Yang Y, Ikezoe T, Zheng Z, Taguchi H, Koeffler HP, Zhu WG. Saw palmetto induces growth arrest and apoptosis of androgen-dependent prostate cancer LNCaP cells via inactivation of STAT 3 and androgen receptor signaling. Int J Oncol. 2007;31(3):593-600.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2013 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.