Saw Palmetto Benign Prostatic Hyperplasia and Endosterol Part 2

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” Extracts of the berries of saw palmetto, a small palm tree native to the southeastern U.S., are used widely to treat benign prostatic hyperplasia (BPH). In this randomized trial conducted in California, 225 men with moderate-to-severe symptoms of BPH received either saw palmetto extract (160 mg twice daily) or placebo. Patients were not permitted to use α-blocking drugs or 5α-reductase inhibitors during the trial.

Treatments for BPH can be evaluated by their effect on symptoms such as diminished urine stream, post-void dribbling, overflow incontinence, and urinary retention, or by less useful measures such as urine flow rate, changes in prostate size, and residual volume. In a Cochrane Review, investigators conducted a meta-analysis of randomized controlled studies comparing saw palmetto with placebo or other drugs.6 [Evidence level A: systematic review of randomized controlled trials (RCTs)] The review combined the results of 21 trials with durations of four to 48 weeks. The 21 studies included a total of 3,139 men with a mean age of 65 years (range: 40 to 88 years).

According to the International Prostate Symptom Scale, these men had moderate symptoms, with an average urologic score of 14.4 points out of a possible 35 (moderate BPH symptoms range from eight to 19).6 In the 13 studies that reported symptom scores, saw palmetto improved symptom scores, individual symptoms, and flow measures more than placebo. Patients and physicians were more likely to report improvement in symptoms with saw palmetto treatment than with placebo. In the 12 studies that reported nocturia results, saw palmetto reduced nocturia by 25 percent compared with placebo.

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