Serenoa repens for benign prostatic hyperplasia
Tacklind J, MacDonald R, Rutks I, Stanke JU, Wilt TJ
Published in Cochrane Database of Systematic Reviews
Abstract
Comprehensive Cochrane systematic review of saw palmetto trials. While quality of evidence variable, several well-designed studies show improvements in urinary symptoms and flow measures in BPH patients with standardized extracts.
Methodology
Cochrane systematic review and meta-analysis of randomised controlled trials comparing Serenoa repens with placebo or standard treatment in men with lower urinary tract symptoms from benign prostatic hyperplasia; outcomes included IPSS/AUASI symptom score, nocturia and peak urine flow.
Key Findings
Across 32 randomised trials with 5,666 men, Serenoa repens did not improve urinary symptom scores, nocturia or peak urine flow compared with placebo. Double-dose and triple-dose regimens in the high-quality STEP and CAMUS trials were also no better than placebo. Adverse event rates were similar to placebo.
Conclusions
Saw palmetto is no more effective than placebo for benign prostatic hyperplasia symptoms, including at doses two and three times the standard 320 mg/day. It is well tolerated but should not be recommended for symptom relief.
Limitations
Included trials varied in extract preparation and duration, and earlier low-quality trials suggested benefit that disappeared in larger, better-blinded trials - so the pooled null result is driven by the highest-quality studies. Longer-term outcomes such as disease progression and surgery were not adequately assessed.
Supplements Studied
Serenoa repens for benign prostatic hyperplasia: no improvement over placebo in urinary symptom scores.
Related Health Concerns
Study Details
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