Herbal supplements that may be used to relieve symptoms of
benign prostatic hyperplasia (BPH) include beta-sitosterol, cernilton, Pygeum africanum, and
In general, the trials using these substances have been
short, and self-reported improvement scores can be biased. Different
preparations are available for each substance, and they are not always
equivalent. So the results cannot be generalized to all preparations, and results
Talk with your doctor before starting any herbal
Beta-sitosterol is an extract made from
Hypoxis rooperi, the South African star grass.
A review of studies done on beta-sitosterol showed that men who took it had fewer symptoms than men who took a placebo. Symptoms were measured using the American Urological Association (AUA) symptom index. Men who took beta-sitosterol also had a better urine flow rate then men who took a placebo.1
Cernilton is an extract made from
Secale cereale, or rye grass pollen.
studies, more men who took rye grass pollen said they had improved symptoms,
compared to men who took a placebo.2 But both studies
were small and had no long-term follow-up. Also, it was not known in either
study how the extract was made or how much the men used.
See more information on rye grass pollen extract.
P. africanum extract is
made from the bark of the African plum tree.
One review of 18
studies shows that P. africanum improved symptoms and nighttime urination
compared to a placebo. It also increased urine flow and decreased the amount of
urine retained in the bladder.3 But these studies did
not follow up for very long. The type of extract and how much was used was also
different in each study, so the results are hard to compare.
palmetto is made from the ripe berries of the plant Serenoa repens, the dwarf palm. The dwarf palm is a native plant in
Most studies show that taking saw palmetto doesn't help symptoms of BPH any more than taking a placebo.4
A review of studies done on saw palmetto showed that men who took saw palmetto had some improvement in nighttime urination. But when only the best studies were included in the review, men who took saw palmetto had no difference in symptoms, urine flow, or nighttime urination compared with men who took a placebo.5
In another study, men who took even higher doses of saw palmetto had no difference in BPH symptoms, urine flow, or nighttime urination compared with men who took a placebo.6
See more information on
Wilt TJ, et al. (1999). Beta-sitosterols for benign prostatic hyperplasia. Cochrane Database of Systematic Reviews (3).
McNicholas T, Kirby R (2011). Benign prostatic hyperplasia, search date July 2009. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
Wilt TJ, Ishani A (1998). Pygeum africanum for benign prostatic hyperplasia. Cochrane Database of Systematic Reviews (1).
Bent S, et al. (2006). Saw palmetto for benign
prostatic hyperplasia. New England Journal of Medicine,
Tacklind J, et al. (2009). Serenoa repens for benign prostatic hyperplasia. Cochrane Database of Systematic Reviews (2).
Barry MJ, et al. (2011). Effect of increasing doses of saw palmetto extract on lower urinary tract symptoms. JAMA, 306(12): 1344–1351.
May 9, 2012
E. Gregory Thompson, MD - Internal Medicine
& J. Curtis Nickel, MD, FRCSC - Urology
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