Frequent nighttime trips to the bathroom (nocturia) and dribbling after urination are common symptoms of an enlarged prostate. Many men have sought relief in a popular herbal remedy; however, experts remain skeptical of its efficacy. In this post, we'll examine what current research surrounding saw palmetto shows, as well as a few science-backed alternatives.
What is saw palmetto
Saw palmetto is a type of palm tree that grows in the southeastern United States. The berry of the saw palmetto plant contains a compound that some studies suggest might inhibit the production of dihydrotestosterone (DHT). This hormone can contribute to the symptoms of benign prostatic hyperplasia (BPH), a noncancerous enlargement of the prostate gland.
Other proposed benefits include anti-inflammatory effects, which have led some individuals to use saw palmetto for chronic pelvic pain, hair loss, migraine and other conditions.
History of use and oversight
From the 1870s until 1950, saw palmetto was a standard treatment for prostate and other urinary problems. After 1950, it was no longer recognized as a drug in the United States, but it is still used in Europe as a treatment for BPH. In countries where it retains its drug status, regulatory bodies similar to the U.S. Food and Drug Administration (FDA) oversee its quality and standardize its formulation. This allows for more consistent dosing and clinical evaluation.
Whereas in the United States, saw palmetto is available as a dietary supplement. The FDA does not regulate dietary supplements in the same way it regulates medicines, which means manufacturers can sell them with limited or no research on how well they work. Due to these inconsistencies, many experts disagree on whether saw palmetto improves symptoms of BPH.
The most current research published by the National Institutes of Health National Library of Medicine concluded that various doses of saw palmetto fruit extract were no more effective than the placebo for reducing lower urinary tract symptoms.
Despite a lack of evidence supporting it's benefits, few side effects have been reported among men taking saw palmetto. However, some people may experience stomach issues such as:
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Diarrhea
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Nausea
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Constipation
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Stomach pain
Treatments that do work
Men who have problems urinating should see a doctor to rule out prostate cancer. Prostate cancer is treatable, but treatment may be more successful when it is addressed as early as possible. In most cases, home treatment, such as avoiding caffeine, alcohol and medications that hinder urination, can help alleviate or manage symptoms associated with BPH. If symptoms become bothersome or lead to issues such as backed-up urine, bladder infections or bladder stones, a urologist may suggest medications or surgical intervention if needed.
Medicines include:
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Alpha-blockers. They relieve symptoms within a few weeks. But they don't stop the process of prostate enlargement.
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5-alpha reductase inhibitors. After six months of use or longer, these may help reduce the size of an enlarged prostate.
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Anticholinergic agents. They may help with urinary problems related to an overactive bladder, such as frequency, urgency, or incontinence.
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Phosphodiesterase-5 (PDE-5) inhibitors. These may reduce BPH symptoms for men who also have erectile dysfunction.
Most surgeries addressing severe urinary symptoms remove the prostate tissue that is pressing on the urethra. Those options might include:
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Simple prostatectomy.
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Transurethral resection of the prostate (TURP).
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Prostatic urethral lift (PUL), also called the UroLift® System
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GreenLight™ Laser Therapy and Thulium Laser Therapy.
Final thoughts
Research on saw palmetto is ongoing, and while some studies show promising results, more research is needed to confirm its effectiveness for all uses.
Always tell your doctor if you are using a dietary supplement or if you are thinking about combining one with your conventional medical treatment. It may not be safe to forgo your conventional medical treatment and rely only on a dietary supplement.
If you're experiencing difficulty urinating, share those concerns with your primary care provider, even if they don't bother you. They may recommend that you see a urologist. To make an appointment with one of our urologists, please call 260-425-5400.
Copyrighted material adapted with permission from Healthwise, Incorporated. This information does not replace the advice of a doctor.
