Saw palmetto for the treatment of men with lower urinary tract symptoms.
OBJECTIVE
A comprehensive review of the literature on the use of saw palmetto in men with lower urinary tract symptoms is provided.


METHODS
A literature search of studies that have assessed the mechanism of action and clinical results of saw palmetto in men with benign prostatic hyperplasia was performed.


RESULTS
A variety of potential mechanisms of action of saw palmetto have been demonstrated through in vitro studies, including 5-alpha reductase inhibition, adrenergic receptor antagonism and intraprostatic androgen receptor blockade. Clinical evidence of the relevance of these effects is largely unavailable. The use of saw palmetto in men with benign prostatic hyperplasia is safe with no recognized adverse effects. No effect on serum prostate specific antigen has been noted. Placebo controlled trials and meta-analyses have suggested that saw palmetto leads to subjective and objective improvement in men with lower urinary tract symptoms. However, most studies are significantly limited by methodological flaws, small patient numbers and brief treatment intervals.


CONCLUSIONS
Evidence suggests that saw palmetto may have a significant effect on urinary flow rates and symptom scores compared to placebo in men with lower urinary tract symptoms. However, large scale, placebo controlled trials are needed to assess the efficacy of saw palmetto.
Gerber
G S
GS
Section of Urology, Department of Surgery, University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA.
D000726:Androgen Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D006801:Humans; D008297:Male; D010936:Plant Extracts / Q000494:pharmacology / Q000627:therapeutic use*; D011470:Prostatic Hyperplasia / Q000150:complications / Q000188:drug therapy*; D028024:Serenoa; D014570:Urologic Diseases / Q000188:drug therapy* / Q000209:etiology
D000726:Androgen Antagonists; D010936:Plant Extracts; C040972:saw palmetto extract