Hopkins professor, Dr. H. Ballentine Carter, reviews the data on saw palmetto for BPH symptoms.
Saw palmetto, otherwise known as serenoa repens and sabal serrulata, is an over-the-counter herbal supplement made from the fruit of the American dwarf palm tree. Its manufacturers claim that saw palmetto can ease the urinary symptoms of an enlarged prostate, or benign prostatic hyperplasia (BPH), faster and with fewer side effects than prescription treatment.
Saw palmetto is touted to help relieve BPH symptoms, including the frequent, urgent need to urinate, a decreased or stop-and-start urine flow, and the feeling that you haven’t completely emptied your bladder.
While many users swear by saw palmetto and some studies have suggested a benefit, other research has found saw palmetto doesn’t help. H. Ballentine Carter, M.D., Professor of Medicine in the Department of Urology at the Johns Hopkins School of Medicine, says he doesn’t often recommend saw palmetto as a treatment for the lower urinary tract symptoms. Dr. Carter believes the mixed results from clinical trials can be explained by differences in study design and among the groups of men that were studied. “The most comprehensive study to date,” says Dr. Carter, “shows that saw palmetto has no benefit over placebo.”
This study, published in The New England Journal of Medicine (NEJM), examined 225 men. The men were randomly assigned either a 160-mg saw palmetto supplement, taken twice daily, or a placebo. After a year, saw palmetto was found to be no more effective than placebo for treating lower urinary tract symptoms. The NEJM study is notable because of its length; many earlier studies were only weeks long.
If you still want to use saw palmetto for BPH, speak with your doctor beforehand and keep in mind that the FDA does not regulate supplement production, so it’s unclear what you’re getting when you buy a saw palmetto product. Side effects of saw palmetto are mild but can include digestive upset and lack of sexual desire. In rare cases, saw palmetto can cause bleeding, so it’s not recommended for men with bleeding disorders, who take anticoagulants such as Coumadin (warfarin), or who are about to undergo surgery. It’s also not a good idea to take saw palmetto in conjunction with a prescription medication for BPH.
