Herbal supplements that may be used to relieve symptoms of benign prostatic hyperplasia (BPH) include beta-sitosterol, cernilton, Pygeum africanum, and saw palmetto.
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 may vary.
Talk with your doctor before starting any herbal therapy.
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 International Prostate Symptom Score (IPSS). Men who took beta-sitosterol also had a better urine flow rate then men who took a placebo.footnote 1
See more information on beta-sitosterol.
Cernilton is an extract made from Secale cereale, or rye grass pollen.
In two studies, more men who took rye grass pollen said they had improved symptoms, compared to men who took a placebo.footnote 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.footnote 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.
Saw palmetto is made from the ripe berries of the plant Serenoa repens, the dwarf palm. The dwarf palm is a native plant in America.
Most studies show that taking saw palmetto doesn't help symptoms of BPH any more than taking a placebo.footnote 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.footnote 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.footnote 6
See more information on saw palmetto.
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- 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 and male lower urinary tract symptoms (LUTS). BMJ Clinical Evidence. http://clinicalevidence.bmj.com/x/systematic-review/1801/overview.html. Accessed April 12, 2016.
- 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, 354(6): 557–566.
- Tacklind J, et al. (2012). Serenoa repens for benign prostatic hyperplasia. Cochrane Database of Systematic Reviews (12). DOI: 10.1002/14651858.CD001423. Accessed October 13, 2014.
- Barry MJ, et al. (2011). Effect of increasing doses of saw palmetto extract on lower urinary tract symptoms. JAMA, 306(12): 1344–1351.
Current as of: May 28, 2019
Author: Healthwise Staff
Medical Review: E. Gregory Thompson, MD - Internal Medicine
Anne C. Poinier, MD - Internal Medicine
Adam Husney, MD - Family Medicine
J. Curtis Nickel, MD, FRCSC - Urology
Current as of: May 28, 2019