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Updated: Jun 24, 2026

Surgical Treatment for Benign Prostatic Hyperplasia: Holmium Laser Enucleation of the Prostate (HoLEP).
06:04

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Published on: March 6, 2018

Serenoa repens for benign prostatic hyperplasia.

James Tacklind1, Roderick MacDonald, Indy Rutks

  • 1Center for Chronic Disease Outcomes Research (111-0), Minneapolis Veterans Affairs Medical Center, One Veterans Drive, Minneapolis, MN 55417, USA. james.tacklind@med.va.gov

The Cochrane Database of Systematic Reviews
|April 17, 2009
PubMed
Summary
This summary is machine-generated.

Serenoa repens (American saw palmetto) was not found to be more effective than placebo for treating lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). This review assessed 30 randomized trials involving over 5,000 men.

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Area of Science:

  • Urology
  • Pharmacology
  • Herbal Medicine

Background:

  • Benign prostatic hyperplasia (BPH) causes lower urinary tract symptoms (LUTS).
  • Phytotherapy, including Serenoa repens (American saw palmetto), is commonly used for BPH-related LUTS.
  • Serenoa repens extract is a popular herbal treatment for BPH.

Purpose of the Study:

  • To systematically review the efficacy of Serenoa repens for treating LUTS in men with BPH.
  • To compare Serenoa repens with placebo and other interventions for BPH symptoms.
  • To evaluate the impact of Serenoa repens on urologic symptom scales and urodynamic measurements.

Main Methods:

  • Systematic review of randomized controlled trials (RCTs) identified through comprehensive database searches.
  • Inclusion criteria: men with symptomatic BPH, Serenoa repens treatment (alone or combined) for ≥4 weeks versus placebo or other interventions.
  • Outcomes assessed included urologic symptom scores, nocturia, urodynamic measures, and adverse events. Data extracted by independent reviewers.

Main Results:

  • Serenoa repens was not superior to placebo in improving overall urinary symptom scores (IPSS).
  • No significant differences were observed when comparing Serenoa repens to finasteride or tamsulosin for symptom scores.
  • While initially showing improvement in nocturia versus placebo, this effect was not sustained in higher-quality trials, and no superiority was found over finasteride or tamsulosin.

Conclusions:

  • Serenoa repens demonstrated no significant benefit over placebo for treating urinary symptoms associated with BPH.
  • The evidence does not support the use of Serenoa repens as a more effective treatment than placebo for BPH-related LUTS.
  • Further high-quality research may be needed to clarify any potential subtle effects or specific patient subgroups.