An overview of phytotherapeutic approaches for the treatment of benign prostatic hyperplasia

Benign prostatic hyperplasia (BPH) is the noncancerous growth of the prostate gland resulting due to overproliferation of the stromal and glandular elements of the prostate and is associated with lower urinary tract symptoms. Natural products, containing inherently vast structural diversity than synthetic compounds, have been the major resources of bioactive agents and will continue to play as protagonists for discovering new drugs. Phytotherapeutic products have been used traditionally in developing countries while the use of them as complementary alternative medicine is increasing rapidly in developed countries for the management of BPH. Although mono preparations (single plant only) are available, many industries manufacture combination products (plant extracts) in an attempt to provide enhanced efficacy to improve marketability, and to provide their own "unique" product that can be registered, because these products have no patent protection. The mechanism of action of the phytotherapeutic agents is not clearly understood as many in vitro experimental studies have demonstrated diverse spectrum of mechanisms. The main mechanisms of action that has received the greatest attention are anti-inflammatory, 5α-reductase inhibition, and more recently growth factor alteration. The current review covers all such studies and critiques the efficacy and value of such phytotherapeutic products and preparations available for the management of BPH.