Resveratrol in benign prostatic hyperplasia: mechanistic insights and therapeutic perspectives

Benign prostatic hyperplasia (BPH) is a common age-related disorder characterized by progressive prostatic enlargement and lower urinary tract symptoms, yet current medical therapies remain constrained by delayed onset, incomplete efficacy, and treatment-related adverse effects. Resveratrol (Res), a naturally occurring polyphenol, has emerged as a promising candidate for BPH intervention because its pharmacological profile aligns closely with the multifactorial biology of the disease. This review synthesizes current evidence showing that Res may counteract BPH progression through coordinated regulation of several interconnected processes, including abnormal prostate cell proliferation, apoptosis resistance, oxidative stress, chronic inflammation, fibrotic remodeling, and androgen-related signaling. Rather than acting on a single target, Res appears to reshape the pro-hyperplastic microenvironment at multiple levels, providing a mechanistic rationale for its therapeutic potential. However, the available evidence remains predominantly preclinical, and its clinical translation is still limited by poor oral bioavailability, extensive first-pass metabolism, uncertainty regarding the active molecular species in prostate tissue, and the lack of standardized formulations and robust clinical trials. Overall, Res represents a biologically plausible but not yet clinically established strategy for BPH management.