Improving BPH symptoms and sexual dysfunctions with a saw palmetto preparation? Results from a pilot trial

School of Pharmacy, University of London, University College London, London, United Kingdom. .
Phytotherapy Research (Impact Factor: 2.66). 02/2013; 27(2). DOI: 10.1002/ptr.4696
Source: PubMed


In elderly men, benign prostatic hyperplasia (BPH) is a major risk factor for sexual dysfunctions (SDys). Additionally, the standard treatments for BPH symptoms, alpha blockers and 5-alpha-reductase inhibitors, cause SDys themselves. Preparations from saw palmetto berries are an efficacious and well-tolerated symptomatic treatment for mild to moderate BPH and have traditionally been used to treat SDys. We conducted an open multicentric clinical pilot trial to investigate whether the saw palmetto berry preparation Prostasan® influenced BPH symptoms and SDys. Eighty-two patients participated in the 8-week trial, taking one capsule of 320 mg saw palmetto extract daily. At the end of the treatment, the International Prostate Symptom Score was reduced from 14.4 ± 4.7 to 6.9 ± 5.2 (p < 0.0001); SDys measured with the brief Sexual Function Inventory improved from 22.4 ± 7.2 to 31.4 ± 9.2 (p < 0.0001), and the Urolife BPH QoL-9 sex total improved from 137.3 ± 47.9 to 195.0 ± 56.3 (p < 0.0001). Investigators' and patients' assessments confirmed the good efficacy, and treatment was very well tolerated and accepted by the patients. Correlation analyses confirmed the relationship between improved BPH symptoms and reduced SDys. This was the first trial with saw palmetto to show improvement in BPH symptoms and SDys as well. [Corrections made here after initial online publication.] Copyright © 2012 John Wiley & Sons, Ltd.

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    • "Although the European Association of Urology is unable to make specific recommendations about plant extracts treatment in patients with LUTS/BPH because of the heterogeneity of the marketed products and the methodological problems associated with meta-analysis, their use in clinical practice is rising with an increased global prescription index, particularly in some European countries (Belgium, Hungary, Poland, France) [2,4,5]. Furthermore, the treatment of BPH with α-blockers and 5α-reductase inhibitors could play an important role in the alteration of sexual functions leading to ejaculatory and erectile disorders [6]. To avoid this issue, natural products derived from plants have been using for treating BPH, especially extracts of Serenoa repens (saw palmetto) obtained from the American dwarf palm [7-9]. "
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    ABSTRACT: Background Bioactive compounds from plants (i.e., Serenoa repens) are often used in medicine in the treatment of several pathologies, among which benign prostatic hyperplasia (BPH) associated to lower urinary tract symptoms (LUTS). Discussion There are different techniques of extraction, also used in combination, with the aim of enhancing the amount of the target molecules, gaining time and reducing waste of solvents. However, the qualitative and quantitative composition of the bioactives depends on the extractive process, and so the brands of the recovered products from the same plant are different in terms of clinical efficacy (no product interchangeability among different commercial brands). Summary In this review, we report on several and recent extraction techniques and their impact on the composition/biological activity of S. repens-based available products.
    Full-text · Article · Aug 2014 · BMC Urology
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    ABSTRACT: Preparations containing saw palmetto berries are used in the treatment of benign prostatic hyperplasia (BPH). There are many products on the market, and relatively little is known about their chemical variability and specifically the composition and quality of different saw palmetto products notwithstanding that in 2000, an international consultation paper from the major urological associations from the five continents on treatments for BPH demanded further research on this topic. Here, we compare two analytical approaches and characterise 57 different saw palmetto products. An established method - gas chromatography - was used for the quantification of nine fatty acids, while a novel approach of metabolomic profiling using (1) H nuclear magnetic resonance (NMR) spectroscopy was used as a fingerprinting tool to assess the overall composition of the extracts. The phytochemical analysis determining the fatty acids showed a high level of heterogeneity of the different products in the total amount and of nine single fatty acids. A robust and reproducible (1) H NMR spectroscopy method was established, and the results showed that it was possible to statistically differentiate between saw palmetto products that had been extracted under different conditions but not between products that used a similar extraction method. Principal component analysis was able to determine those products that had significantly different metabolites. The metabolomic approach developed offers novel opportunities for quality control along the value chain of saw palmetto and needs to be followed further, as with this method, the complexity of a herbal extract can be better assessed than with the analysis of a single group of constituents.
    Full-text · Article · Jan 2014
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    ABSTRACT: Purpose: To determine if men with self-reported lower urinary tract symptoms (LUTS) can make a correct decision to use an over-the-counter (OTC) alpha-1 blocker. Further, to assess the frequency of medically significant conditions (MSCs) presenting with urinary symptoms in these consumers. Materials and methods: Subjects reviewed a mock-up of the OTC product for male LUTS (Part 1). Subjects who selected the product underwent urine dipstick testing and male subjects completed the AUA Symptom Index (AUA-SI) (Part 2). Urologic assessment was conducted in women; men <45 years; men ≥45 years who reported "Do Not Use" symptoms listed on the OTC label, had glucose, leukocytes, and/or blood in their urine, or had an AUA-SI score ≥20. Results: Of 1967 subjects enrolled, 1953 completed Part 1 (men/women: 1697/256), 1311 (1294/17) entered Part 2, and 1289 (1274/15) were evaluated. Frequently reported baseline medical conditions were hypertension (45.8%/46.7%) and dyslipidemia (36.4%/60.0%). LUTS were present for >3 years in 47.6% men and 40% women. The mean AUA-SI score was 18.9. Urine dipstick results were positive in 20.9% men. Overall, 729 men and 12 women underwent urologic assessment: 517 (70.9%) men had urologist-confirmed LUTS, 200 (27.4%) men did not. Newly diagnosed MSCs causing/contributing to LUTS were identified in 21 (2.9%) men and 2 (16.7%) women. Conclusions: Most men correctly selected the OTC product for management of LUTS/BPH, while most women correctly de-selected to use the product. Since very few men had undiagnosed MSCs causing/contributing to urinary symptoms, the risk of harm due to incorrect selection was low.
    No preview · Article · Sep 2015 · The Journal of urology