Saw palmetto for the treatment of men with lower urinary tract symptoms

Purpose: A comprehensive review of the literature on the use of saw palmett o in men with lower urinary tract symptoms is provided. Materials and Methods: A literature search of studies that have assessed th e mechanism of action and clinical results of saw palmetto in men with beni gn prostatic hyperplasia was performed. Results: A variety of potential mechanisms of action of saw palmetto have b een demonstrated through in vitro studies, including 5-alpha reductase inhi bition, adrenergic receptor antagonism and intraprostatic androgen receptor blockade. Clinical evidence of the relevance of these effects is largely u navailable. The use of saw palmetto in men with benign prostatic hyperplasi a is safe with no recognized adverse effects. No effect on serum prostate s pecific antigen has been noted. Placebo controlled trials and, meta-analyse s have suggested that saw palmetto leads to subjective and objective improv ement in men with lower urinary tract symptoms. However, most studies are s ignificantly limited by methodological flaws, small patient numbers and bri ef treatment intervals. Conclusions: Evidence suggests that saw palmetto may have a significant eff ect on urinary Row rates and symptom scores compared to placebo in men with lower urinary tract symptoms, However, large scale, placebo controlled tri als are needed to assess the efficacy of saw palmetto.