Across 4 studies, 3 reported beneficial effects on lower urinary tract symptoms (LUTS), with moderate effect sizes in the highest-quality randomized controlled trial (320 mg/day over 365 days). One review found neutral/small effects. Effects were observed primarily in treatment-naïve men with moderate-to-severe LUTS due to benign prostatic hyperplasia.
Effective dose range: 320 mg/day
Studied populations: treatment-naïve men with moderate-to-severe LUTS (IPSS > 7) and prostate volume > 30 cc due to benign prostatic hyperplasia
Caveats: Evidence base is small (only 4 studies) — conclusions should be considered preliminary. Available evidence is overwhelmingly positive — clinical literature in this area is subject to publication bias (null-result studies are less likely to be published or indexed). The most robust evidence comes from a single RCT combining saw palmetto with alfuzosin, making it difficult to isolate the supplement's independent effect.
Generated Jul 13, 2026
Doses used in studies
mg/day: 320 (median 320, IQR 320–320)— 1 study
Time to effect
Median: 12.2 months · IQR 12.2 months–12.2 months · Range 12.2 months–12.2 months— Reported in 1 of 4 studies
Safety in these studies
Overall tolerabilityReported
Generally, though, all treatments were tolerated well with minimal side effects.
The combination of HESr and alfuzosin was significantly more effective than alfuzosin monotherapy in relieving LUTS, with greater benefits from Month 3 onward.
Recent meta-analyses found the effectiveness of Serenoa repens similar or inferior of that of finasteride and tamsulosin but clearly higher than that of placebo in the treatment of mild and moderate low urinary tract symptoms (LUTS), nocturia and discomfort.
This articles review the mode of action, the efficacy, and the safety, including herb-drug interactions of the most common botanicals (Serenoa repens, Pygeum africanum, Urtica dioica, and Cucurbita pepo) and nutraceuticals (isoflavones, lycopene, selenium, and β-Sitosterol) in controlling the lower urinary tract symptoms associated to BPH.