Saw Palmetto and Improved Lower Urinary Tract Symptoms

Research synthesisLow evidenceMixed effect size3 studies · 2 beneficial · 1 neutral · 0 harmful

Across 3 studies, 2 reported beneficial effects (1 moderate, 1 small) and 1 was neutral, with 2 statistically significant findings. The predominant effect direction is beneficial, with a mixed effect size (moderate to small). The most-studied dose was 320 mg/day in a single 12-month RCT in treatment-naïve men with moderate-to-severe LUTS and prostate volume >30 cc. Effects were observed from Month 3 onward in that trial.

Effective dose range: 320 mg/day
Studied populations: treatment-naïve men with moderate-to-severe LUTS (IPSS > 7) and prostate volume > 30 cc

Caveats: Evidence base is small (only 3 studies) — conclusions should be considered preliminary. The highest-quality study combined saw palmetto with alfuzosin, so isolated effects of saw palmetto are not clear. The two review-level studies provide limited granularity on dose and form.

Generated May 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 3 studies

Safety in these studies

Overall tolerabilityReported
Generally, though, all treatments were tolerated well with minimal side effects.
from: Role of Phytotherapy in the Management of BPH: A Summary of the Literature.

3 of 3 papersPopulation:

Efficacy of Serenoa repens Extract Combined With Alfuzosin Versus Alfuzosin Alone in Men With Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: A Multicenter Randomized Study.
- 2025-10-16
- RCT
- The Prostate 86(2)
- - Giulio Bevilacqua
  - Dalila Carino
  - Stefano Salciccia
  - Alessandro Gentilucci
  - Flavio Forte
  - Massimiliano Di Marco
  - Antonio Pastore
  - Marco Martini
  - Stefano Signore
  - Alessandro Calarco
  - Martino Recchia
  - Olivia Voglino
  - Valenzi Fabio Maria
  - Pietro Viscuso
  - Fabrizio Presicce
  - Ervin Shehu
  - Marco Frisenda
  - Alessandro Sciarra
- PubMed: 41098072
- DOI: 10.1002/pros.70071
3 Insights on
- Improved Lower Urinary Tract Symptoms
- High evidence
- Clinical
The combination of HESr and alfuzosin was significantly more effective than alfuzosin monotherapy in relieving LUTS, with greater benefits from Month 3 onward.
Effect
Beneficial
Effect size
Moderate
Significant
Yes
Dose
320 mg/day
Role of Phytotherapy in the Management of BPH: A Summary of the Literature.
- 2023-02-28
- Review
- Journal of clinical medicine 12(5)
- - Vaki Antoniou
  - Vineet Gauhar
  - Sachin Modi
  - Bhaskar Kumar Somani
- PubMed: 36902686
- DOI: 10.3390/jcm12051899
1 Insight on
- Improved Lower Urinary Tract Symptoms
- Low evidence
For most of the reviewed substances, only modest effectiveness was reported.
Effect
Neutral
Effect size
Small
Significant
No
Dose
not stated
Nutraceutical treatment and prevention of benign prostatic hyperplasia and prostate cancer.
- 2019-10-02
- Review
- Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica 91(3)
- - Arrigo F G Cicero
  - Olta Allkanjari
  - Gian Maria Busetto
  - Tommaso Cai
  - Gaetano Larganà
  - Vittorio Magri
  - Gianpaolo Perletti
  - Francesco Saverio Robustelli Della Cuna
  - Giorgio Ivan Russo
  - Kostantinos Stamatiou
  - Alberto Trinchieri
  - Annabella Vitalone
- PubMed: 31577095
- DOI: 10.4081/aiua.2019.3.139
11 Insights on
- Improved Lower Urinary Tract Symptoms
- Low evidence
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.
Effect
Beneficial
Effect size
Small
Significant
Yes

Saw Palmetto and Improved Lower Urinary Tract Symptoms

Efficacy of Serenoa repens Extract Combined With Alfuzosin Versus Alfuzosin Alone in Men With Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: A Multicenter Randomized Study.

Role of Phytotherapy in the Management of BPH: A Summary of the Literature.

Nutraceutical treatment and prevention of benign prostatic hyperplasia and prostate cancer.