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Exploring Serenoa repens for BPH and LUTS: Efficacy, Mechanism, and Safety

This session delves into Serenoa repens (saw palmetto) for treating benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS). Highlights include its mechanisms, comparison with other treatments, safety, and potential effects in different populations.


  • Serenoa repens

  • Serenoa repens, commonly known as saw palmetto, is frequently utilized for its therapeutic benefits, particularly in the treatment of benign prostatic hyperplasia (BPH) and associated lower urinary tract symptoms (LUTS). Here's a summary of its key uses and efficacy:

    1. Treatment of BPH and LUTS: Serenoa repens is widely used for alleviating symptoms of BPH, such as nocturia, reduced urinary flow, and frequent urination. Numerous studies have shown that Serenoa repens can improve urinary symptom scores and enhance urinary flow measures12. However, the degree of improvement can vary depending on the study design and duration.

    2. Mechanism of Action: The extract from Serenoa repens has several proposed mechanisms, including antiandrogenic effects, anti-inflammatory properties, modulation of prolactin signaling, and inhibition of growth factors3. These mechanisms contribute to its potential in reducing BPH symptoms.

    3. Comparison with Other Treatments: Serenoa repens has been compared to other treatments such as finasteride and tamsulosin. It generally shows similar efficacy in symptom management but tends to have fewer side effects14.

    4. Safety and Tolerability: Serenoa repens is well-tolerated with mild and infrequent adverse effects. Withdrawal rates due to side effects are relatively low compared to other treatments15.

    5. Efficacy in Specific Populations: While most studies focus on men, Serenoa repens has been examined for potential urinary benefits in women, showing improvements in symptoms like daytime frequency and nocturia6.

    Despite the promising results, further high-quality, long-term studies are necessary to confirm its efficacy and safety comprehensively.

    Footnotes

    1. T Wilt, "Serenoa repens for benign prostatic hyperplasia - PubMed," PubMed, 2009. 2 3

    2. Petrisor Geavlete, "Serenoa repens extract in the treatment of benign prostatic hyperplasia," PubMed Central, 2011.

    3. Youngjoo Kwon, "Use of saw palmetto (Serenoa repens) extract for benign prostatic hyperplasia," PubMed Central, 2019.

    4. Tong Cai, "Comparison of Serenoa repens With Tamsulosin in the Treatment of Benign Prostatic Hyperplasia: A Systematic Review and Meta-Analysis," PubMed Central, 2020.

    5. Zhangqun Ye, "Efficacy and Safety of Serenoa repens Extract Among Patients with Benign Prostatic Hyperplasia in China: A Multicenter, Randomized, Double-blind, Placebo-controlled Trial," PubMed, 2019.

    6. Shizuo Yamada, "Beneficial Effects of Saw Palmetto Fruit Extract on Urinary Symptoms in Japanese Female Subjects by a Multicenter, Randomized, Double-Blind, Placebo-Controlled Study," PubMed Central, 2022.

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