TUESDAY, Sept. 27 (HealthDay News) -- For men suffering from
urinary problems related to an enlarged prostate, saw palmetto
extract doesn't seem to relieve symptoms any better than a placebo,
even when taken at high doses, a new study finds.
Many men in the United States and Europe use plant extracts to
relieve lower urinary tract symptoms related to benign prostatic
hyperplasia (BPH), a condition that enlarges the prostate gland.
Saw palmetto is the most commonly used extract, but its
effectiveness has not been proven.
"Despite pushing the dose up to three times what's traditionally been used, we couldn't find the extract we studied lowered urinary tract symptoms more than placebo," said lead researcher Dr. Michael J. Barry, chief of the General Medicine Unit at Massachusetts General Hospital in Boston.
Men with BPH experience bothersome symptoms such as frequent
urination, urgency and hesitation. Medical treatments include
drugs, minimally invasive therapies or surgery, but natural
treatments have a strong following.
A 2007 survey found that 17.7 percent of U.S. adults had used a
natural product in the previous 30 days, and just over 5 percent
had taken saw palmetto, the researchers said. The frequency among
older men would be even higher, they added.
In the current study, no side effects were seen with saw
palmetto extract, which is a plus. "With no side effects and some
men getting improvement, there may be some men who want to give it
a try to see if it will work for them even though it's no better
than placebo," Barry said.
"For me, I don't think I would take it," he added.
The report was published in the Sept. 28 issue of the
Journal of the American Medical Association.
For the study, Barry's team randomly assigned 369 men with BPH
to increasing doses of saw palmetto extract or placebo. The men
were 45 or older -- average age 61 -- and seen at 11 sites in North
America between June 2008 and October 2010.
After 72 weeks of treatment, 42.6 percent of the men receiving
saw palmetto extract had a 2.2 improvement in scores on the
American Urological Association Symptom Index, while about 44
percent of men taking placebo showed about a 3-point improvement in
their score, the researchers found.
Overall, there was a difference in the scores of 0.79 points in
favor of the placebo, they added.
Even at the highest dose -- 960 milligrams -- saw palmetto fared
no better than placebo. Also, saw palmetto extract was no better
than placebo for any of the other outcomes, including measures of
urinary bother, excessive urination at night, measures of sexual
function, continence, sleep quality and symptoms of prostatitis
(inflammation of the prostate).
"We've always known there's a pretty big placebo effect with lower urinary tract symptoms," Barry said.
There are different ways to extract chemicals from saw palmetto
berries, and it's possible that another method -- or another
extract -- might work, Barry said. "But, given the series of
well-done negative studies, it's harder to think that someone will
be able to find an extract that will work," he added.
Dr. Stephen Bent, an assistant professor of medicine at the
University of California, San Francisco, who has done his own
research on BPH and saw palmetto extract, said the study results
didn't surprise him.
The findings from this study are "definitively negative," he
"When men try saw palmetto, chances are they are going to have some improvement, because they are going to experience a placebo effect," Bent said. "It may be that men get a benefit when they take a saw palmetto product, but it has nothing to do with saw palmetto."
For more information on BPH, visit the
U.S. National Library of Medicine.
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