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Saw palmetto reduces sexual dysfunctions in BPH patients

Benign prostatic hyperplasia (BPH), the most frequent reason for urinary problems in elderly men is also the main reason to cause sexual dysfunctions in this patient group.

Existing standard pharmaceutical therapies for BPH symptoms like alpha-blocking agents or 5-alpha-reductase inhibitors are known to cause further sexual dysfunctions. Thus, treatments are sought which improve urinary symptoms as well as concomitant sexual problems.

Preparations made from berries of saw palmetto, a palm tree growing in the south-eastern regions of the USA are the most popular herbal treatment worldwide for mild to moderate BPH symptoms. The use goes back to Native American uses of the plants for a broad range of indications including urinary problems, sexual dysfunctions and also bronchitis. Traditional knowledge and clinical experiences pointed out that this plant could decrease associated sexual problems as well.

For the first time a new pilot study conducted at the School’s Centre for Pharmacognosy and Phytotherapy and published in the journal Phytotherapy Research shows that a treatment with a saw palmetto preparation leads to an improvement not only of urinary symptoms but also of sexual problems or dysfunctions.

The trial is part of a larger project on the potential of saw palmetto as a herbal medicine and was developed under the guidance of Prof. Michael Heinrich. The intervention was carried out in Switzerland. After a treatment duration of eight weeks with a standardize saw palmetto preparation the urinary symptoms improved by more than 50% and sexual problems like erectile dysfunction, ejaculatory problems, or lack of sexual drive by about 40%.

“This is one of the first therapies ever to show an improvement of BPH symptoms and of sexual dysfunctions at the same time. Furthermore the treatment was very well tolerated, cost effective and patient’s compliance was excellent,” notes Dr. Eugen Riedi, urologist and head of the clinical trial.

“This preliminary trial is interesting as it is the first clinical study suggesting that saw palmetto is beneficial in patients with BPH and corresponding sexual problems. The promising results of this intervention study should lead to larger studies using a controlled design in order to further validate these claims” comments Prof. Michael Heinrich.

The authors of the study emphasize that with respect to the adverse side effects of the synthetic standard medications frequently prescribed to men with BPH, these are very promising results for patients seeking a well-tolerated, efficacious, and cost-effective treatment as shown in this trial.

Study details

A total of of 82 patients with at least moderate BPH symptoms (both obstructive and irritative) and sexual problems (like erectile dysfunctions or lack of libido) for at least two months were recruited from two urological and four general practices in Switzerland to participate in this trial.

For eight weeks patients took one capsule daily containing 320mg of a commercial saw palmetto berry extract. At the beginning and end of the treatment BPH symptoms were assessed using the International Prostate Symptom Score (IPSS) and sexual dysfunctions were evaluated with the brief Sexual Function Inventory (bSFI) and the Urolife BPH Quality of Life-9 questionnaire.

In the end, the symptom score (IPSS) was reduced highly significantly by 51% and the function inventory (bSFI) which measures sexual drive, erectile function, ejaculatory function, problem assessment, and satisfactions improved by a total average of 40%. An improvement of 36% was observed with the Urolife Score which assesses sexual drive, erections, and sexual satisfactions.

The saw palmetto preparation was shown to be generally safe and well tolerated. Both the patients and the clinical investigators assessed the saw palmetto treatment in the majority of men as very efficacious. The majority of the patients experienced the most beneficial effects on both libido and erectile function, and 90% of the patients stated that they would take the saw palmetto extract again.

Source: Suter A, Saller R, Riedi E, Heinrich M. Improving BPH symptoms and sexual dysfunctions with a saw palmetto preparation? Results from a pilot trial. Phytother Res. 2012 Apr 23. doi: 10.1002/ptr.4696. [Published online ahead of print]

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