Improving BPH symptoms and sexual dysfunctions with a saw palmetto preparation? Results from a pilot trial

Abstract

In elderly men, benign prostatic hyperplasia (BPH) is a major risk factor for sexual dysfunctions (SDys). Additionally, the standard treatments for BPH symptoms, alpha blockers and 5-alpha-reductase inhibitors, cause SDys themselves. Preparations from saw palmetto berries are an efficacious and well-tolerated symptomatic treatment for mild to moderate BPH and have traditionally been used to treat SDys. We conducted an open multicentric clinical pilot trial to investigate whether the saw palmetto berry preparation Prostasan® influenced BPH symptoms and SDys. Eighty-two patients participated in the 8-week trial, taking one capsule of 320 mg saw palmetto extract daily. At the end of the treatment, the International Prostate Symptom Score was reduced from 14.4 ± 4.7 to 6.9 ± 5.2 (p < 0.0001); SDys measured with the brief Sexual Function Inventory improved from 22.4 ± 7.2 to 31.4 ± 9.2 (p < 0.0001), and the Urolife BPH QoL-9 sex total improved from 137.3 ± 47.9 to 195.0 ± 56.3 (p < 0.0001). Investigators' and patients' assessments confirmed the good efficacy, and treatment was very well tolerated and accepted by the patients. Correlation analyses confirmed the relationship between improved BPH symptoms and reduced SDys. This was the first trial with saw palmetto to show improvement in BPH symptoms and SDys as well. [Corrections made here after initial online publication.]

Modern extraction techniques and their impact on the pharmacological profile of Serenoa repens extracts for the treatment of lower urinary tract symptoms

“…Although the European Association of Urology is unable to make specific recommendations about plant extracts treatment in patients with LUTS/BPH because of the heterogeneity of the marketed products and the methodological problems associated with meta-analysis, their use in clinical practice is rising with an increased global prescription index, particularly in some European countries (Belgium, Hungary, Poland, France) [2,4,5]. Furthermore, the treatment of BPH with α-blockers and 5α-reductase inhibitors could play an important role in the alteration of sexual functions leading to ejaculatory and erectile disorders [6]. To avoid this issue, natural products derived from plants have been using for treating BPH, especially extracts of Serenoa repens (saw palmetto) obtained from the American dwarf palm [7-9].…”

Effects of a supplement combining Pycnogenol® and l-arginine aspartate on lower urinary dysfunction compared with saw palmetto extract

“…SP have a long standing use in the treatment of mild to moderate LUTS and ED 3, 4, 5, 6, 7. More than 30 controlled clinical trials evaluating treatments for LUTS and SDys have demonstrated long-term efficacy 5, 6, 7.…”

“…SP have a long standing use in the treatment of mild to moderate LUTS and ED 3, 4, 5, 6, 7. More than 30 controlled clinical trials evaluating treatments for LUTS and SDys have demonstrated long-term efficacy 5, 6, 7. The plant, which is indigenous to Florida, was first used by white settlers in the United States not only for treatment of LUTS but also a treatment for ED, to improve testicular atrophy and sperm production 3, 4.…”

“…Preparations made from the berries of saw palmetto (SP) ( Serenoa repens ) have a long history of use in the treatment of LUTS and SDys 3, 4, 5, 6, 7. Reported modes of action include inhibition of 5AR and anti-inflammatory activities, as well as inhibition of autonomous receptors in the lower urinary tract 7 .…”

“…Reported modes of action include inhibition of 5AR and anti-inflammatory activities, as well as inhibition of autonomous receptors in the lower urinary tract 7 . On the other hand, clinical studies have reported that the proprietary, patented combination of l -arginine aspartate and French maritime pine ( Pinus pinaster ) bark extract Pycnogenol ® might improve mild to moderate SDys 8 .…”