August 2019

Saw Palmetto remains a widely used treatment for symptoms attributed to benign enlargement of the prostate or simply BPH.  BPH occurs frequently in men beginning after age 50 and manifest as urgency, frequency, nighttime urinations, straining, hesitancy, dribbling and inability to completely empty the bladder.

The active ingredient in Saw Palmetto remains to be identified.  Considerable controversy surrounds the optimal method of extracting the raw product into useable phytotherapy.  Preparations differ significantly between France, Germany and the United States.

Whether St. John’s Wort actually provides relief remains a matter for debate.  Studies demonstrate about 40% of men note improved symptoms with the herb.  This precisely matches the frequency of benefit with placebo therapy.  Several large double blind studies conducted with funding from the NIH cast doubt that St. John’s Wort offers any advantages.  

Studies conducted with funding from the various manufacturers suggest modest improvement with the compound.  Problems with commercial extracts include adulterants, added or substituted vegetable oils and use of different plants.  The FDA does not assure either the safety or efficacy of St. John’s Wort.