Background

• Saw palmetto (Serenoa repens, Sabal serrulata) is used popularly in Europe for symptoms associated with benign prostatic hypertrophy (enlargement of the prostate). Although not considered standard of care in the United States, it is the most popular herbal treatment for this condition.
• Historical use of saw palmetto can be traced in the Americas to the Mayans who used it as a tonic and to the Seminoles who took the berries as an expectorant and antiseptic.
• Saw palmetto was listed in the United States Pharmacopeia from 1906 to 1917 and in the National Formulary from 1926 to 1950. Saw palmetto extract is a licensed product in several European countries.
• Multiple mechanisms of action have been proposed, and saw palmetto appears to possess 5-α-reductase inhibitory activity (thereby preventing the conversion of testosterone to dihydrotestosterone). Hormonal/estrogenic effects have also been reported, as well as direct inhibitory effects on androgen receptors and anti-inflammatory properties.

References

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• Preuss HG, Marcusen C, Regan J, et al. Randomized trial of a combination of natural products (cernitin, saw palmetto, B-sitosterol, vitamin E) on symptoms of benign prostatic hyperplasia (BPH). Int Urol.Nephrol 2001;33(2):217-225.
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• Veltri RW, Marks LS, Miller MC, et al. Saw palmetto alters nuclear measurements reflecting DNA content in men with symptomatic BPH: evidence for a possible molecular mechanism. Urology 2002;60(4):617-622.
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