What herbal remedies can help treat benign prostatic hyperplasia (BPH)?

Marc B. Garnick, MD
Hematology & Oncology
Although a variety of plant products are marketed as benign prostatic hyperplasia (BPH) remedies, so far the evidence of their effectiveness remains limited, and standardized doses and preparations have not been determined. Among these products are Pygeum africanum and beta sitosterols:
  • Pygeum africanum: An extract of an African prune tree, P. africanum is sometimes used as a treatment for urinary symptoms. A report in The Cochrane Database of Systematic Reviews concluded that this substance moderately but significantly improves urologic symptoms and flow. However, the effectiveness of P. africanum has not been compared with standard medical interventions, such as alpha blockers or 5-alpha-reductase inhibitors. Nor is there information about whether it prevents long-term complications of BPH, such as acute urinary retention.
  • Beta sitosterols: Preparations containing beta sitosterols -- derived from the South African star grass, Hypoxis rooperi, and also from species of Pinus and Picea -- are sometimes used to treat symptoms of BPH. A review published in The Cochrane Database of Systematic Reviews said the evidence suggests that these substances improve urinary symptoms and urinary flow, but their long-term effectiveness, safety, and ability to prevent BPH complications are completely unknown.
The most popular and most widely used plant extract for treating benign prostatic hyperplasia (BPH)-related symptoms is saw palmetto (Serenoa repens).

Other plant extracts that are used to treat lower urinary tract symptoms are
  • the bark of the African plum tree (Pygeum africanum)
  • stinging nettle roots (Urtica dioca)
  • South African star grass (Hipoxis rooperi)
  • rye pollen (Secale cereale)

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