Saw palmetto berry in the treatment of benign prostatic hyperplasia

Phytotherapeutic agents are widely used for treating the symptoms of benign prostatic hyperplasia (BPH). Saw palmetto berry (SPB) is the most widely studied of these agents. It's mechanism of action is poorly understood. It does not have 5-alpha-reductase activity. The active ingredient in this extract is also unknown. There is much controversy concerning the efficacy of SPB. The double-blind trials, although usually favorable, do not show usual placebo response as seen in other BPH studies. Because of the variability of the natural history of BPH, the uncontrolled studies of these agents contribute little to determine efficacy. Further well-design placebo-controlled trials are necessary to establish the safety and efficacy of phytotherapy in the treatment of BPH.