Do herbs help or harm an enlarged prostate?


As men grow older, there’s a good chance they will have to deal with the hassle of an enlarged prostate.  The prostate, a walnut-sized gland situated below the bladder, has a tendency to grow larger over the years as a man ages.  As the prostate gland grows, a man can experience annoying symptoms of frequent urination along with excessive urination at night, dribbling after urination, urinary urgency, urinary leaking, and a sense of not emptying the bladder completely after urinating.

The medical term for an enlarged prostate is benign prostatic hyperplasia (BPH).  BPH is when the prostate cells proliferate causing the gland to grow slowly which eventually will begin to press on the bladder and part of the urethra.  As the prostate grows, this is what leads to the symptoms of BPH making life unbearable at times for a man causing him to seek out what treatment methods are available.  About 50 percent of all men over the age of 50 will have symptoms of BPH while men over 80 have a 90 percent chance of having the condition.  The symptoms of BPH can vary from man to man and can worsen over time as the prostate gland continues to enlarge.

When a man is not getting a good night’s sleep due to frequent nighttime bathroom trips or worries he may dribble or leak while in public, BPH can make life miserable enough for men to want to try almost anything.  It is not unusual that health food stores and pharmacies who advertise supplements for “men’s health” are often referring to care of the prostate.

One remedy for BPH that has been around for centuries and practiced regularly in Chinese and Japanese medicine is the use of herbs to treat the urinary symptoms associated with an enlarged prostate. Around the world, other countries such as Germany, France, and Austria, have turned to herbs as a first-line treatment for mild to moderate urinary symptoms of BPH. 

The effectiveness and safety of herbs for BPH

Are herbs a safe and effective treatment for reducing the symptoms of BPH?  Many of the studies conducted on herbs used for BPH have insufficient evidence or the supplements are proprietary formulas in which the manufacturers have sponsored the research making it difficult to judge their objectivity and comparisons with other products.

Whether herbs are helpful or harmful is hard to say.  In the meantime, here are herbs that are commonly promoted and perhaps even recommended by some doctors:

·      Saw palmetto

Coming from the American saw palmetto plant, this herbal extract from the plant’s purple berries may help shrink the prostate and improve urinary symptoms by reducing the activity of the enzyme 5-alpha-reductase, similar to how medication such as finasteride and dutasteride work.

Even though research on saw palmetto has had inconsistent results, the Natural Standard which evaluates dietary supplements gave it an “A” rating with regard to showing improvements of BPH.  However before a man decides to stock up on saw palmetto supplements, other studies have a different view.  In 2011, the American Medical Association found that at three times the standard 320-milligram dose, saw palmetto did not reduce prostate symptoms.  A review by the Cochrane Collaboration in 2012 looked at 32 controlled clinical trials on men with BPH and concluded that saw palmetto did not improve urine flow. 

It should be noted that one problem is the lack of standardization in many products of saw palmetto, just like other herbs, meaning that their active ingredients can vary considerably. 

Also a word of caution on using saw palmetto for BPH – men who have a bleeding disorder or are taking blood thinners should not take this herb and any man getting ready to have surgery should not take it before the procedure as it can increase bleeding. 

·      African plum

This herb uses an extract that has been used in traditional medicine to treat urinary problems for centuries.  African plum or pygeum comes from the bark of an African evergreen tree.  Pygeum has been shown in several scientific studies to have little evidence of relieving BPH symptoms including nocturia or increased urination at night or improving urine flow.  In addition, some men may experience side effects in using this herb that could include diarrhea, constipation or gastrointestinal distress.

·      Rye grass pollen

A pollen extract from rye grass has also been used to treat BPH.  The brand of rye grass pollen most often used in Cernilton and is also the most studied.  It is made in Sweden and is registered as an herbal drug in Western Europe, Japan, Argentina and Korea.  In 2000, a review found rye grass pollen to modestly improve urinary symptoms but there was no significant improvement of urinary function.  Most studies of this herb have been small, short in length and with inconsistent evidence of effectiveness.  This herb may also have side effects of respiratory or skin allergic reactions as well as gastrointestinal distress.

What should a man do?


The first thing a man should do is to make an appointment with his doctor to discuss and diagnosis for certain if his symptoms are truly caused by BPH or not.  If his doctor does diagnosis it as BPH, then they can decide if using herbal supplements would be advisable or not.  Men should also consider FDA approved medications used for treating BPH that do have strong scientific backing of being effective.  Using herbal products for BPH is not well understood and ideally there needs to be more clinical trials to determine if they are effective, at what doses, their side effects and how do they interact with other medications and supplements. 


Until some of these questions can be answered definitively, a man who does decide to use an herbal supplement for treating BPH, needs to let his doctor be aware of this so he can be monitored closely.  Men with mild BPH symptoms who are reluctant to use standard pharmaceutical medication may try herbal products but need to understand they do have limitations.  Men with moderate or severe BPH should be discouraged from the use of alternative treatments such as herbs due to lack of scientific evidence of their efficacy.