TLDR Finasteride improves chronic pelvic pain, saw palmetto doesn't.
The study aimed to compare the effectiveness of saw palmetto and finasteride in treating chronic nonbacterial prostatitis/chronic pelvic pain syndrome. A total of 64 men were randomized to either finasteride or saw palmetto for 1 year. The study found that patients treated with finasteride had significant and durable improvement in all various parameters except voiding, while saw palmetto had no appreciable long-term improvement. Adverse events included headache in the saw palmetto group and decreased libido in the finasteride group. Further studies are warranted to ascertain the mechanism and reproducibility of these effects in a placebo-controlled trial.
65 citations,
March 1999 in “Urology” Finasteride didn't significantly improve ICPPS symptoms, more research needed.
1054 citations,
February 1998 in “The New England Journal of Medicine” Finasteride reduces urinary issues and surgery need in men with enlarged prostates by over 50%.
124 citations,
January 1993 in “The Prostate” Finasteride effectively inhibits 5α reductase, while plant extracts like Permixon and Bazoton don't show significant results.
127 citations,
May 2004 in “PubMed” Finasteride may help some male chronic pelvic pain patients, but more research needed.
5 citations,
March 2005 in “Current Urology Reports” Saw palmetto helps with nighttime urination and urine flow, similar to finasteride.
67 citations,
February 2015 in “Life Sciences” Some plant-based treatments can help with benign prostatic hyperplasia symptoms, but more research is needed to confirm their safety and effectiveness.
24 citations,
February 2012 in “Prostate cancer and prostatic diseases” 5α-reductase inhibitors help shrink the prostate, improve urinary symptoms, and may reduce prostate cancer risk.
54 citations,
October 2019 in “Cochrane library” Some drugs may reduce prostatitis symptoms short-term with few side effects.
