Saw Palmetto and Finasteride in the Treatment of Category-III Prostatitis/Chronic Pelvic Pain Syndrome

This document discusses the use of saw palmetto and finasteride in the treatment of category-III prostatitis/chronic pelvic pain syndrome (CP/CPPS). Saw palmetto has been extensively studied in the symptomatic relief of CP, but there is little clinically significant evidence of the effects of saw palmetto as a 5-a reductase inhibitor. A meta-analysis of 16 randomized, double-blind clinical trials involving 2939 patients with benign prostatic hyperplasia (BPH) revealed that saw palmetto was superior to placebo with regard to nocturia and peak urinary flow, and suggested similar effectiveness when compared with finasteride. Definitive guidelines for the role of phytotherapy and finasteride in CP/CPPS will be shaped by future larger randomized, double-blind, placebo-controlled trials and better regulation of the herbal products available to consumers.