Serenoa Repens (Saw Palmetto) for Lower Urinary Tract Symptoms (LUTS): The Evidence for Efficacy and Safety of Lipidosterolic Extracts. Part III

    August 2021 in “Uro
    Stephen B. Strum
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    TLDR Saw palmetto may improve urinary symptoms with fewer sexual side effects compared to some medications.
    The document reviews the efficacy and safety of lipidosterolic extracts of Serenoa repens (LSESr), or saw palmetto, for treating lower urinary tract symptoms (LUTS). While two major U.S. clinical trials did not show a benefit over placebo, global literature and non-English studies generally support its efficacy and safety. LSESr is shown to be nearly equivalent to alpha-blockers and 5-alpha-reductase inhibitors in effectiveness, with potential additive effects when combined with tamsulosin, especially in severe LUTS cases. The review includes several studies, with a total of 2752 patients, demonstrating improvements in symptoms and suggesting fewer sexual side effects compared to finasteride. The document concludes that LSESr may be an active agent against LUTS or that the prescription drugs compared are no better than a placebo, and emphasizes the need for high-quality, standardized LSESr products and consideration of patient demographics and lifestyle factors in clinical trials.
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