Serenoa repens (saw palmetto) for Lower Urinary Tract Symptoms (LUTS): The Evidence for Efficacy and Safety of Lipidosterolic Extracts. Part III

    July 2021
    Stephen B. Strum
    TLDR Saw palmetto extract is effective and safe for treating lower urinary tract symptoms, working as well as certain medications, and works even better in severe cases.
    The review presents data from global literature confirming the efficacy and safety of a lipidosterolic extract of Serenoa repens (LSESr) in treating Lower Urinary Tract Symptoms (LUTS). Despite two US-based placebo-controlled clinical trials failing to confirm a benefit of LSESr vs. placebo in LUTS, the global body of peer-reviewed literature attests to its efficacy and safety. Trials comparing LSESr to alpha-blockers such as tamsulosin (Flomax®) and 5α-reductase inhibitors such as finasteride (Proscar®) demonstrate near equivalency between LSESr and these pharmacologic agents. The review also presents studies indicating an additive effect or synergy between LSESr and tamsulosin. The effectiveness of LSESr is heightened in men with severe LUTS vs. moderate LUTS. Non-English language peer-reviewed publications have consistently provided evidence of LSESr efficacy in treating LUTS/BPH, showing that the effect of LSESr is not that of a placebo.
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