Beta-Sitosterol

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Beta-sitosterol is probably the most important, active ingredient in phytosterols, which are found in plants and are thought to be useful in treating urinary problems related to BPH. Evidence that phytosterols inhibit enzymes, hormones, and growth factors, and produce inflammatory effects has been found, but the precise mechanisms by which phytosterols improve urinary symptoms are not known.

In Germany, beta-sitosterol is commonly used in two herbal products: Harzol and Azuprostat.

Scientific Evidence
There is some evidence that beta-sitosterol can improve symptomatic BPH. But more studies are needed to confirm the benefit and to compare its effect with saw palmetto and alpha-blocker drugs. There also is a need for better standardization of other beta-sitosterol products.

• Of the studies that are available, one randomized, placebo-controlled study investigated Harzol, a prescription product derived from beta-sitosterol. This study, which involved 200 men who were treated with either the herbal product or a placebo for six months, found that the average symptom score was reduced by 5.1 points and the peak urinary flow rates increased by 4.1 ml/sec more in the Harzol group than in the placebo group. Also a significant decrease in post-void residual urine volume was seen in the men taking Harzol compared to the men taking the placebo. But, the study showed that Harzol had little effect on prostate volume, suggesting that its effect was not the result of enzyme inhibition.
• Another randomized, placebo-controlled study investigated Azuprostat, another prescription product of beta-sitosterol. The study showed that the symptom score was much more improved in men who took the beta-sitosterol product than in men who took the placebo (5.4 points better). Peak urinary flow rate was improved, too: There was a 4.5 ml/sec greater improvement with Azuprostat.
• In a combined analysis of the available evidence (only 4 studies), beta-sitosterol was shown to improve symptoms scores by a reduction of 35%, peak urinary flow rates by an increase of 34%, and post-void urinary volume by a reduction of 24%.