Treating BPH with Phytotherapy
Phytotherapy is the use of plant extracts to treat a medical condition. Some plant extracts have been used for centuries to treat urinary symptoms secondary to BPH. Today, there is wide variation in the use of these herbal products around the world. In some European countries -- Germany, Austria, and France, for example -- plant extracts are commonly used as initial treatment for men with urinary symptoms.
The interest in treating BPH-related symptoms with herbs has increased in the U.S. because of herbal use in Europe and for the following other reasons:
- The public considers herbs to be safer than medications because herbs are natural. In fact, the herbal preparations that are used with BPH are very safe, with few adverse effects and no serious ones. (But because some herbs used for other conditions can cause significant side effects and can interact with prescription medications, your doctor should know if you are taking any herbal product.)
- Herbs are inexpensive and readily available, so many men think that herbs are worth trying before they go to the doctor.
Although plant extracts have a long history of use in treating BPH, questions still remain about how they work and how effective they really are.
Important effects have been identified in laboratory studies that use high doses of plant extracts, but the clinical relevance of the effects for men with BPH is not well understood. For example, saw palmetto has been shown in lab studies to inhibit 5-alpha reductase -- an effect that is similar to the one produced by finasteride (Proscar®). In theory, then, saw palmetto should decrease prostate size when tested in men; but this outcome has not been observed consistently.
The lack of long-term, placebo-controlled studies of saw palmetto also adds an element of uncertainty to the use of herbal therapies. Short-term trials show that plant extracts usually are more effective than placebo, but longer studies are needed to show whether the effect lasts longer than a placebo.
The lack of standardization among herbal products adds another element of uncertainty. You cannot have the same confidence that you are getting exactly what is stated on the label of an herbal product as you would with pharmaceutical products that are closely regulated by the Food and Drug Administration.
