Benign prostatic hyperplasia is a disorder that develops in many older men. In BPH, the prostate gland enlarges and compresses the urethra that runs through its center. This often causes symptoms that include difficulty urinating and a need to urinate frequently, especially at night. The condition may also cause strain on the bladder and recurring bladder infections. Treatments for BPH include use of finasteride, a prescription medication, and of saw palmetto, an herbal remedy. Consult your doctor to determine if either of these approaches is right for you.
A Possible Cause
The underlying cause of BPH is not clear, although it seems to be related to general aging in men. The most widely accepted theory is that DHT, a metabolite of testosterone, is a possible cause of the disorder. DHT is produced by an enzyme in the prostate and other organs. It is thought that DHT accumulates in the prostate with age, causing the gland to grow and giving rise to BPH in some men. Both finasteride and saw palmetto may help relieve BPH by blocking production of DHT.
Finasteride
Finasteride is a synthetic steroid that blocks the enzyme that converts testosterone into DHT. As a result, finasteride depletes the amount of DHT in the prostate. The prescription drug was approved for use in men with BPH by the FDA in 1992 and is widely prescribed today. Finasteride may prevent progression of BPH in some men and, in others, it may cause the prostate to shrink and relieve symptoms. Although generally considered safe, finasteride may produce some significant side effects, including a decrease in sexual desire, an inability to achieve an erection, testicular pain and changes in the breasts.
Saw Palmetto
Saw palmetto is a plant with palmlike leaves that grows naturally in the southeastern U.S. Its berries have been used traditionally by Native Americans to treat several conditions, including urinary problems. Saw palmetto may inhibit the action of testosterone and DHT through several mechanisms. It has been the subject of a number of clinical trials for BPH. In 1998, a study published in the journal "Urology" reported very positive findings in patients who took saw palmetto, as did another study published in 2000 in "The Journal of Urology." However, these studies were small; larger, more comprehensive trials of saw palmetto are still needed.
Dosage and Precautions
Saw palmetto is available from health food stores in powdered form as capsules or tablets. It may also be purchased as an extract or a tincture. The recommended dose is 160 mg of dried herb twice daily or 5 to 6 ml of liquid extract daily. Saw palmetto is generally considered safe, although it may interact with some prescription medications, including hormones and blood thinners. You may develop an allergy to saw palmetto, and it may also cause mild digestive upset. Consult your doctor before taking saw palmetto to determine if it is a good option for you.
References
- National Kidney and Urologic Diseases Clearinghouse: Benign Prostatic Hyperplasia
- MedlinePlus: Finasteride
- MedlinePlus: Saw Palmetto
- Memorial Sloan Kettering Cancer Center: Saw Palmetto
- University of Maryland Alternative Medicine Center: Saw Palmetto
- "Urology"; Saw Palmetto ... in Men...; G. Gerber et al.; 1998
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