Saw palmetto (Serenoa repens [Bartram] Small)

background

Saw palmetto (Serenoa repens, Serenoa serrulata) is used popularly in Europe to treat symptoms of enlarged prostate. Although it is not considered the standard of care in the United States, it is the most popular herbal treatment for this condition. More than two million American men use saw palmetto for enlarged prostate, and it is commonly recommended as an alternative treatment by the U.S. Food and Drug Administration (FDA).
Many studies report that saw palmetto may be as effective as the hormonal agent finasteride (Proscar®) and may cause fewer side effects when used to treat bladder problems. Most research has focused on the saw palmetto product Permixon®. However, results are still mixed, and further research is needed.
Saw palmetto has also been used for low sperm count, low sex drive, hair loss, bronchitis, diabetes, inflammation, migraine, and prostate cancer, although there is limited evidence supporting its effectiveness for these conditions.

Related Terms

American dwarf palm tree, American saw palmetto, Arecaceae (family), Bazoton®, Beltrax Uno®, cabbage palm, dwarf palm, dwarf palm plant, Elusan® Prostate, fatty acids, Harzol®, IDS 89, Libeprosta®, LSESR, myristoleic acid, PA 109, Palmae (family), palmetto scrub, palmier de l' Amerique du nord (French), palmier nain (French), PC-SPES®, Permicaps®, Permixon®, Prostadyn®, Prostagood Mono®, Prostamen®, Prostamol Uno®, Prostasan®, Prostaserene®, Prostaserine®, ProstaX®, Remigeron®, sabal, Sabalfruchte (German), Sabal fructus, Sabal serrulata, Sabal serrulata (Michx.) Nutall ex. Schultes & Schultes, Sabal serrulatum, savpalme (Danish), saw palmetto berry, Serendar, Serenoa, Serona repens, Serenoa serrulata, Serenoa serrulata Hook F., Serenoae repentis fructus, SG 291, sterols, Strogen®, Strogen forte®, Tadenan®, Talso®, Urocaps®, Urogutt®, WS 1473, Zwegpalme.
Select combination products: Cernitin®, Cerniton AF™, indigal plus, IPBTRE, PRO 160/120 (Prostagutt® forte), Profluss®, Prostagutt®, Prostataplex™.
Note: Information on pygeum (Prunus africanum, Pygeum africanum) is available in a separate Natural Standard monograph.

evidence table

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
 
Enlarged prostate (Grade: A)
Saw palmetto has been long been used to treat enlarged prostate. According to a report, more than two million American men use saw palmetto for enlarged prostate, and it is often recommended as an alternative therapy by the U.S. Food and Drug Administration (FDA). Many studies report that saw palmetto may be as effective as the hormonal agent finasteride (Proscar®) and may cause fewer side effects when used to treat bladder problems. Most studies used the saw palmetto product Permixon®. Although more recent research failed to find significant benefits of saw palmetto, the available evidence suggests that it may be an effective treatment for enlarged prostate.
Hair loss (Grade: C)
Saw palmetto may block some hormonal effects and may be an effective treatment for hair loss, with benefits similar to the agent finasteride (Propecia®), when applied to the scalp. Early research suggests that saw palmetto may improve hair density, but evidence is limited at this time. Further research is needed before conclusions can be made.
Preparation for surgery (prostate surgery) (Grade: C)
Saw palmetto may help the recovery process in patients undergoing prostate surgery. Early research suggests that saw palmetto may improve the effectiveness of surgery, as well as reduce bleeding and duration of catheter use. However, results are conflicting, and more research is needed in this area.
Prostate cancer (Grade: C)
Saw palmetto is commonly used for many types of prostate problems, including prostate cancer. Research suggests that saw palmetto may block the growth of cancer cells. However, there is limited human research on the effectiveness of saw palmetto for this condition. Evidence is lacking in support of PC-SPES®, a discontinued product that contains saw palmetto, for prostate cancer. The U.S. Food and Drug Administration (FDA) has issued a warning not to use PC-SPES® because it may contain warfarin and alprazolam, which may cause bleeding.
Prostate inflammation (Grade: C)
There is conflicting evidence on the use of saw palmetto in treating prostate inflammation. Although some studies report that saw palmetto may improve symptoms, obvious benefit over standard drugs is lacking. Much of the research has focused on saw palmetto as part of a combination therapy. Further research is needed to understand the potential effects of saw palmetto alone.
Urination (Grade: C)
There is limited evidence on the use of saw palmetto to treat underactive bladder. Available studies are low-quality or use saw palmetto in combination with other therapies. More research is needed in this area.