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If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
An enlarged prostate or “Benign Prostatic Hyperplasia (BPH)” is a common problem that men experience as they age. It occurs when the prostate gland enlarges, sometimes doubling or tripling in size. This is a benign condition, not cancerous, and is believed to be caused by inflammation and changing hormone levels (NIH, 2014).
Not all enlarged prostates cause symptoms. However, it is common for the growing prostate to squeeze the urethra—the tube that carries urine. This can restrict the flow, making it harder to empty the bladder, leading to symptoms such as frequent urination, a weak urine stream, inability to urinate, and nighttime urination (nocturia) (Chughtai, 2016; Everaert, 2018).
When that’s the case, healthcare providers may prescribe medications that can relax the muscles around the prostate and urethra (alpha-blockers like tamsulosin) or reduce the size of the prostate (5-alpha-reductase inhibitors like finasteride) (Ng, 2020).
Some men, however, try turning to natural remedies for an enlarged prostate. Natural remedies come from plants or other natural sources and claim medicinal value.
Finding a natural remedy that works for you
Natural remedies, also called herbal remedies, are commonly used to treat a wide range of ailments. Still, it’s important to know that just because a supplement is labeled “natural” doesn’t always mean it’s safe, healthy, or effective.
Natural or herbal supplements are not regulated by the Food and Drug Administration (FDA). That means that unlike prescription and over-the-counter medications, you can’t be entirely sure that what’s listed on the label is inside the bottle (NIH, 2020).
Herbal medicines typically don’t go through the rigorous, large-scale clinical trials that conventional medications do. This has led to a lack of high-quality data (Parveen, 2015).
But, despite lacking and mixed results from studies, many men do find success with herbal supplements for BPH. Some have been used for centuries, and there is scientific evidence to back them up. Ultimately, what works for some men, may not work for others.
Most importantly, natural remedies are not supposed to replace professional medical care for BPH. However, if your healthcare provider does not think you currently need medication or surgery for an enlarged prostate, there are some natural remedies that men with BPH use alone or in combination with other treatments (Allkanjari, 2015).
The following eight natural remedies are among the most commonly used, and there’s at least some scientific research to back them up:
Some studies show it can improve urinary flow and more completely empty the bladder, lessening symptoms of having to go frequently (Espinosa, 2013).
Beta-sitosterol is thought to work by inhibiting 5-alpha-reductase—the enzyme that converts testosterone into dihydrotestosterone (DHT). Medical experts believe that DHT is a trigger for the development of BPH (Furhad, 2021).
You can get beta-sitosterol from a lot of foods, including pecans, saw palmetto, avocados, and pumpkin seeds. It’s one of more than 100 types of phytosterols—compounds in plants similar to cholesterol (Yang, 2019). Beta-sitosterol has also been shown to reduce inflammation and is credited with many medicinal benefits, such as wound healing, but more research is needed (Babu, 2020).
Beta-sitosterol is generally well-tolerated. Some gastrointestinal side effects have been reported. In one study, the side effects were comparable in frequency to a placebo (Wilt, 2020).
BPH treatment: when is it needed and what’s available?
Pumpkin seeds contain beta-sitosterol, which has been shown to improve urine flow and reduce the amount of urine left in the bladder (Ramak, 2018).
A 12-month trial compared pumpkin seeds, pumpkin seed extract, and placebo in more than 1,400 men between 50 and 80. The study showed a reduction in BPH symptoms like frequent urination in those who consumed the whole pumpkin seeds (Vahlensieck, 2015).
Pumpkin seed and pumpkin seed extract are well-tolerated by most, but gastrointestinal issues may occur in some (Vahlensieck, 2015).
Saw palmetto is made from the berries of the saw palmetto palm tree found in the Southeastern United States. Containing fatty acids and beta-sitosterol, it was used for centuries by Native Americans and is the most well-known herbal remedy for BPH (Furhad, 2021).
Like beta-sitosterol, saw palmetto has also been shown to inhibit 5-alpha-reductase (Furhad, 2021). Some studies report that men who treat BPH with saw palmetto notice fewer urinary symptoms, improved urinary flow, and less nocturia (Espinosa, 2013).
More recent larger trials show mixed results, with some showing no benefits at all. Researchers say the varying results may partly be due to a wide variety of different quality products that have been used for studies (Penugonda, 2013). A 2019 study showed enriching saw palmetto oil with beta-sitosterol was more effective than saw palmetto alone (Sudeep, 2019).
Side effects of saw palmetto are uncommon and mild and may include dizziness, headache, nausea, vomiting, constipation, and diarrhea (NCCIH, 2016).
What is saw palmetto: does saw palmetto boost testosterone?
Pygeum africanum comes from the bark of the African plum tree. Traditional medicine has made use of it to treat urinary problems for centuries, and men often use it to treat BPH symptoms (Papaioannou, 2009).
Pygeum contains a wide range of fatty acids and sterols such as beta-sitosterol. It appears to reduce inflammation in the prostate, suppress prostate growth factors, and decrease testosterone (Nickel, 2008). One review of 18 different studies found it increased urine flow, decreased nocturia, and reduced the amount of urine remaining in the bladder (Wilt, 2002).
Another review found that daily pygeum could improve urinary symptoms and urine flow in as little as 1–2 months. However, the medical community needs to conduct more research to determine its benefits and how it works (Allkanjari, 2015).
Pygeum africanum is generally well-tolerated in studies. When side effects do occur, they are mild and include constipation, diarrhea, headache, and nausea (NCCIH, 2016).
Stinging nettle (Urtica Dioica) is another plant that’s been used for centuries for medicinal purposes. It contains sterols and lignans and is believed to lower prostate growth factors.
Small trials have shown it to reduce BPH symptoms and improve urine flow (Nickel, 2008; Safarinejad, 2005).
Other studies, however, show mixed results. Stinging nettle is usually combined with saw palmetto for use in treating BPH (Kregiel, 2018). While additional, larger trials are needed to explore stinging nettle for BPH, research is underway looking at it to treat other diseases such as cancer (Dhouibi, 2020; Esposito, 2019).
Stinging nettle is generally well-tolerated but may cause mild gastrointestinal effects. It does contain tannins, which can counter the effects of iron supplementation (NCCIH, 2016).
What is the prostate?
Rye grass pollen
In a small, six-month study, rye grass pollen, also known as Cernilton, was shown to be modestly helpful in reducing urinary symptoms, including nocturia. Researchers say more extensive randomized placebo-controlled trials are needed to confirm results (Espinosa, 2013).
Laboratory studies have shown that pollen extracts have anti-inflammatory and anti-growth effects. In one animal study, rye pollen had these effects on the prostate tissue of mice (Cai, 2017).
Researchers say rye grass pollen extract (Cernilton) is well-tolerated. However, studies have been small with unknown data about the quality of the preparations being used (MacDonald, 2000).
Lycopene is a naturally occurring molecule found in red, pink, and orange vegetables or fruits, such as tomatoes, watermelon, red bell peppers, and apricots (Schwarz, 2008).
Studies using a lycopene extract show it may help slow the progression of BPH. In a small randomized, double-blinded, placebo-controlled trial, lycopene was shown to reduce symptoms at a dose of 15 mg per day for six months (Schwarz, 2008).
Lycopene is also being researched to explore how it may help protect against other health conditions such as cardiovascular disease and cancer (Saini, 2020).
Lycopene foods: tomatoes, pink grapefruit, and others
There is not a lot of data about lycopene supplements. Potential adverse effects of lycopene in supplement form may be low blood pressure, an increased risk of bleeding, and gastrointestinal issues (La Placa, 2000; NCCIH, 2016).
If you are experiencing symptoms that may be caused by an enlarged prostate, the first step should be to talk to a healthcare provider about treatment options and how supplements might interact with any medications you’re taking. It’s also a good chance to talk about lifestyle changes that can boost prostate health.
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Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.