Saw palmetto extract is an extract of the fruit of the

saw palmetto ''Serenoa repens'', commonly known as saw palmetto, is the sole species currently classified in the genus ''Serenoa''. It is a small palm, growing to a maximum height around . It is endemic to the subtropical and tropical Southeastern United S ...

. It is marketed as a treatment for

benign prostatic hyperplasia Benign prostatic hyperplasia (BPH), also called prostate enlargement, is a noncancerous increase in size of the prostate gland. Symptoms may include frequent urination, trouble starting to urinate, weak stream, inability to urinate, or loss o ...

, but there is no clinical evidence that it is effective for this purpose.

Uses and research

Saw palmetto extract is commonly sold as a dietary supplement intended to improve symptoms of

(BPH)—also called

prostate gland The prostate is both an accessory gland of the male reproductive system and a muscle-driven mechanical switch between urination and ejaculation. It is found only in some mammals. It differs between species anatomically, chemically, and physio ...

enlargement—which is a common condition among men as they age. An enlarged prostate may cause increased frequency or urgency of urination, difficulty initiating urination, weak urine stream or a stream that stops and starts, dribbling at the end of urination, and inability to completely empty the bladder. Saw palmetto extract has been studied in

clinical trial Clinical trials are prospective biomedical or behavioral research studies on human participants designed to answer specific questions about biomedical or behavioral interventions, including new treatments (such as novel vaccines, drugs, diet ...

s as a possible treatment for people with prostate cancer and for men with lower urinary tract symptoms associated with BPH. , there is insufficient scientific evidence that saw palmetto extract is effective for treating cancer or BPH and its symptoms. One 2016 review of clinical studies with a standardized extract of saw palmetto (called ''Permixon'') found that the extract was safe and may be effective for relieving BPH-induced urinary symptoms compared with a

placebo A placebo ( ) is a substance or treatment which is designed to have no therapeutic value. Common placebos include inert tablets (like sugar pills), inert injections (like saline), sham surgery, and other procedures. In general, placebos can af ...

Folk medicine

Saw palmetto was used in

folk medicine Traditional medicine (also known as indigenous medicine or folk medicine) comprises medical aspects of traditional knowledge that developed over generations within the folk beliefs of various societies, including indigenous peoples, before the ...

to treat coughs or other disorders.

Precautions and contraindications

Children

The use of saw palmetto extract is not recommended in children under 12 years old because it may affect the metabolism of

androgen An androgen (from Greek ''andr-'', the stem of the word meaning "man") is any natural or synthetic steroid hormone that regulates the development and maintenance of male characteristics in vertebrates by binding to androgen receptors. This in ...

and

estrogen Estrogen or oestrogen is a category of sex hormone responsible for the development and regulation of the female reproductive system and secondary sex characteristics. There are three major endogenous estrogens that have estrogenic hormonal ac ...

hormones.

Pregnancy and lactation

Saw palmetto extract should not be used during pregnancy. The effects of saw palmetto extract on androgen and estrogen metabolism can potentially impair fetal genital development. Saw palmetto extract should also be avoided during breastfeeding due to a lack of available information.

Surgery and bleeding risk

In a case report, a patient taking saw palmetto extract had increased bleeding time during surgery. Bleeding time returned to normal after stopping taking the herb. One clinical trial pre-treated prostate surgery patients with saw palmetto for five weeks prior to the surgery, because there was evidence from earlier literature that such pre-treatment reduced operative bleeding. The trial reported no improvement compared to

. As a general rule surgeons should ask patients to discontinue dietary supplements prior to scheduled surgery.

PSA test interference

Saw palmetto has been shown to reduce the levels of PSA in the blood, a hormone produced by the prostate and used as a marker by healthcare providers to evaluate the presence of prostate cancer. Taking saw palmetto can artificially reduce the levels of PSA, interfering with test results.

Interactions

Saw palmetto extract has extensive interactions with other medications. It may decrease the effectiveness of estrogen products by reducing estrogen levels in the body via its anti-estrogenic effects. It can interfere with the use of birth control pills that contain estrogen as an active ingredient. As a result, it is recommended that an additional form of birth control, such as a condom, be used to prevent

pregnancy Pregnancy is the time during which one or more offspring develops (gestation, gestates) inside a woman, woman's uterus (womb). A multiple birth, multiple pregnancy involves more than one offspring, such as with twins. Pregnancy usually occur ...

in patients taking birth control pills with saw palmetto extract. In addition, saw palmetto extract can also interfere with

hormone replacement therapy Hormone replacement therapy (HRT), also known as menopausal hormone therapy or postmenopausal hormone therapy, is a form of hormone therapy used to treat symptoms associated with female menopause. These symptoms can include hot flashes, vaginal ...

by reducing the effectiveness of estrogen pills. The combination of saw palmetto extract with

products should be used with caution. When used in combination with an anticoagulant or anti-platelet drug, saw palmetto extract can increase the risk of bleeding by enhancing the anticoagulation or anti-platelet effects. Some examples of anticoagulant and anti-platelet drugs include

aspirin Aspirin, also known as acetylsalicylic acid (ASA), is a nonsteroidal anti-inflammatory drug (NSAID) used to reduce pain, fever, and/or inflammation, and as an antithrombotic. Specific inflammatory conditions which aspirin is used to treat inc ...

clopidogrel Clopidogrel — sold under the brand name Plavix, among others — is an antiplatelet medication used to reduce the risk of heart disease and stroke in those at high risk. It is also used together with aspirin in heart attacks and following ...

, nonsteroidal anti-inflammatory drugs (NSAIDs), and

warfarin Warfarin, sold under the brand name Coumadin among others, is a medication that is used as an anticoagulant (blood thinner). It is commonly used to prevent blood clots such as deep vein thrombosis and pulmonary embolism, and to prevent st ...

References

{{Androgenics 5α-Reductase inhibitors Dietary supplements Hair loss medications Herbalism