Saw palmetto is an herbal product used in the treatment of symptoms related to benign prostatic hyperplasia. The active component is found in the fruit of the American dwarf palm tree. Studies have demonstrated the effectiveness of saw palmetto in reducing symptoms associated with benign prostatic hyperplasia. Saw palmetto appears to have efficacy similar to that of medications like finasteride, but it is better tolerated and less expensive. There are no known drug interactions with saw palmetto, and reported side effects are minor and rare. No data on its long-term usage are available. The herbal product also has been used to treat chronic prostatitis, but currently there is no evidence of its efficacy.

Phytotherapy has become a more popular treatment option among American men with benign prostatic hyperplasia (BPH). The most popular herbal agent is saw palmetto (Serenoa repens), which is derived from the berry of the American dwarf palm tree. Pygeum africanum and beta-sitosterol are also used by many patients with BPH, either alone or in combination with saw palmetto. A significant limiting factor to our understanding of the use and effectiveness of phytotherapy is the lack of standardization of these products. Despite this lack of standardization and the variation in results that may be seen with herbal products, there is growing evidence from well-conducted clinical trials that phytotherapeutic agents may lead to subjective and objective symptom improvement beyond a placebo effect in men with BPH. In addition, histologic evidence has been presented demonstrating that saw palmetto causes atrophy and epithelial contraction within the prostate gland. Overall, it is likely that herbal therapy will continue to be used by a growing number of Americans to treat a variety of ailments. Physicians should attempt to remain open-minded regarding alternative approaches and educate themselves so that they may counsel patients in an informed and credible fashion.