Serenoa repens (Saw Palmetto) - Saw palmetto is an effective treatment for benign prostatic hyperplasia (BPH). Several clinical studies have shown significant improvement in lower urinary tract symptoms (LUTS) like frequent urination, painful urination, hesitancy, urgency, and perineal heaviness (1-3). It also decreases nocturia, improves peak and mean urinary flow, and lowers residual urine volume in patients with BPH. A recent study showed that unlike the pharmaceutical medications, Tamsulosin and Finasteride, Saw palmetto had no negative side effects on sexual function (4). Saw palmetto appears to have a number of effects including, antiandrogenic action, an anti-inflammatory effect and an antiproliferative influence through the inhibition of growth factors (5).This herbal extract is safe and effective even in cases with moderate and severe symptoms (6). It has even demonstrated superior effectiveness over conventional medications for BPH, without the bothersome side effects and is less expensive (7). Saw palmetto can also decrease complications and improve efficacy of the surgical procedure, transurethral resection of prostate (TURP) (8).

Pygeum africanum (Pygeum bark) - A review of current studies on pygeum for BPH suggests this botanical medicine is also an effective and safe treatment, improving both urological symptoms and measurements of flow (9). In double blind controlled studies, dosage levels of 100mg daily have proven effective and safe to take long term (10). Like Serenoa treatment, negative sexual side effects are absent (11). Pygeum inhibits cell growth of prostate cancer and hyperplastic cell lines (12,13).

Urtica dioica (Nettle root) - Urtica is another safe and effective herbal treatment for BPH. Placebo controlled studies have demonstrated its effectiveness even in moderate and severe cases (6). Uritca has similar effectiveness to finasteride, a pharmaceutical medication, but is much better tolerated (14). It may work thorugh an antiproliferative effect on prostatic cells and may also lessen the effects of androgenic hormones by competitively blocking access to human sex hormone binding globulin (SHBG) (15,16). Urtica extracts have also demonstrated anti-cancer activity in prostate cancer cell lines (15,17).

Isoflavones (soy extract) - Epidemiological studies show that diets higher in soy products are associated with reduced risk and progression of prostate cancer and prostatitis (18-20).The isoflavone, genistien, appears to be involved in the pathogenesis of BPH and prostate cancer (21,22). Data suggests that supplementing early stage prostate cancer patients with soy isoflavones, for as little as 12 weeks, can alter markers of proliferation like serum PSA and free testosterone (23).

Lycopene - Lycopene is beneficial for both prevention and treatment of prostate cancer. Men who consume 6 mg per day or more of lycopene from foods such as tomatoes and tomato products seem to have a significantly reduced risk of developing prostate cancer (24,25). In patients with hormone refractory metastatic prostate cancer, lycopene therapy can improve lower urinary tract symptoms, bone pain and rising PSA and ECOG performance (26). It also improves the survival rate of orchidectomy in advanced metastatic prostate cancer, and decreases the rate of growth of prostate cancer when given before radical prostatectomy (27,28).

Selenium - Increased intake of dietary selenium seems to reduce the risk of prostate cancer and slows the progression of tumor growth (29,30). Serum levels of selenium appear to be lower in patients with prostate cancer. A large scale trial called SELECT is currently underway to investigate the effects of the antioxidants, selenium and vitamin E, on prevention of prostate cancer (31).

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