In terms of Western drugs, Proscar is the currently the most widely prescribed. Available for only the last few years, it slows down the formation of dihydrotestosterone, the "bad" hormone that increases cell growth in the prostate. It does so by inhibiting the action of an enzyme called 5-alpha reductase, responsible for the conversion of testosterone to dihydrotestosterone. Clinically speaking, Proscar shrinks enlarged prostatic tissue, but its effects are sometimes slow-- from 3 to 12 months for a change in urinary symptoms. Proscar is an expensive medication, with annual costs of approximately $600 to $700. And it must be taken for life, even though the full range of its side-effects will not be known for some time.
Herbal Medicine for the Prostate
On the bright side, natural therapies have a long history of use in this country and abroad to support optimal prostate health. Saw Palmetto (Serenoa repens berry) has been traditionally used in treating male urogenital conditions. Serenoa is a small palm tree indigenous to the Atlantic seaboard from South Carolina to Florida. It produces a small berry that contains approximately 1.5% fat made up of fatty acids and sterols which affect testosterone metabolism. Like the drug Proscar, it too is a 5-alpha reductase inhibitor-- blocking the formation of dihydrotestosterone, which is responsible for prostate enlargement. In addition, no toxicity has been reported for Saw Palmetto.
Recent research on this herb shows what clinical medicine has known for centuries-- it works! Since 1983, there have been numerous double-blind trials involving hundreds of patients. All of the studies show that Saw Palmetto extract is effective for both subjective and objective measurements of prostatic enlargement (2). For instance, in one study of 110 men with BPH symptoms, the herb decreased night-time urination by 45%, increased urinary flow rate over 50%, and reduced post-urination residual volume (the amount of urine left in the bladder after urination) by 42% (3). Other studies show that Saw Palmetto extract selectively antagonizes 52% of the dihydrotestosterone receptors in the prostate, thus inhibiting the hormone from binding to them, and therefore minimizing its stimulation of cell growth (4).
For men suffering from prostate enlargement, Saw Palmetto is the place to start. You may use a capsule that contains what is called a "lipophilic" extract. This is merely a standardized concentrate of the fat soluble sterols in the berry which have been shown to be responsible for its beneficial activity. You may also consider a liquid extract. And the herb may be used alone or in a combination. In either case, take one dose three times daily for at least one month before evaluating its effectiveness. For those who do not have symptoms, considering taking the herb three times daily for one to two weeks out of the month for prevention.
Two other botanicals deserve mention here. Although not as widely studied as Saw Palmetto berry, both Nettle and Pygeum have been shown to be effective for symptoms of BPH. One recent study shows that Nettle (Urtica dioica root) inhibits membrane activity of the prostate, which may subsequently suppress prostate cell metabolism and growth (5). This, of course, reduces inflammation and enlargement of these tissues. And Pygeum (Pygeum africanum bark) contains "pyto-sterols" which have been shown to have anti-inflammatory properties. In clinical trials, extract of Pygeum was found to reduce symptoms of enlarged prostate, and is available as an over-the-counter medication for BPH in Europe (6). Both Nettle and Pygeum may be used alone, or combined with Saw Palmetto for a more effective protocol for prostate health.