Evidence supporting the use of: Saw palmetto
For the body system: Male Reproductive System

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Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Saw palmetto (Serenoa repens) is commonly used as a herbal remedy to support the male reproductive system, particularly for symptoms associated with benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate gland. Historically, Native American populations used saw palmetto berries to address urinary and reproductive issues in men. In contemporary research, multiple clinical trials and systematic reviews have examined the efficacy of saw palmetto extract for reducing urinary symptoms related to BPH. Some studies have shown modest improvements in urinary flow and decreases in nocturia (nighttime urination), suggesting a potential benefit.

However, the scientific evidence is mixed. While some early studies reported positive effects, more recent large-scale, well-designed randomized controlled trials (including the 2011 STEP trial published in JAMA) found that saw palmetto was no more effective than placebo in reducing BPH symptoms. Meta-analyses have concluded that, overall, saw palmetto may have only a small, if any, effect compared to placebo.

Saw palmetto is generally considered safe with mild side effects. Despite inconsistent evidence, it remains widely used due to its traditional use, favorable safety profile, and the desire for non-pharmaceutical alternatives. In summary, while there is a scientific basis for its use, the overall strength of evidence supporting saw palmetto for male reproductive health is moderate at best.

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