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Enlarged Prostate: A Complex Problem

There are many treatments for enlarged prostates (BPH), but all have side effects and possible complications. Learn what to expect -- and how to decide.

Herbal Therapies for an Enlarged Prostate continued...

Something else to consider: Like any drug, a herbal remedy can affect how other medications or treatments work, or interact dangerously with your other medications. They can also have side effects. And, the AUA points out, they have not been well-studied for effectiveness or safety.

Before trying any alternative treatment, learn as much as you can about it, the AUA says. Most importantly -- talk to your doctor before you try an herbal remedy. Many doctors consider alternative therapies like saw palmetto to "have no effect on symptoms, except as expensive placebos," Slawin tells WebMD.

Saw palmetto: Saw palmetto is one of the most popular herbal supplements taken for BPH. The extract comes from ripened berries of the saw palmetto shrub. Extracts are thought to prevent testosterone from breaking down and triggering prostate tissue growth, similar to the 5-alpha reductase inhibitor medications. Studies of this supplement have had varied results.

"Saw palmetto does not work," Slawin tells WebMD. He points to a recent "very nicely done" randomized study that found palmetto was no more effective than a placebo in relieving BPH symptoms. However, other studies have found it to be as effective as Proscar, a BPH medication. Varying quality of herbal products (dosages, ingredients, or purity) may account for the conflicting results, researchers say. Also, many studies of herbals have not been well-controlled.

Beta-sitosterol: This compound is extracted from pollen of rye grass. There has been some evidence that it provides relief from urinary symptoms. However, in four studies the supplement did not increase urinary flow rates, shrink the prostate, or improve bladder emptying.

Pygeum: This extract comes from the bark of the African plum tree. Numerous studies have found positive results for pygeum. In 18 studies, this extract relieved BPH symptoms twice as often as the placebo; it also increased urinary flow by nearly 25%.

Enlarged Prostate Treatments in the Pipeline

Researchers continue to investigate new therapies for enlarged prostates. "Another category of drugs is under development," says Slawin. "We've come a long way in treating BPH. It's no longer the life-threatening disease it once was. Now, in treatment, we're working on quality of life issues… reducing side effects of treatment."

Also being studied is a procedure called water-induced thermotherapy (WIT), an experimental procedure that involves destroying excess prostate tissue utilizing heated water and an air-filled balloon, which protects normal prostate tissue. The procedure is performed with only local anesthesia. Results may not be fully apparent for three to four months. However, preliminary studies examining WIT have shown positive results, with a near doubling in urine flow. However, the American Urological Association has not thus far endorsed WIT as a viable treatment option for symptoms of BPH.

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Reviewed on August 29, 2011

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