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Herbal Remedies Can Aid Prostate Health

A Review of Supplements Finds Pros and Cons
WebMD Health News

Feb. 4, 2003 -- There's a third inevitability to "death" and "taxes" for most American men -- an enlarged prostate.

Medically known as benign prostatic hyperplasia (BPH), this condition eventually affects at least 80% of men and is most common after age 50. As the usually walnut-sized prostate grows, sometimes as big as a grapefruit, it presses on the urethra (the outflow tract from the bladder), causing incomplete emptying of the bladder, a weakened urine stream, the need to urinate frequently and urgently, and most notably, frequent bathroom breaks -- especially at night. While BPH is often more bothersome than dangerous, it can result in bladder and urinary tract infections or even kidney damage.

One in three men are treated for BPH with surgery or, more commonly, prescription drugs such as Flomax or Proscar. But growing research suggests that some symptoms may be treated as effectively with over-the-counter herbal remedies -- sometimes less expensively and thus far, with no reported side effects. What's more, some of these treatments claim they may help prevent prostate cancer, the second leading cause of cancer death in men.

"I don't want to give the impression that herbal solutions are better than traditional medications, but they definitely do have their place," says Aaron Katz, MD, director of The Center for Holistic Urology at Columbia-Presbyterian Medical Center. "In the past, the role of these herbal remedies has been overlooked by many. But there is now enough laboratory and clinical evidence to recommend their use in many patients with BPH and to maintain good overall prostate health."

Katz recently reviewed dozens of recent studies on various herbs used to treat BPH for a report in the December 2002 issue of The Journal of Alternative and Complementary Medicine. "While I would generally recommend pharmaceuticals to patients with more severe symptoms, these herbs can definitely improve mild to moderate BPH symptoms in many men," he tells WebMD.

Saw palmetto is the leading herbal treatment for BPH and among the best selling of all herbal products, with annual U.S. sales of more than $25 million, according to the American Botanical Council.

"Saw palmetto is usually the first line of therapy against BPH -- at least by patients or their spouses," quips Franklin Lowe, MD, MPH, associate director of the Department of Urology at St. Luke's/Roosevelt Hospital and chairman of the American Urological Association's Complementary & Alternative Medicine Committee. "Most patients are taking it before they come to their urologist's office to find out if they should be taking it." Still, many urologists endorse it use for patients with early, troubling symptoms.

Pros: This herb brings relief in about one in three patients, with a suspected effect similar to Proscar, by blocking the production of a hormone that causes the prostate to grow. "Nobody really knows exactly why it works, because studies are conflicted on the suspected mechanism," says urologist Eric K. Seaman, MD, FACS. "What is clear is that it helps a lot of people, and there is no documented evidence of any side effects. I know a urologist who was waking up at least three times a night because of BPH, and since taking saw palmetto, he's up only once a night. So even if the majority of patients don't get a benefit, they don't lose anything either other than a few dollars."

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