Search

BACKGROUND: The use of herbal products, one component of the growing field of integrative cancer care, is a common yet controversial practice. OBJECTIVES: This article distinguishes nursing issues specific to patient safety when herbal products are used during cancer treatment and identifies available evidence-based resources to enhance patient and professional comprehension. METHODS: PubMed®, CINAHL®, and Google Scholar™ databases were searched for literature published between 2018 and 2024 specific to the clinical sequelae of the use of herbal products and their interactions with antineoplastic drugs, as well as patient and healthcare providers' perceptions of efficacy and safety. METHODS: PubMed®, CINAHL®, and Google Scholar™ databases were searched for literature published between 2018 and 2024 specific to the clinical sequelae of the use of herbal products and their interactions with antineoplastic drugs, as well as patient and healthcare providers' perceptions of efficacy and safety. [ABSTRACT FROM AUTHOR]

Alopecia, a condition characterized by hair loss, affects a significant portion of the population and has various psychological and physical impacts. This review article explores the efficacy and safety of herbal treatments for alopecia, integrating traditional knowledge with contemporary scientific research. The article examines various herbal remedies used across cultures, such as Saw Palmetto, Ginseng, Green Tea, and Phyllanthus Emblica, delving into their bioactive compounds and mechanisms of action. Studies and case reports, adhering to APA citation style, highlight the potential of these natural remedies in promoting hair growth and managing different types of alopecia. The review also addresses the safety profile and toxicological considerations of these herbal treatments, underscoring the importance of comprehensive evaluations and standardized dosages. The integration of herbal treatments with conventional therapies is discussed as a promising avenue for enhancing treatment outcomes. The article concludes by emphasizing the need for more rigorous clinical trials, exploration of new herbal compounds, and the development of standardized, safe herbal formulations for alopecia treatment. [ABSTRACT FROM AUTHOR]

Background: Saw palmetto extract (SPE) is one of the most widely used supplements for benign prostatic hyperplasia (BPH) due to its pharmacological effects. ß-sitosterol-enriched saw palmetto oil (VISPO™) contains more than 3% ß-sitosterol and 85% total fatty acids and has been shown to improve symptoms in patients with BPH. Lower urinary tract symptoms (LUTS) require primary preventive measures in countries with accelerated population aging, including Japan. VISPO™ is expected to be effective against the early symptoms of LUTS. However, the effect of VISPO™ on urinary function in healthy individuals has not been elucidated. Objective: This clinical study evaluated the efficacy and tolerability of VISPO™ in the management of urinary complaints among healthy middle-aged and older men who did not require treatment. Methods: We conducted a randomized, double-blind, placebo-controlled trial that included 54 male participants who were assigned to consume VISPO™ or placebo (olive oil) capsules for 12 weeks. Biometric data, uroflowmetry results, and salivary hormone levels were assessed at weeks 1 and 12. Urinary function and quality of life were assessed at weeks 1, 4, 8, and 12 using the International Prostate Symptom Score (IPSS), Overactive Bladder Symptom Score (OABSS), Core Lower Urinary Tract Symptom Score (CLSS), and WHOQOL-26. Results: Two-way analysis of variance revealed that IPSS and OABSS were significantly lower in the VISPO™ group that in the placebo group. However, there were no significant differences in urine volume, urinary flow rate, or salivary hormone levels. In addition, no participants reported adverse effects (diarrhea, abdominal pain, etc.). Conclusion: The results of the present study, which is the first randomized controlled trial of VISPO™ conducted among healthy participants, demonstrate the effectiveness of VISPO™ in the management of lower urinary tract complaints that do not require treatment. [ABSTRACT FROM AUTHOR]

Heggar Venkataramana Sudeep,1 Sriram Rashmi,2 Thomas V Jestin,3 Aleksander Richards,4 Kuluvar Gouthamchandra,1 Kodimule Shyamprasad1 1Department of Biomedicinal Research, R&D Center for Excellence, Vidya Herbs Pvt Ltd, Bangalore, Karnataka, India; 2BGS Global Institute of Medical Sciences, Bangalore, Karnataka, India; 3Department of Clinical Research, Leads Clinical Research and Bio Services Private Ltd, Bangalore, Karnataka, India; 4Department of Clinical Studies, R&D, Vidya Herbs, Red Bank New Jersey USACorrespondence: Heggar Venkataramana Sudeep, Department of Biomedicinal Research, R&D Center for Excellence, Vidya Herbs Pvt Ltd, Bangalore, Karnataka, India, Email research@vidyaherbs.com; sudeepkashyap.82@gmail.comPurpose: Androgenetic alopecia (AGA) is the most common type of hair loss in humans, affecting self-esteem and emotional well-being. This study aimed to assess the safety and efficacy of VISPOTM, a standardized saw palmetto oil (2– 3% β-sitosterol), in subjects with mild-to-moderate AGA.Methods: In a double-blind, placebo-controlled, four-arm clinical study, 80 healthy male and female subjects aged 18– 50 years were randomly allocated (1:1:1:1) to receive either 400 mg capsules of VISPO or 5 mL of a topical formulation containing 20% VISPO or the respective placebo once daily for 16 weeks. The primary endpoints included hair count (hair comb and hair pull tests) and the self-assessment of perceived efficacy. Objective evaluation was performed using the global photographic assessment score. Hair density, thickness, and anagen/telogen ratio were evaluated using phototrichogram analysis.Results: At the end of the study, oral and topical formulations of VISPO reduced hair fall by up to 29% (p< 0.001) and 22.19% (p< 0.01) from the baseline, respectively. Hair density increased by 5.17% and 7.61% in the oral and topical VISPO groups, respectively (p< 0.001). In addition, oral ingestion of VISPO resulted in a marked reduction in serum dihydrotestosterone (DHT) levels in the subjects compared to placebo (p< 0.001). However, the effect of the VISPO formulations on the anagen/telogen ratio was insignificant. No serious adverse effects were observed during the study.Conclusion: VISPO formulations reduced hair fall and promoted hair regrowth and scalp appearance in AGA patients.Keywords: hair loss, androgenetic alopecia, saw palmetto, β-sitosterol, fatty acids

Androgenetic alopecia (AGA) is a dermatologic condition with no current cure. Treatments such as minoxidil have been proven to be effective; however, the side effects can be unpleasant. As a result, the utilization of natural remedies for treatment has increased over the years. There is limited scientific evidence that addresses the efficacy of these supplements in combating AGA. A review was conducted of the effectiveness of popular complementary and alternative medicines (CAMs) in adult patients experiencing AGA. A literature search was performed for the period of 1993 to 2023 using PubMed, Embase, Google Scholar, Web of Science, and Cochrane. Natural ingredients like pumpkin seed oil, saw palmetto, melatonin extract, caffeine extract, and rosemary oil were effective in treating AGA either when compared to baseline or a definite AGA Western medication, such as minoxidil. These natural agents also presented minimal side effects. Certain CAMs can be promising for hair loss treatment. There is a need for more scientific research to better explore the efficacy of currently identified CAMs in treating AGA. [ABSTRACT FROM AUTHOR]

The safety of Serenoa repens (SR)‐containing products was evaluated conducting a retrospective worldwide analysis of pharmaco‐ and phytovigilance report forms of suspected adverse reactions (SARs) collected up to 31 January 2022. Multivariate logistic regression was performed to estimate the odds ratios (ORs) of serious SAR. A total of 1810 report forms were analysed; 92% of subjects were males, with a median age of 69 years; 44% of cases were defined as serious. Subjects exposed to dietary supplements had a higher risk of developing serious SARs (OR: 1.60 [95% CI: 1.20–2.15]), as subjects exposed to 2–5 (OR: 1. 83 [95% CI: 1.30–2.58]) or more than 5 (OR: 3.45 [95% CI: 2.36–5.06]) suspect/interacting products. The probability of experiencing serious SAR was higher for subjects exposed to concomitant products (OR: 1.55 [95% CI: 1.15–2.08]), to more than four active compounds (OR: 4.38 [95% CI: 3.21–5.99]) and to SR for more than 14 days (OR: 1.89 [95% CI: 1.10–3, 22]), and lower for subjects exposed to higher doses of SR (OR: of 0.34 [95% CI: 0.20–0.58]). This evidence improves awareness on safety of SR containing products, suggesting the need of a further update of periodic reviews by national and international regulatory agencies. [ABSTRACT FROM AUTHOR]

The study presents the mechanism of male androgenetic alopecia (MAGA), with a focus on the role of the enzyme 5-α-reductase, which is responsible for converting testosterone, the primary male hormone, into its active form, dihydrotestosterone (DHT). The consequences of the DHT stimulation of androgen receptors (ARs) located in the X chromosome of dermal papilla cells (DPCs) are described. This leads to androgen-induced gene transcription, disrupted hair follicle nourishment, and most importantly, an accelerated transition from the anagen to the catagen phase. The study also discusses how this enzyme can be targeted by molecules acting as inhibitors. Furthermore, the justification for conducting more in-depth studies on the mechanisms of action involving extracts of saw palmetto (Serenoa repens) and their inhibitory effects on 5-α-reductase is presented. The study also advocates the identification and measurement of active substances present in saw palmetto extracts, with two promising phytosterolic compounds, stigmasterol and β-sitosterol, due to their demonstrated inhibitory activity on 5-α-reductase in extracts from other plant species. As part of the proposal to deepen the research, attention is drawn to the need to investigate the impact of saw palmetto extract on the hair growth cycle, hair follicle life cycle, various growth factors and angiogenesis, immune system activity, and oxidative stress. Other areas of observation for the action of saw palmetto extracts could include their use in combination with other plant extracts or therapeutic agents such as platelet-rich plasma or fibrin-rich plasma.

In alternative medicine, Saw palmetto is used in the treatment of many diseases, as it is effective in treating urinary system diseases through anti-androgen effects and effects on involuntary receptors in the lower urinary tract, in addition to being used in the treatment of patients with benign prostatic hyperplasia and cancer Prostatitis, chronic prostatitis (CP) and erectile dysfunction (ED). Scientific research has proven that Saw palmetto is considered a herbal remedy because it contains 3 phytosterols, 14 fatty acids, and SRM3251 contains 3 phytosterols, 17 fatty acids, β-carotene, and γ-tocopherol. It also played an important role as an anti-androgen as 5a-dihydrotestosterone (DHT) is converted from testosterone by the action of 5a-reductase, and this helps in the development of male sexual characteristics, transcription of androgen-regulating genes, prostate enlargement. Also, it affects on enzymes and chemokines that effect on the inflammatory process. Saw palmetto is used in the treatment of Chronic Prostatitis (CP) and Chronic Pelvic Pain Syndrome (CPPS). In this review, the phytochemical content of Saw palmetto will be highlighted and the pharmacological effect on male hormones, urinary system diseases and infections will be studied. [ABSTRACT FROM AUTHOR]

This review summarises the material covered during a workshop entitled “Natural Products as Treatments for Urinary Incontinence” that was presented at the online ICS (Melbourne) annual conference held in 2021. The clinical and scientific evidence of the effectiveness of naturally sourced treatments such as traditional Chinese medicines, phytoestrogens and saw palmetto for lower urinary tract symptoms are discussed, and also the use of cranberry and D-mannose for the treatment of bacterial infections of the urinary tract. The workshop and this review finish with a look towards the future and a discussion of potential treatments to repair the barrier function of the urothelium, an action that may be useful in conditions such as interstitial cystitis/bladder pain syndrome.

Copyright of Medicina Pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Saw palmetto (SP), a botanical extract with antiandrogenic properties, has gained commercial popularity for its purported benefits on hair regrowth. To summarize published evidence on the efficacy, safety, and tolerability of supplements containing SP in the treatment of alopecia, we conducted a PubMed, Google Scholar, and Cochrane database search using the following terms: (saw palmetto and hair loss), (saw palmetto and androgenetic alopecia), and (saw palmetto and natural supplement and alopecia). Five randomized clinical trials (RCTs) and 2 prospective cohort studies demonstrated positive effects of topical and oral supplements containing SP (100-320 mg) among patients with androgenetic alopecia (AGA) and telogen effluvium. Sixty percent improvement in overall hair quality, 27% improvement in total haircount, increased hair density in 83.3% of patients, and stabilized disease progression among 52% were noted with use of various topical and oral SP-containing supplements. SP was well tolerated and not associated with serious adverse events in alopecia patients. Although robust high-quality data are lacking, supplements containing SP may be a treatment option for patients with AGA, telogen effluvium, and self-perceived hair thinning. Further large-scale RCTs focusing on the sole contribution of SP to hair growth outcomes are needed to confirm efficacy and determine long-term adverse events.

Inhibition of 5α-reductase (5αR), which blocks the conversion of testosterone to its active metabolite, dihydrotestosterone, has been shown to impact further prostate enlargement (benign prostatic hyperplasia, or BPH). Clinical trials of standardized lipidosterolic extracts of Serenoa repens (LSESr), also known as standardized extracts of saw palmetto, have demonstrated improvement in lower urinary tract symptoms (LUTS) and delayed progression of BPH. The aim of this preclinical study was to compare two standardized LSESr, a proprietary ultrahigh-pressure supercritical carbon dioxide extract of S. repens (UHP-sCESr) and the well-established hexanic extract of S. repens (HESr), for both 5αR inhibition activity and lipid profiles. UHP-sCESr and HESr had nearly identical inhibition curves and comparable IC50 values for 5αR-1 (9.25 ± 0.87 and 9.86 ± 0.11 μg/mL, respectively; p = 0.43) and 5αR-2 (7.47 ± 0.07 and 7.72 ± 0.05 μg/mL, respectively; p = 0.0544). UHP-sCESr and HESr also had comparable lipid profiles based on similar total fatty acid levels (87.7% and 91.5%, respectively), weight/weight comparisons of individual fatty acids, and individual fatty acid ratios to lauric acid. In addition, UHP-sCESr meets the standard set by the United States Pharmacopeia (USP) monograph for authenticity and purity for a supercritical carbon dioxide (SCCO2) extract of saw palmetto, whereas HESr meets the standard set by the European Medicines Agency (EMA) for a well-established medicinal product. In conclusion, based on enzyme inhibition curves and IC50 values, a standardized lipid profile is important to achieve comparable mechanisms of action for lipidosterolic extracts of saw palmetto. UHP-sCESr offers a comparable, standardized LSESr for men with LUTS/BPH in regions where the proprietary HESr is not available.

The military situation in Ukraine significantly worsened the quality of medical care for the population. Of all Ukrainian men the age category from 30 to 60 years old who take part in military operations is the most effective one. Another, no less important part of the male population is the old persons, who, as a result of military operations, have limited opportunities to receive medical care. Currently, observing by urologist, required for benign prostatic hyperplasia (BPH) or lower urinary tract symptoms (LUTS) due to combat operations in the country, is often performed via distance curation. The doctor needs a clear understanding of the patient's medical history, taking into account his psychological and somatic status, the use of medicines. Stress negatively affects men's health, worsening the hormonal background, mental state and aggravating problems of the genital and urinary systems. Psychological stress is a factor in the exacerbation or occurrence of urological complaints, which can lead to the pathological activation of certain parts of the sympathetic nervous and hormonal systems, the development of LUTS by BPH. Tamsulosin is considered to be the most recognized and widely used treatment for LUTS in patients with BPH. The classic medicament approach of BPH monotherapy is the use of Serenoa repens extract. The distance appointment of selective α-adrenoblockers, both in monotherapy and in combinations, is an important measure of providing specialized urological care to the population. [ABSTRACT FROM AUTHOR]

The objective: to analyze the effectiveness and tolerability of a dietary supplement, which includes: Saw Palmetto (Serenoa repens), pumpkin seeds (Cucurbita moschata), African tuber (Hypoxis hemerocallidea), stinging nettle root (Urtica dioica), African plum bark (Prunus africana), rye pollen extract (Secale cereale), in the treatment of patients with benign prostatic hyperplasia (BPH) and chronic prostatitis (CP) for 6 months. Materials and methods. 60 men were examined, they were divided into two groups: the main group (MG) - 28 patients who received the dietary supplement for 6 months, and the comparison group (CG) - 32 patients who used another combined herbal preparation for the treatment of BPH and CP. MG and CG patients were similar in terms of age, disease duration, and urination rate. Patients of both groups were examined using clinical, laboratory and instrumental methods before the start of treatment and after its completion in 6 months. Results. The main result of the research can be considered that the use of a dietary supplement based on Saw Palmetto (Serenoa repens), pumpkin seeds (Cucurbita moschata), African tuber (Hypoxis hemerocallidea), stinging nettle root (Urtica dioica), African plum bark (Prunus africana), extract of rye pollen (Secale cereale) gives an excellent long-term effect in 96.4% of patients with CP and BPH. As a result of the study, this dietary supplement demonstrated its effectiveness in the treatment of patients with BPH and CP for both subjective (IPSS and QOL, pain sensation) and objective indicators over a period of 6 months. During therapy the volume of residual urine in patients probably decreased and the maximum urinary flow rate increased. Conclusions. Dietary supplement, which includes Saw Palmetto (Serenoa repens), pumpkin seeds (Cucurbita moschata), African tuber (Hypoxis hemerocallidea), nettle root (Urtica dioica), African plum bark (Prunus africana), rye pollen extract (Secale cereale), is well tolerated by patients, has high therapeutic efficiency, does not cause side effects, does not disturb the sexual function of patients with BPH and CP, which allows to prescribe it for a long time. [ABSTRACT FROM AUTHOR]

Inhibition of 5α-reductase (5αR), which blocks the conversion of testosterone to its active metabolite, dihydrotestosterone, has been shown to impact further prostate enlargement (benign prostatic hyperplasia, or BPH). Clinical trials of standardized lipidosterolic extracts of Serenoa repens (LSESr), also known as standardized extracts of saw palmetto, have demonstrated improvement in lower urinary tract symptoms (LUTS) and delayed progression of BPH. The aim of this preclinical study was to compare two standardized LSESr, a proprietary ultrahigh-pressure supercritical carbon dioxide extract of S. repens (UHP-sCESr) and the well-established hexanic extract of S. repens (HESr), for both 5αR inhibition activity and lipid profiles. UHP-sCESr and HESr had nearly identical inhibition curves and comparable IC50 values for 5αR-1 (9.25 ± 0.87 and 9.86 ± 0.11 μg/mL, respectively; p = 0.43) and 5αR-2 (7.47 ± 0.07 and 7.72 ± 0.05 μg/mL, respectively; p = 0.0544). UHP-sCESr and HESr also had comparable lipid profiles based on similar total fatty acid levels (87.7% and 91.5%, respectively), weight/weight comparisons of individual fatty acids, and individual fatty acid ratios to lauric acid. In addition, UHP-sCESr meets the standard set by the United States Pharmacopeia (USP) monograph for authenticity and purity for a supercritical carbon dioxide (SCCO2) extract of saw palmetto, whereas HESr meets the standard set by the European Medicines Agency (EMA) for a well-established medicinal product. In conclusion, based on enzyme inhibition curves and IC50 values, a standardized lipid profile is important to achieve comparable mechanisms of action for lipidosterolic extracts of saw palmetto. UHP-sCESr offers a comparable, standardized LSESr for men with LUTS/BPH in regions where the proprietary HESr is not available. [ABSTRACT FROM AUTHOR]

Introduction: The effect of the lipidosterolic extract derived from Serenoa repens (commonly known as “saw palmetto extract” or LSESr) berries on benign prostatic hyperplasia (BPH) and male lower urinary tract symptoms (LUTS) has been extensively studied in the global literature. However, a lack of global consensus with regard to its effectiveness remains, resulting in differing recommendations on the role of LSESr in the BPH/LUTS treatment paradigm. Here, we describe the consensus reached by an international panel of urology experts. Methods: In an independent meeting on 24 April 2021, an international panel of urology experts convened with the goal of developing consensus statements to address the following: the differences between the AUA and EAU guidance regarding the use of LSESr for the treatment of BPH/LUTS, the proposed mechanism of action of LSESr, and data examining the efficacy and safety of LSESr. These consensus statements were developed over the course of several months after an extensive review of the global literature and a discussion thereof. Results: A total of seven consensus statements were agreed upon by the panel. These statements addressed the proposed mechanism of action of LSESr, LSESr quality, and the results from clinical trials examining the efficacy and safety of various LSESrs. Conclusion: Based on the reviewed evidence, the panel recommends that LSESr should be considered as a treatment option for men with mild-to-moderate BPH/LUTS as an alternative to watchful waiting.

Copyright of Urologie Pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Part I of this 3-part series provided the groundwork for understanding the role of a standardized lipidosterolic extract of Serenoa repens (LSESr) in the treatment of LUTS. It documented that a treatment having a high therapeutic index (i.e., a ratio of benefit to adverse reactions) is a critical need in the demographic context of a rapidly growing elder population. Part I described the clinical symptomatology of LUTS and how it is quantified. A critique of the reports from four authoritative bodies: the European Scientific Cooperative on Phytotherapy (ESCOP), Cochrane 2012, the European Medicines Agency (EMA), and the AUA (American Urological Association) was presented. The foundation above then fine-tuned our search to require (a) consistent evaluability criteria, (b) the quantification of clinical findings, (c) the need to focus on studies employing a standardized LSESr product meeting the fatty acid profile set forth by the European Medicines Agency (EMA) and the US Pharmacopeia and (d) a global assessment of scientific investigations published in all languages and not limited to only English. With the above four constraints, “new” findings about LSESr vs. LUTS are presented. How did the search strategy and selection criteria lead to new understandings about the role of LSESr vs. LUTS? How safe is LSESr in contrast to its counterpart prescription drugs? Of the proposed major mechanisms of action of LSESr (e.g., 5-alpha reductase inhibition and anti-inflammatory activity), what are the key points? After initiating treatment with LSESr, when is clinical improvement seen? How durable is LSESr in ameliorating LUTS? Can LSESr prevent the progression of BPH?

Saw palmetto (SAW), the herbal drug used to treat prostatic hyperplasia, exerts its antiproliferative effects by blocking steroid 5 alpha-reductase (SRD5A1) activity, that has also been involved in gingival hyperplasia (GH) pathogenesis. Concurrently, folic acid (FA) could reduce GH prevalence via its antioxidant and anti-inflammatory effects. Thus, this study tended to assess the potential therapeutic efficacy of SAW, alone and along with FA, against amlodipine-induced gingival inflammation and overgrowth in rats. Rats were grouped into (CONT, AIGH, SAW, SAW-treated, FA-treated, and SAW + FA-treated). SAW and FA were administered once daily for 4 weeks. Gingival SRD5A1, CTGF, GSK-3β, and NLRP3 expressions, as well as T, DHT, MDA, TAC, ET-1, and MMP2 levels were determined. In addition, histopathological and immunohistochemical analyses of TNF-α, IL-6, TGF-β1, and α-SMA were documented. Results declared that SAW and FA administration markedly ameliorated amlodipine-associated GH and may be presenting a novel therapeutic avenue in the future. [Display omitted] • SAW inhibits SRD5A1 activity and, as a consequence, NF-κB activation • SAW and FA prohibits TNFα and IL-1β outflow, ET-1 synthesis, and MMP-2 release • SAW and FA suppresses GSK-3β-mediated activation of NLRP3 inflammasome • SAW and FA down-regulates TGF-β1 and α-SMA expression in the gingival tissue • SAW and FA counteracts amlodipine-induced gingival hyperplasia (AIGH) [ABSTRACT FROM AUTHOR]

Androgenetic alopecia (AGA) is the most common cause of hair loss in men, often requiring medical attention. The US FDA approved topical minoxidil and oral finasteride to treat AGA. Topical minoxidil requires a long‐term application to observe improvement; oral finasteride may cause undesirable side effects. Therefore, natural products may be an alternative when patients are skeptical about these two conventional treatments. Physicians may also suggest natural products in conjunction with topical minoxidil or oral finasteride to enhance clinical outcomes. This article reviews the prospect of natural products in treating male AGA. A systematic search was conducted in PubMed, CINAHL, Scopus, Web of Science, and EMBASE (Ovid) on July 19, 2021. In addition, the bibliographies of selected articles were hand‐searched to identify relevant studies. After deduplication and screening, 11 clinical studies meet the criteria for detailed review. The selected clinical studies suggest that saw palmetto, caffeine, melatonin, marine extracts, rosemary oil, procyanidin, pumpkin seed oil, and cannabidiol oil might be considered in male AGA treatment. [ABSTRACT FROM AUTHOR]

Functional foods and pharmaceuticals are currently used for the prevention and treatment of diseases. In particular, foods with health claims which can label a functional claim are getting extremely popular for the maintenance of health in the elderly. The functional foods, in relation to the complementary and alternative medicine and the concept of common origin of pharma and food are discussed. Previous studies with functional foods such as saw palmetto extract (SPE) and peusedanum japonicum showed significant alleviation of lower urinary tract symptoms in rats and human. Their pharmacological effects may be associated with several mechanisms such as 5a-reductase inhibition, pharmacological receptor binding activity and muscle relaxant activity. Further vigorous preclinical and clinical research of functional foods may provide more reliable scientific evidence for their health promotive effects. [ABSTRACT FROM AUTHOR]

The article focuses on growing consumer demand, weather related supply fluctuations and shortages, conservation concerns, and habitat loss due to development also inform saw palmetto's sustainability. Topics include Bennett and Hicklin described saw palmetto as the most versatile economic plant in Florida, and the palmetto berries and their extracts are best known for their use in phytomedicines to treat benign prostatic hyperplasia and dietary supplements used to support prostate health.

The article discusses the effectiveness of herbal medicine in inflammatory diseases of the prostate. This literature review presents clinical studies of the successful use of herbal ingredients in the treatment of chronic prostatitis and relief of lower urinary tract symptoms (LUTS). Biological active substances of Urtica dioica, Cucurbita moschata, Saw palmetto (Serenoa repens), and zinc are effective in the treatment of chronic prostatitis due to anti-inflammatory, antiproliferative, antiandrogenic and antioxidant action. Phytopreparations containing these substances can be recommended as the first line of correction of LUTS in chronic forgive categories III and IV; as a general tonic for men leading a sedentary lifestyle over the age of 35 years.

Background: Over the counter preparations containing Saw palmetto and Pygeum africana extracts are commonly used in the treatment of benign prostatic hyperplasia with lower urinary tract symptoms. Their effects are likely due to their anti-androgenic activity, involving the interaction with type 1 and type 2 isoenzymes of the 5α-reductase family. Hypothesis/purpose: For effects similar to the above, the inhibitors of 5α-reductase (e.g., finasteride) are classified as confounding factors in the evaluation of the urinary steroid profile in sport doping. We aimed to verify whether the oral intake of products containing Saw palmetto and Pygeum africana could affect the urinary concentration of a series of steroids, not limited to those included in the “steroidal module” of the Athlete Biological Passport (ABP). Study design: We have followed the effects of a five-day administration of Saw palmetto (320 mg) and Pygeum africana (100 mg) to three non-smokers male subjects on the urinary parameters constituting the “steroidal module” of the ABP, and on the concentration of additional steroid markers. In parallel, we have also measured the urinary concentration of β-sitosterol, which is the active component of Saw palmetto and Pygeum Africana. Methods: Sample collection was performed five days before starting the controlled administration study to obtain the baseline urinary steroid pattern for each subject. After this period, the three volunteers took a dose of Saw palmetto (320 mg) and Pygeum africana (100 mg) formulation orally, once a day, for five consecutive days. Urine samples were collected at different times of the day and stored at −20 °C until analysis. Samples were analyzed by a previously developed and validated method based on gas chromatography coupled to tandem mass spectrometry (GC–MS/MS). Results: Our results show that the intake of a single oral dose of Saw palmetto and Pygeum africana for five consecutive days leads to a broader data dispersion of the target steroids' concentration levels, and, consequently, to a variation of the corresponding individual normality ranges. Conclusion: The intake of dietary supplements containing Saw palmetto and Pygeum africana could be a source of interference in the correct longitudinal evaluation of the individual steroid profile, as described in the framework of ABP. We believe their urinary levels should be monitored as it is presently done for other confounding factors of the steroidal module of the ABP.

Background: The current study was designed to explore the effectiveness of Saw Palmetto as monotherapy or supplementation with tamsulosin in the treatment of patients with lower urinary tract symptoms consistent with benign prostatic hyperplasia. Method: The present study is diagnosed patient with moderate to severe symptomatic BPH. (60) Patients were divided into 3 groups; Group (1) treated with Saw Palmetto cap (320 mg); Group (2) treated with Saw Palmetto cap (320 mg) and tamsulosin (0.4mg); Group (3) treated with tamsulosin (0.4mg), daily for 3 months. The assessment is done based on the change in urological IPSS, urodynamic activity, urine flow, voiding quantity measures, and prostate volume. Also, some measurement such as erection function, urinary incontinence, sleeps quality, and quality of life. Results: Saw Palmetto supplementation with tamsulosin revealed a significant decrease in the IPSS score (P<0.01), a significant increase in the urine flow rate and the voided volume, a significant decrease in the post-void residual volume and prostate volume (P<0.01), and decrease in serum PSA level (P<0.01). Additionally, improved erection function decreased urinary incontinence score, improvement in sleep quality, and improvement in the quality of life score among the Saw Palmetto supplementation group was noticed (P<0.01). Conclusion: The phytotherapy with saw palmetto alone or as supplement collectively produced marked improvement in objective and subjective measurements in men with lower urinary tract symptoms consistent with BPH: [ABSTRACT FROM AUTHOR]

Copyright of Al-Mustansiriyah Journal for Pharmaceutical Sciences is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Benign prostatic hyperplasia (BPH) is one of the most common urinary diseases affecting men, generally after the age of 50. The prevalence of this multifactorial disease increases with age. With aging, the plasma level of testosterone decreases, as well as the testosterone/estrogen ratio, resulting in increased estrogen activity, which may facilitate the hyperplasia of the prostate cells. Another theory focuses on dihydrotestosterone (DHT) and the activity of the enzyme 5α-reductase, which converts testosterone to DHT. In older men, the activity of this enzyme increases, leading to a decreased testosterone/DHT ratio. DHT may promote prostate cell growth, resulting in hyperplasia. Some medicinal plants and their compounds act by modulating this enzyme, and have the above-mentioned targets. This review focuses on herbal drugs that are most widely used in the treatment of BPH, including pumpkin seed, willow herb, tomato, maritime pine bark, Pygeum africanum bark, rye pollen, saw palmetto fruit, and nettle root, highlighting the latest results of preclinical and clinical studies, as well as safety issues. In addition, the pharmaceutical care and other therapeutic options of BPH, including pharmacotherapy and surgical options, are discussed, summarizing and comparing the advantages and disadvantages of each therapy.

The aim of the present study was to investigate the effects of 12‐week consumption of saw palmetto fruit extract (320 mg per day) on urination issues. A total of 44 Japanese men aged 40–69 years who experienced urination issues and awaken ≥2 times at night to urinate participated in a randomized, double‐blind, placebo‐controlled study between June and December 2017. All subjects were randomly allocated into a saw palmetto fruit extract group (SP group, n = 22) or a placebo group (P group, n = 22) using a computerized random number generator. Each group took their assigned one capsule every day for 12 weeks. Subjective symptoms and impact on daily life were assessed using the international prostate symptom score (IPSS) as a primary outcome, King's health questionnaire (KHQ), and overactive bladder symptom score. A safety evaluation was also performed. A total of 20 subjects in each group were analyzed. There was a significant group–time interaction for total IPSS. The SP group also showed a significant decrease in IPSS at 8 weeks compared with the P group, suggesting reduced subjective symptoms related to urination issues. We observed no adverse effects. The consumption of saw palmetto fruit extract capsule for 12 weeks relieved subjective symptoms related to urination, which suggests improvement of the issue in healthy Japanese men. [ABSTRACT FROM AUTHOR]

Objective: To compare the effectiveness of alpha blocker and phytotherapy in relieving the lower urinary tract symptoms (LUTS) in patients with Benign Prostatic Hyperplasia (BPH). Methodology: This randomized controlled trial was conducted in Department of Urology, Institute of Kidney Diseases, Peshawar from June 2017 to December 2018. A total of 308 patients, divided randomly in two groups, with 154 patients in each group, were enrolled using consecutive sampling. Group A received tamsulosin (alpha blocker) while patients in group B were put on Saw Palmetto as Phytotherapy. International Prostate Symptom Score (IPSS) and Uro-flowmetry were recorded before the therapy after 1st, 2nd, 3rd and 6th months respectively. A pre-designed proforma was used to enter the data, which was analyzed on SPSS version 20.0. Descriptive and inferential statistics were calculated where needed. Results: Mean age in group A was 65.1 ± 7.09 years, while group B showed 64.7 ± 8.01 years (p=0.442). The mean of IPSS before initiation of treatment in group A was 15.3 ± 3.02 and in group B it was 16.2 ± 3.04 (p=0.07), while post treatment IPSS at 6 months, in group A mean was recorded as 8.5 ± 7.4 and in group B it was 12.07 ± 2.75 (p=0.01). In Uroflowmetry, group A showed mean pre-treatment maximum flow as 8.4 ± 1.3 and in group B it was 8.2 ± 1.1 (p=0.064), while post-treatment maximum flow at 6 months for group A showed mean of 11.8 ± 1.5 and group B had 8.2 ± 1.1 (p=0.001). Conclusion: Alpha blockers are more effective than Phytotherapy in management of symptomatic BPH. [ABSTRACT FROM AUTHOR]

The agricultural by-products are a significant source of health benefiting bioactive compounds. In this trend, the phenolic and flavonoid contents and functional properties of date palm seeds (DPS) and saw palmetto seeds (SPS) extracts were evaluated in this study. Considerable phenolic and flavonoid contents of 11.8, 7.75 mg GAE/g seed and 3.13, 1.1 mg CE/g seed were detected in DPS ethanol and SPS acetone extracts, respectively. The protocatechuic acid was the major compound in SPS and DPS extracts and represented 1.41 and 1.1 mg/g seed, respectively as well as similar phenolic compounds were detected using HPLC analysis. The DPS and SPS phenolic compounds possessed a strong antioxidant activity with IC50 values of 10.0, 2.2 and 2.0, 0.6 µg GAE/mL, using the DPPH and ABTS assays, respectively. The phenolic compounds of DPS and SPS extracts showed a potent and broad anti-bacterial activity against clinical multiple drug resistance bacterial strains with lower MIC values besides an effective anti-fungal activity against a number of human pathogenic fungal strains. Interestingly, in a model of LPS-induced inflammation in RAW 264.7 cells, DPS and SPS showed efficient anti-inflammatory effects to inhibit the iNOS protein expression and activity (NO release). [ABSTRACT FROM AUTHOR]

Introduction: To evaluate the efficacy of Bifiprost® + Serenoa Repens 320 mg versus Serenoa Repens 320 mg alone for the prevention of chronic bacterial prostatitis (CBP) due to enterobacteriaceae. Methods: Between September 2016 and September 2018, 120 patients with CBP at the National Institutes of Health (NIH type II) with recurrent infections due to enterobacteriaceae (Escherichia Coli and Enterococcus faecalis) were enrolled and randomized into 2 groups each to receive Bifiprost® + Serenoa Repens 320 mg (Group A) or Serenoa Repens 320 mg alone (Group B) daily for 24 weeks (after receiving a proper antibiotic treatment with subsequent culture negativization). The primary endpoint was the reduction in the episodes of prostatitis. The secondary endpoint evaluated was the score of the NIH-Chronic Prostatitis Symptom Index (NIH-CPSI). Evaluation was performed at baseline and at 12, 24, and 36 weeks. Results: The patients of the Group A experienced a significantly larger reduction in the prostatitis episodes than the Group B at 24 and 36 weeks, but they did not experience a significantly larger reduction at 12 weeks. After 12 weeks of treatment, the mean NIH-CPSI score was reduced in both groups compared with baselines, but no significant differences were seen between the Group A and Group B. On the contrary, we observed a significant difference in the mean NIH-CPSI score between the 2 groups at 24 and 36 weeks. Conclusion: The association of Bifiprost® and Serenoa Repens 320 mg improves the prevention of the episodes of CBP due to enterobacteriaceae and ameliorates prostatitis-related symptoms after 6 months of therapy. The long-term impact on the entero-urinary route was also seen 3 months after the end of the treatment. [ABSTRACT FROM AUTHOR]

Objective: To investigate the knowledge and prevalence of use of saw palmetto and other herbal products among men attending the urology outpatient clinic at San Fernando General Hospital. Subjects and methods: This was a prospective, cross-sectional study carried out between February and May 2015. A structured, interviewer administered questionnaire was used to collect data from randomly selected men with prostate cancer or benign prostatic hyperplasia (BPH) and who were part of our outpatient clinics. This questionnaire contained sections on sociodemographic details as well as knowledge and attitudes towards herbal supplements with emphasis on saw palmetto. Data were compiled in Microsoft Excel and analysed using SPSS version 20. Results: Two hundred (200) men were interviewed. The mean age of the population was 69 years (Std. Dev. = 8.06) and most were from the south (56.5%) or central (19%) regions of Trinidad. 52% had BPH and 34.5% had prostate cancer. Overall, 85 men (42.5%) indicated use of herbal supplements of whom 53 (62.3%) used saw palmetto either alone or in combination with other products. Among men who had heard of saw palmetto or used it, 25% believed it may be used to reduce the risk of or treat prostate cancer. Thirty-six percent (36%) were of the opinion that saw palmetto is effective in treating the symptoms of an enlarged prostate. Conclusion: This study demonstrates that the use of herbal products is common among men with prostate disease in Trinidad and Tobago and that saw palmetto is the most common product used. It also highlights the prevalence of unsubstantiated beliefs as well as the uncertainty about the efficacy of saw palmetto.

Objectives: Lower urinary tract symptoms (LUTS) and sexual dysfunction (SDys) are common problems that affect quality of life (QOL) in elderly men. In addition to prescribed drugs, many over-the-counter medications including supplements are used to treat QOL diseases. Phosphodiesterase inhibitors are reported to be effective for both LUTS and SDys by increasing nitric oxide levels. French maritime pine bark extract Pycnogenol®, which is a potent nitric oxide donor, is reported to be effective for SDys. However, no reports have been published on whether it ameliorates LUTS. Design: Open-labeled, randomized study. The effects of two supplements, Nokogiriyashi EX® containing 160 mg saw palmetto (SP) extract per tablet and Edicare® containing 10 mg of Pycnogenol®, 115 mg of l-arginine and 92 mg of aspartate (PAA) per tablet on International Prostate Symptom Score (IPSS), IPSS–QOL, Overactive Bladder Symptom Score (OABSS), International Index of Erectile Function 5 (IIEF5), Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), urinary 8-OHdG and uroflowmetry (UFM) of total 40 men with LUTS and SDys were examined. Results: 19 subjects were instructed to take two tablets of SP, on the other 20 were on four tablets of PAA for 16 weeks. IPSS and IPSS–QOL showed statistically significant improvements in both groups. OABSS and IIEF5 were significantly improved in the PAA group. Conversely, ICIQ-SF, 8-OHdG and UFM did not change in either group. Conclusions: PAA might be an effective therapeutic alternative for elderly patients with LUTS and SDys.

Benign Prostatic Hyperplasia (BPH) is a prevalent condition that affects aging men, leading to the development of lower urinary tract symptoms (LUTS) and potentially severe complications such as complete obstruction. The management of BPH typically involves the use of medications from different classes, including alpha-1 antagonists, 5-alpha reductase inhibitors, and anticholinergics. Combination therapy utilizing drugs from different classes can also effectively manage the BPH-LUTS complex. Recent research has revealed that phosphodiesterase 5 (PDE5) inhibitors, including Tadalafil and Sildenafil, are highly effective in treating LUTS associated with BPH. Tadalafil as a monotherapy has recently been shown to significantly improve LUTS in BPH patients. Additionally, the use of herbal remedies as a treatment option for BPH has also been widely debated. Previous research suggests that saw palmetto can reduce BPH symptoms through several proposed mechanisms, but recent trials have found inconsistencies in its efficacy. In this literature review, we conducted an extensive PubMed database search to provide current and comprehensive insights into BPH treatment options. This review comprehensively evaluates available treatments for managing BPH, highlighting the effectiveness of different classes of medications and combination therapies in managing associated symptoms. The present investigation also discusses recent research on the efficacy of PDE5 inhibitors in treating LUTS associated with BPH and the uncertain efficacy of herbal remedies. The insights provided by this study can guide healthcare professionals in making informed decisions about managing BPH, ultimately improving patient outcomes., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, O'Quin et al.)

Background: Androgenetic alopecia (AGA) is a dermatologic condition with no current cure. Treatments such as minoxidil have been proven to be effective; however, the side effects can be unpleasant. As a result, the utilization of natural remedies for treatment has increased over the years. There is limited scientific evidence that addresses the efficacy of these supplements in combating AGA., Methods: A review was conducted of the effectiveness of popular complementary and alternative medicines (CAMs) in adult patients experiencing AGA. A literature search was performed for the period of 1993 to 2023 using PubMed, Embase, Google Scholar, Web of Science, and Cochrane., Results: Natural ingredients like pumpkin seed oil, saw palmetto, melatonin extract, caffeine extract, and rosemary oil were effective in treating AGA either when compared to baseline or a definite AGA Western medication, such as minoxidil. These natural agents also presented minimal side effects., Conclusion: Certain CAMs can be promising for hair loss treatment. There is a need for more scientific research to better explore the efficacy of currently identified CAMs in treating AGA., Competing Interests: The author reports no funding or conflicts of interest., (Copyright © 2023 Baylor University Medical Center.)

Herbal supplements are widely used to enhance prostate health. These supplements may contain several types of plant sterols, vitamins, and minerals. By weight, however, plant sterols make up an abundant ingredient component, with saw palmetto extract or its primary component, beta-sitosterol, often comprising the most abundant sterol. Saw palmetto extract/beta-sitosterol has been shown to promote anti-tumorigenic processes in prostate cancer cells and rodent models of prostate cancer. It has also been shown to inhibit the 5α-reductase enzyme, thereby behaving similarly to finasteride and dutasteride, which are widely used to treat prostatic enlargement, or benign prostatic hyperplasia (BPH). The aim of this study is to critically examine in vitro , in vivo , and human clinical studies to assess the safety and clinical utility of herbal supplements containing saw palmetto extract/beta-sitosterol for prostate health. The results of this study suggest multiple mechanisms through which beta-sitosterol represses prostate cancer in vitro and in vivo , particularly through its pro-apoptotic effect on prostate epithelial cells. Multiple studies also show that beta-sitosterol significantly improves lower urinary tract symptoms (LUTS) associated with BPH, but to an extent that is generally less effective than that achieved by pharmaceutical grade alpha-adrenergic receptor antagonists or 5α-reductase inhibitors. This latter finding suggests that supplements containing beta-sitosterol might be most appropriate for younger men with minimal LUTS who don't wish to embark on a clinical drug regimen for BPH treatment., Competing Interests: None., (AJCEU Copyright © 2023.)

Objective: To evaluate the efficacy and safety of Serenoa repens among patients with benign prostatic hyperplasia (lower urinary tract symptoms/benign prostatic hyperplasia [LUTS/BPH]) in China.Methods: We conducted a double blind, placebo-controlled study of 354 patients with LUTS/BPH from 19 institutions, to evaluate the efficacy and safety of Serenoa repens. Participants were randomly assigned (1:1) into the Serenoa repens extract (320 mg) or placebo groups for 24 weeks. Primary efficacy parameters were changes in International Prostate Symptom Score and peak urinary flow from baseline to each assessment. Secondary efficacy parameters included improvement of storage symptom and voiding symptom scores, prostate volume, urinary frequency, and total prostate-specific antigen level. Other parameters assessed were quality of life score, a four-item male sexual function questionnaire score, and International Index of Erectile Function score across the consecutive double-blind visits.Results: Statistically significant improvement in the peak urinary flow, International Prostate Symptom Score, scores of storage symptoms and voiding symptoms, quality of life score, four-item male sexual function questionnaire score, and International Index of Erectile Function score were observed in the Serenoa repens extract group compared with those in the placebo group (P <.05). Two (1.18%) of 169 patients in the placebo group and 3 (1.89) of 159 patients in the Serenoa repens extract group experienced 1 or more adverse events.Conclusion: The Serenoa repens extract was effective, safe, well-tolerated, and clinically and statistically superior to placebo in the target LUTS/BPH population. [ABSTRACT FROM AUTHOR]

Current treatments for hair follicle (HF) disruption are based on 5‐α reductase inhibitors and prostaglandin modulators. Botanicals and nutraceutical compounds interfere with hair loss or stimulate its partial regrowth. Here, we used in vitro cocultures to investigate the activity of Serenoa repens (SR) and N‐acetyl glucosamine + milk proteins (NAG/Lac) on the paracrine interactions between human microvascular endothelial cells (HMVEC) and HF dermal papilla cells (FDPC). Both SR and NAG/Lac‐induced endothelial tubulogenesis were enhanced by FDPC. SR promoted proliferation of both the cell types, while NAG/Lac was effective on endothelium. Vascular endothelial growth factor production, enhanced by SR, was further augmented by FDPC. In FDPC 5‐α reductase‐II and β‐catenin expressions were modified by SR and less by NAG/Lac, with no additional effect by HMVEC. SR and NAG/Lac prevented lipid peroxidation, whereas NAG/Lac was effective on interleukin 1β production. Finally, SR and NAG/Lac differentially affected HMVEC permeability and tight junction proteins content. These data provide a mechanistic background for the potential use of these compounds as promoters of HF vascularization. 1)Paracrine communication between endothelial and follicle dermal papilla cells.2)Characterization of the role of natural compounds on in vutro cocultures systems.3)mechanistic background for the potential use of natural compounds as promoters of HF vascularization. [ABSTRACT FROM AUTHOR]

Highlights • In situ measures of fuel moisture exchange reveal complex responses to meteorology variables among dominant fuel types. • Pine and saw palmetto litter showed multiple lagged responses to precipitation, relative humidity, and net radiation. • Fine dead fuel moisture prediction for fire management cannot rely on current assumptions and simplified tools in humid forests. Abstract Fine dead fuel moisture has a major influence on wildland fire behavior yet the dynamics driving water exchange of fuel particles in forested environments remain poorly understood. Most fire behavior models rely on simple, stand-level fuel moisture estimates, ignoring potentially important variation occurring within fuelbeds that could influence fire behavior. This is especially true in surface fire regimes where variation in fine-scale fuel properties drive fire behavior and subsequent fire effects. Saw palmetto [ Serenoa repens (Bartr.) Small] dominated fuelbeds in the pine forests of the southeastern United States have high within stand variation in one of the most fire prone habitats in the world. Pine needles and palmetto fronds dominate the biomass of fine dead fuel types that produce extreme fire behavior. To assess predictors of fine dead fuel moisture, we analyzed fuel moisture dynamics of these two fine dead fuel types over a two-year period in conjunction with under- and overstory forest meteorological data. Using multiple models and time lag analysis of within-stand moisture dynamics, the results indicate that saw palmetto and pine dramatically differ in drying regimes, primarily resulting from different responses to cumulative rainfall, net radiation, and antecedent atmospheric moisture content. Despite being responsive to changes in relative humidity, saw palmetto was significantly dryer than pine under nearly all meteorological conditions, and it was capable of maintaining extremely low fuel moisture despite high relative humidity or rainfall. Our results point to the need to capture additional drivers of microclimatic variation to aid fire managers in accurately predicting within-stand fuel moisture and subsequent fire behavior. Improving the scientific community's understanding of variation in complex fuel beds is critical for effectively managing risk in fire prone ecosystems. [ABSTRACT FROM AUTHOR]

Objectives: To comprehensively evaluate the efficacy and safety of the hexanic extract of Serenoa repens (HESr, Permixon®; Pierre Fabre Médicament, Castres, France), at a dose of 320 mg daily, as monotherapy for the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH). Materials and methods: We conducted a systematic review and meta‐analysis of randomised controlled trials (RCTs) and prospective observational studies in patients with LUTS/BPH identified through searches in Medline, Web of Knowledge (Institute for Scientific Information), Scopus, the Cochrane Library, and bibliographic references up to March 2017. Articles studying S. repens extracts other than Permixon were excluded. Data were collected on International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), nocturia, quality of life, prostate volume, sexual function, and adverse drug reactions (ADRs). Data obtained from RCTs and observational studies were analysed jointly and separately using a random effects model. A sub‐group analysis was performed of studies that included patients on longer‐term treatment (≥1 year). Results: Data from 27 studies (15 RCTs and 12 observational studies) were included for meta‐analysis (total N = 5 800). Compared with placebo, the HESr was associated with 0.64 (95% confidence interval [CI] −0.98 to −0.31) fewer voids/night (P < 0.001) and an additional mean increase in Qmax of 2.75 mL/s (95% CI 0.57 to 4.93; P = 0.01). When compared with α‐blockers, the HESr showed similar improvements on IPSS (weighted mean difference [WMD] 0.57, 95% CI −0.27 to 1.42; P = 0.18) and a comparable increase in Qmax to tamsulosin (WMD −0.02, 95% CI −0.71 to 0.66; P = 0.95). Efficacy assessed using the IPSS was similar after 6 months of treatment between the HESr and 5α‐reductase inhibitors (5ARIs). Analysis of all available published data for the HESr showed a mean improvement in IPSS from baseline of −5.73 points (95% CI −6.91 to −4.54; P < 0.001). HESr did not negatively affect sexual function and no clinically relevant effect was observed on prostate‐specific antigen. Prostate volume decreased slightly. Similar efficacy results were seen in patients treated for ≥1 year (n = 447). The HESr had a favourable safety profile, with gastrointestinal disorders being the most frequent ADR (mean incidence of 3.8%). Conclusion: The present meta‐analysis, which includes all available RCTs and observational studies, shows that the HESr (Permixon) reduced nocturia and improved Qmax compared with placebo and had a similar efficacy to tamsulosin and short‐term 5‐ARI in relieving LUTS. HESr (Permixon) appears to be an efficacious and well‐tolerated therapeutic option for the long‐term medical treatment of LUTS/BPH. [ABSTRACT FROM AUTHOR]

The aim of the present study was to investigate the effects of the consumption of saw palmetto fruit extract capsule on urination issues. Japanese men whose age ranged from 40 to 69 years (n = 44) who were experiencing urination issues and nocturia two times or more per night participated in a randomized, double-blind, parallel-group, placebo-controlled study. With the use of a computerized random-number generator, all subjects were randomly allocated into either a saw palmetto fruit extract group (SP group, n=22) or a placebo group (P group, n = 22). Participants in each group took either one capsule of saw palmetto fruit extract or one placebo capsule per day for 12 weeks. Urination issues were assessed using questionnaires before intake and at 4, 8, and 12 weeks after intake, and safety evaluations were carried out before intake and at 12 weeks after intake. The SP group showed significantly lower changes on the International Prostate Symptom Score at 8 weeks compared with the P group (P = 0.007). Moreover, the changes in the personal limitation and the physical limitation in the Kings' Health Questionnaire were significantly decreased at 4 weeks in the SP group compared with those in the P group (P = 0.033, P = 0.038, respectively). Therefore, we conclude that consumption of saw palmetto fruit extract capsule improves urination issues. Furthermore, safety evaluations showed no medical changes, and no adverse events were observed. [ABSTRACT FROM AUTHOR]