Benign Prostatic Hyperplasia and Complementary and Integrative Approaches

January 2022

Benign prostatic hyperplasia (BPH) can lead to obstructive and bothersome lower urinary tract symptoms. Prostate gland enlargement can block the flow of urine out of the bladder, which can cause bladder, urinary tract, or kidney problems. The use of some complementary health approaches such as phytotherapy for the treatment of lower urinary tract symptoms is common. Although there is limited evidence that some phytotherapeutic agents may help improve symptoms related to BPH over the short term, most of the trials conducted have been small in size, of short duration, and used varied doses and preparations.

This issue of the Digest provides a summary of the current evidence of complementary health approaches that are frequently used for symptoms associated with BPH.

What the Science Says:
Benign Prostatic Hyperplasia and Complementary and Integrative Approaches

Modality and Summary of Current Evidence

Acupuncture

There is limited evidence that acupuncture may be beneficial for BPH symptoms in the short term; however, more rigorous studies with longer follow-up times are needed before definite conclusions can be drawn.

Lycopene

There is insufficient evidence to support the use of lycopene for the prevention or treatment of BPH.

Pygeum africanum

There is some limited evidence that Pygeum africanum may improve some symptoms of BPH over the short term, including urinary symptoms, flow parameters, spermogram, and quality of life.

Saw palmetto (Serenoa repens)

Although several small studies have suggested modest benefit of saw palmetto for treating symptoms of BPH, a large study evaluating high doses of saw palmetto and a Cochrane review found that saw palmetto was not more effective than placebo for treatment of urinary symptoms related to BPH. However, a recent systematic review and meta-analysis found that Serenoa repens had the same effect as tamsulosin in treating BPH in terms of International Prostate Symptom Score, quality of life, maximum flow rate, postvoid residual volume, and prostate-specific antigen, with the exception of prostate volume. A single randomized controlled trial showed combination therapy of saw palmetto plus lycopene, selenium, and tamsulosin was more effective than single therapies alone.

Urtica dioica

There is some limited evidence that Urtica dioica may improve some symptoms of BPH, including lower urinary tract symptoms. There is also some limited evidence that a combination of Urtica dioica and saw palmetto (Serenoa repens) may be efficacious for lower urinary tract symptoms associated with BPH.

Clinical Guidelines

Management of Benign Prostatic Hyperplasia (BPH) (American Urological Association)

Scientific Literature

Information for Your Patients

NCCIH Clinical Digest is a service of the National Center for Complementary and Integrative Health, NIH, DHHS. NCCIH Clinical Digest, a monthly e-newsletter, offers evidence-based information on complementary health approaches, including scientific literature searches, summaries of NCCIH-funded research, fact sheets for patients, and more.

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