Table of ContentsView AllTable of ContentsHow It WorksProstate HealthHair LossChronic Pelvic PainUnproven UsesSide EffectsPossible RisksInteractions
Table of ContentsView All
View All
Table of Contents
How It Works
Prostate Health
Hair Loss
Chronic Pelvic Pain
Unproven Uses
Side Effects
Possible Risks
Interactions
Saw palmetto (Serenoa repens), a member of the palm tree family, is frequently used in complementary and alternative medicine to treat enlarged prostate, hair loss, chronic pelvic pain, and migraines. It is widely sold in the United States as a supplement to improve urinary health.
Despite its longstanding use in folk medicine, the evidence supporting the benefits of saw palmetto in treating or preventing any medical condition is weak. Even so, some evidence indicates that certain compounds in saw palmetto may have medical uses.
In the United States, the Food and Drug Administration (FDA) does not regulate supplements the way it regulates prescription drugs. That means some supplement products may not contain what the label says. Whenchoosing a supplement, look for independently tested products and consult a healthcare provider, registered dietitian nutritionist (RD or RDN), or pharmacist.
Verywell / Anastasia Tretiak
How Saw Palmetto Works
Saw palmetto contains a variety of compounds that are thought to have medical benefits. Most are derived from the berry of the plant.
These compounds include:
Saw palmetto is widely sold as a supplement in capsule, softgel, powder, and liquid extract forms. There are also oil-based saw palmetto serums that you can apply directly to the hair.
There is no recommended dose for saw palmetto in any form. The manufacturer-recommended dosage can vary dramatically with some recommending 160 milligrams (mg) per day and others recommending dosages as high as 4,800 mg per day. As a general rule, never exceed the manufacturer’s recommended daily dose.
The Surprising Benefits of Lauric Acid for Your Skin and Health
Supports Prostate Health
Saw palmetto is best known as an alternative or complementary treatment forbenign prostatic hyperplasia (BPH), also known as an enlarged prostate. Compounds in saw palmetto are thought to improve lower urinary tractsymptoms of BPH, includingnocturia(nighttime urination),frequent urination, decreased urine flow,incomplete bladder emptying, andurinary urgency.
It is thought that phytosterols in saw palmetto help block the action of testosterone which may, in turn, easeprostate inflammation. Fatty acids like lauric acid have also been shown in test tube studies to block an enzyme called 5-alpha-reductase in the same way as the drugFlomax (tamsulosin), commonly used to treat enlarged prostate.
The evidence supporting the benefits of saw palmetto in treating or preventing BPH is lacking.
A 2020 analysis of four studies involving 1,080 adults with bPH concluded that saw palmettotaken daily for six months improved urinary flow as well as Flomax, however, it did not reduce the size of the prostate gland in the way that Flomax and other 5-alpha-reductase inhibitors do.
Of concern is the suggestion that testosterone somehow worsens BPH and that the suppression of testosterone will improve symptoms (a hypothesis referred to as “androgen saturation”).
Studies show just the opposite. In fact, low testosterone (hypogonadism) is an important risk factor for BPH and lower urinary tract symptoms.
The Purpose of Prostate Surgery
Prevents Hair Loss
A two-year study conducted at the University of Rome in 2012 compared a daily 320-mg oral saw palmetto supplement to a daily 1-mg dose of Propecia for 100 males with mild to moderate AGA. When compared to the saw palmetto group, those who were given Propecia had better retention of hair on the top and frontal areas of the scalp.
Helps With Chronic Pelvic Pain
Some researchers contend that a fatty acid in saw palmetto, calledpalmitoylethanolamidePEA), has anti-inflammatory andanalgesic(pain-relieving) effects that can benefit people with CP/CPPS.
A 2021 study published in theWorld Journal of Urologyinvestigated the benefits of saw palmetto in 221 males with CP/CPPS, half of whom were given a daily 160-mg dose of saw palmetto and the other half of whom received a placebo. After 12 weeks, those given saw palmetto had lower overall pain scores than those given the placebo.
Findings from other studies have been inconsistent. Of five clinical trials included in a 2022 review of studies in theAsian Journal of Surgery, only one concluded that saw palmetto was beneficial to people with CP/CPPS. One reported worsening symptoms, while the remaining three showed no significant changes in pain symptoms.
Other Unproven Uses of Saw Palmetto
The National Center for Complementary and Integrative Health (NCCIH) reports that saw palmetto is sometimes used as a treatment formigraine headaches.
There is not yet any good evidence to support this claim, and many studies investigating the use of saw palmetto report headache as a common side effect.
According to the NCCIH, “There isn’t enough research on saw palmetto for conditions other than BPH to allow any conclusions to be reached.” With regards to BPH, the NCCIH states that “no saw palmetto product has been conclusively shown to be effective for BPH.”
What Are the Side Effects of Saw Palmetto?
The U.S. Food and Drug Administration (FDA) regards dietary supplements like saw palmetto as generally safe for use.Side effects are uncommon and tend to be mild.
Possible side effects of saw palmetto include:
Rare Side EffectsOn rare occasions, males have reportederectile dysfunction, breast tenderness,gynecomastia(abnormal breast growth), and a loss of libido (sex drive) when using saw palmetto for a long period of time. This may be due to saw palmetto’s suppressive effect on testosterone.
Rare Side Effects
On rare occasions, males have reportederectile dysfunction, breast tenderness,gynecomastia(abnormal breast growth), and a loss of libido (sex drive) when using saw palmetto for a long period of time. This may be due to saw palmetto’s suppressive effect on testosterone.
Who Shouldn’t Take Saw Palmetto?
Precautions should be taken when considering the use of saw palmetto in the following groups:
Supplement Safety
Does Saw Palmetto Interact with Other Drugs?
The NCCIH states that saw palmetto has not been shown to interact with medications. Even so, there are theoretical risks you should be aware of:
Can Saw Palmetto Affect My PSA?Theprostate-specific antigen (PSA) testis a blood test that can help identify problems with the prostate gland, including BPH and prostate cancer. According to the NCCIH, saw palmetto has no effect on a person’s PSA levels when tested.
Can Saw Palmetto Affect My PSA?
Theprostate-specific antigen (PSA) testis a blood test that can help identify problems with the prostate gland, including BPH and prostate cancer. According to the NCCIH, saw palmetto has no effect on a person’s PSA levels when tested.
Summary
Saw palmetto is a plant belonging to the palm tree family that is thought to treat or prevent medical conditions like enlarged prostate, testosterone-related hair loss, and chronic pelvic pain. To date, the evidence supporting these claims is weak.
While generally safe for use, saw palmetto is not known to treat or prevent any medical condition.
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Center for Complementary and Integrative Health.Saw palmetto.Kwon Y.Use of saw palmetto (Serenoa repens) extract for benign prostatic hyperplasia.Food Sci Biotechnol. 2019;28(6):1599-1606. doi:10.1007/s10068-019-00605-9Lok W, Lin T, Cao D, Wei Q.IsSerenoa repenseffective for the treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)? A systematic review and meta-analysis.Asian J Surg. 2022;45(9):1746-1747. doi:10.1016/j.asjsur.2022.01.038Cai T, Cui Y, Yu S, et al.Comparison ofSerenoa repenswith tamsulosin in the treatment of benign prostatic hyperplasia: a systematic review and meta-analysis.Am J Mens Health. 2020;4(2):1557988320905407. doi:10.1177/1557988320905407Miah S, Tharakan T, Gallagher KA, et al.The effects of testosterone replacement therapy on the prostate: a clinical perspective.Version 1. F1000Res.2019;8:F1000 Faculty Rev-217. doi:10.12688/f1000research.16497.1Baas W, Kohler TS.Testosterone replacement therapy and BPH/LUTS. What is the evidence?Curr Urol Rep.2016;17(6):46. doi:10.1007/s11934-016-0600-8600-8MedlinePlus.Androgenetic alopecia.Wessagowit V, Tangjaturonrusamee C, Kootiratrakarn T, et al.Treatment of male androgenetic alopecia with topical products containingSerenoa repensextract.Australas J Dermatol. 2016;57(3):e76-e82. doi:10.1111/ajd.12352Rossi A, Mari E, Scarnò M, et al.Comparative effectiveness and finasteride vsSerenoa repensin male androgenetic alopecia: a two-year study.Int J Immunopathol Pharmacol. 2012;25(4):1167-1173. doi:10.1177/039463201202500435Polackwich AS, Shoskes DA.Chronic prostatitis/chronic pelvic pain syndrome: a review of evaluation and therapy.Prostate Cancer Prostatic Dis. 2016;19(2):132-138. doi:10.1038/pcan.2016.8Zhang K, Guo RQ, Chen SW, et al.The efficacy and safety ofSerenoa repensextract for the treatment of patients with chronic prostatitis/chronic pelvic pain syndrome: a multicenter, randomized, double-blind, placebo-controlled trial.World J Urol. 2021;39(9):3489-3495. doi:10.1007/s00345-020-03577-2Ronis MJJ, Pedersen KB, Watt J.Adverse effects of nutraceuticals and dietary supplements.Annu Rev Pharmacol Toxicol.2018;58:583–601. doi:10.1146/annurev-pharmtox-010617-052844National Institute of Diabetes and Digestive and Kidney Diseases.Saw palmetto.Agbabiaka TB, Pittler MH, Wider B, Ernst E.Serenoa repens(saw palmetto): a systematic review of adverse events.Drug Saf.2009;32(8):637-47. doi:10.2165/00002018-200932080-00003
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Center for Complementary and Integrative Health.Saw palmetto.Kwon Y.Use of saw palmetto (Serenoa repens) extract for benign prostatic hyperplasia.Food Sci Biotechnol. 2019;28(6):1599-1606. doi:10.1007/s10068-019-00605-9Lok W, Lin T, Cao D, Wei Q.IsSerenoa repenseffective for the treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)? A systematic review and meta-analysis.Asian J Surg. 2022;45(9):1746-1747. doi:10.1016/j.asjsur.2022.01.038Cai T, Cui Y, Yu S, et al.Comparison ofSerenoa repenswith tamsulosin in the treatment of benign prostatic hyperplasia: a systematic review and meta-analysis.Am J Mens Health. 2020;4(2):1557988320905407. doi:10.1177/1557988320905407Miah S, Tharakan T, Gallagher KA, et al.The effects of testosterone replacement therapy on the prostate: a clinical perspective.Version 1. F1000Res.2019;8:F1000 Faculty Rev-217. doi:10.12688/f1000research.16497.1Baas W, Kohler TS.Testosterone replacement therapy and BPH/LUTS. What is the evidence?Curr Urol Rep.2016;17(6):46. doi:10.1007/s11934-016-0600-8600-8MedlinePlus.Androgenetic alopecia.Wessagowit V, Tangjaturonrusamee C, Kootiratrakarn T, et al.Treatment of male androgenetic alopecia with topical products containingSerenoa repensextract.Australas J Dermatol. 2016;57(3):e76-e82. doi:10.1111/ajd.12352Rossi A, Mari E, Scarnò M, et al.Comparative effectiveness and finasteride vsSerenoa repensin male androgenetic alopecia: a two-year study.Int J Immunopathol Pharmacol. 2012;25(4):1167-1173. doi:10.1177/039463201202500435Polackwich AS, Shoskes DA.Chronic prostatitis/chronic pelvic pain syndrome: a review of evaluation and therapy.Prostate Cancer Prostatic Dis. 2016;19(2):132-138. doi:10.1038/pcan.2016.8Zhang K, Guo RQ, Chen SW, et al.The efficacy and safety ofSerenoa repensextract for the treatment of patients with chronic prostatitis/chronic pelvic pain syndrome: a multicenter, randomized, double-blind, placebo-controlled trial.World J Urol. 2021;39(9):3489-3495. doi:10.1007/s00345-020-03577-2Ronis MJJ, Pedersen KB, Watt J.Adverse effects of nutraceuticals and dietary supplements.Annu Rev Pharmacol Toxicol.2018;58:583–601. doi:10.1146/annurev-pharmtox-010617-052844National Institute of Diabetes and Digestive and Kidney Diseases.Saw palmetto.Agbabiaka TB, Pittler MH, Wider B, Ernst E.Serenoa repens(saw palmetto): a systematic review of adverse events.Drug Saf.2009;32(8):637-47. doi:10.2165/00002018-200932080-00003
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Center for Complementary and Integrative Health.Saw palmetto.Kwon Y.Use of saw palmetto (Serenoa repens) extract for benign prostatic hyperplasia.Food Sci Biotechnol. 2019;28(6):1599-1606. doi:10.1007/s10068-019-00605-9Lok W, Lin T, Cao D, Wei Q.IsSerenoa repenseffective for the treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)? A systematic review and meta-analysis.Asian J Surg. 2022;45(9):1746-1747. doi:10.1016/j.asjsur.2022.01.038Cai T, Cui Y, Yu S, et al.Comparison ofSerenoa repenswith tamsulosin in the treatment of benign prostatic hyperplasia: a systematic review and meta-analysis.Am J Mens Health. 2020;4(2):1557988320905407. doi:10.1177/1557988320905407Miah S, Tharakan T, Gallagher KA, et al.The effects of testosterone replacement therapy on the prostate: a clinical perspective.Version 1. F1000Res.2019;8:F1000 Faculty Rev-217. doi:10.12688/f1000research.16497.1Baas W, Kohler TS.Testosterone replacement therapy and BPH/LUTS. What is the evidence?Curr Urol Rep.2016;17(6):46. doi:10.1007/s11934-016-0600-8600-8MedlinePlus.Androgenetic alopecia.Wessagowit V, Tangjaturonrusamee C, Kootiratrakarn T, et al.Treatment of male androgenetic alopecia with topical products containingSerenoa repensextract.Australas J Dermatol. 2016;57(3):e76-e82. doi:10.1111/ajd.12352Rossi A, Mari E, Scarnò M, et al.Comparative effectiveness and finasteride vsSerenoa repensin male androgenetic alopecia: a two-year study.Int J Immunopathol Pharmacol. 2012;25(4):1167-1173. doi:10.1177/039463201202500435Polackwich AS, Shoskes DA.Chronic prostatitis/chronic pelvic pain syndrome: a review of evaluation and therapy.Prostate Cancer Prostatic Dis. 2016;19(2):132-138. doi:10.1038/pcan.2016.8Zhang K, Guo RQ, Chen SW, et al.The efficacy and safety ofSerenoa repensextract for the treatment of patients with chronic prostatitis/chronic pelvic pain syndrome: a multicenter, randomized, double-blind, placebo-controlled trial.World J Urol. 2021;39(9):3489-3495. doi:10.1007/s00345-020-03577-2Ronis MJJ, Pedersen KB, Watt J.Adverse effects of nutraceuticals and dietary supplements.Annu Rev Pharmacol Toxicol.2018;58:583–601. doi:10.1146/annurev-pharmtox-010617-052844National Institute of Diabetes and Digestive and Kidney Diseases.Saw palmetto.Agbabiaka TB, Pittler MH, Wider B, Ernst E.Serenoa repens(saw palmetto): a systematic review of adverse events.Drug Saf.2009;32(8):637-47. doi:10.2165/00002018-200932080-00003
National Center for Complementary and Integrative Health.Saw palmetto.
Kwon Y.Use of saw palmetto (Serenoa repens) extract for benign prostatic hyperplasia.Food Sci Biotechnol. 2019;28(6):1599-1606. doi:10.1007/s10068-019-00605-9
Lok W, Lin T, Cao D, Wei Q.IsSerenoa repenseffective for the treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)? A systematic review and meta-analysis.Asian J Surg. 2022;45(9):1746-1747. doi:10.1016/j.asjsur.2022.01.038
Cai T, Cui Y, Yu S, et al.Comparison ofSerenoa repenswith tamsulosin in the treatment of benign prostatic hyperplasia: a systematic review and meta-analysis.Am J Mens Health. 2020;4(2):1557988320905407. doi:10.1177/1557988320905407
Miah S, Tharakan T, Gallagher KA, et al.The effects of testosterone replacement therapy on the prostate: a clinical perspective.Version 1. F1000Res.2019;8:F1000 Faculty Rev-217. doi:10.12688/f1000research.16497.1
Baas W, Kohler TS.Testosterone replacement therapy and BPH/LUTS. What is the evidence?Curr Urol Rep.2016;17(6):46. doi:10.1007/s11934-016-0600-8600-8
MedlinePlus.Androgenetic alopecia.
Wessagowit V, Tangjaturonrusamee C, Kootiratrakarn T, et al.Treatment of male androgenetic alopecia with topical products containingSerenoa repensextract.Australas J Dermatol. 2016;57(3):e76-e82. doi:10.1111/ajd.12352
Rossi A, Mari E, Scarnò M, et al.Comparative effectiveness and finasteride vsSerenoa repensin male androgenetic alopecia: a two-year study.Int J Immunopathol Pharmacol. 2012;25(4):1167-1173. doi:10.1177/039463201202500435
Polackwich AS, Shoskes DA.Chronic prostatitis/chronic pelvic pain syndrome: a review of evaluation and therapy.Prostate Cancer Prostatic Dis. 2016;19(2):132-138. doi:10.1038/pcan.2016.8
Zhang K, Guo RQ, Chen SW, et al.The efficacy and safety ofSerenoa repensextract for the treatment of patients with chronic prostatitis/chronic pelvic pain syndrome: a multicenter, randomized, double-blind, placebo-controlled trial.World J Urol. 2021;39(9):3489-3495. doi:10.1007/s00345-020-03577-2
Ronis MJJ, Pedersen KB, Watt J.Adverse effects of nutraceuticals and dietary supplements.Annu Rev Pharmacol Toxicol.2018;58:583–601. doi:10.1146/annurev-pharmtox-010617-052844
National Institute of Diabetes and Digestive and Kidney Diseases.Saw palmetto.
Agbabiaka TB, Pittler MH, Wider B, Ernst E.Serenoa repens(saw palmetto): a systematic review of adverse events.Drug Saf.2009;32(8):637-47. doi:10.2165/00002018-200932080-00003
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