Saw Palmetto Treatment for Prostatitis: A Systematic Review of the Literature

Abstract

Purpose: This systematic review was conducted to determine the safety and efficacy of Serenoa repens extract (saw palmetto extract) in treating chronic prostatitis, as compared with existing treatment regimens and placebo. Methods: Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic query was performed across multiple databases in December 2021 to identify relevant studies. The selection criteria focused on studies evaluating the treatment regimens, safety, and efficacy of saw palmetto in treating chronic prostatitis/chronic pelvic pain syndrome. Results: Of 259 references, 21 studies encompassing 1666 patients were selected. These studies included a range of trial types, with a mean follow-up period of approximately 6.975 months. Saw palmetto extract showed improved symptom relief compared with placebo, with mixed results when compared with alpha-blockers or 5-ARIs. Multimodal treatments, especially those including saw palmetto extract alongside antibiotics, displayed better efficacy in managing both Category II and Category III prostatitis. Conclusion: Saw palmetto extract provides symptom relief in patients with chronic prostatitis. Although monotherapy exhibited certain benefits over placebo, its best efficacy was observed when integrated into multimodal treatment regimens, particularly with antibiotics for Category II prostatitis. Future research may unveil specific adjuncts that enhance the therapeutic outcomes of regimens containing saw palmetto extract.