Abstract
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.
Highlights
Benign prostatic hyperplasia (BPH) is one of the most common urinary diseases in aging men, which can lead to lower urinary tract symptoms (LUTS)
The DHT has a higher affinity to androgen receptors, and seems to stimulate protein synthesis, differentiation, and prostate cell growth [5,6]; (2) The second theory about BPH development is based on the prostate cells, which are androgen-independent and can self-renew in androgen-deficient conditions [7]; (3) The third is based on the interactions between stroma and epithelium
Basic information related to the chemistry of the D-004 extract was given in an earlier review [4], as well as preclinical studies on this extract, as well as in vivo studies on prevention and improving BPH induced by testosterone in rats, and a randomized, double-blind study on healthy volunteers, indicating significant antioxidant effects on plasmatic oxidative markers of D-004 taken for 6 weeks (Table 2)
Summary
Benign prostatic hyperplasia (BPH) is one of the most common urinary diseases in aging men, which can lead to lower urinary tract symptoms (LUTS). The DHT has a higher affinity to androgen receptors, and seems to stimulate protein synthesis, differentiation, and prostate cell growth [5,6]; (2) The second theory about BPH development is based on the prostate cells, which are androgen-independent and can self-renew in androgen-deficient conditions [7]; (3) The third is based on the interactions between stroma and epithelium. Both of them can convert testosterone into DHT. The most common active ingredients they contain are phytosterols, β-sitosterol, lectins, etc. [9]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
