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Complementary and Alternative Medicine Interventions for BPH/LUTS

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Complementary & Alternative Medicine for Prostate and Urologic Health

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Abstract

A plethora of complementary and alternative medicine (CAM) interventions, primarily dietary supplements, have been utilized in some preliminary clinical trials that have demonstrated an ability to reduce the symptoms of benign prostatic hyperplasia/lower urinary tract symptoms (BPH/LUTS). However, the one supplement that arguably had the most positive data in the history of urology was saw palmetto, but compared to placebo in two separate definitive North American clinical trials dosages of 320–960 mg over 18 months, it proved to work no better than placebo, which somewhat contradicts the positive findings that occurred in several European trials of a standardized trademarked saw palmetto extract known as Permixon (Pierre Fabre, Castres, France) and other products. Currently, two dietary supplements have consistent older (no recent supportive trials) positive meta-analysis data compared to placebo—beta-sitosterol and pygeum (endangered herbal list in some geographic areas). Several supplements have preliminary positive clinical data; these include cernilton, pumpkin seed oil, and, to a lesser extent, stinging nettle. Some supplements have no efficacy or may even be harmful and encourage the growth of BPH, including high-dose (80 mg or higher) zinc supplements, based on some clinical and observational data. BPH prescription medications are arguably more rapidly effective compared to any dietary supplement, but the benefit-to-risk ratio or side effect profile and, at times, cost arguably favor some supplements over prescription medications along with lifestyle changes for mild to moderate BPH, or some patients could theoretically use both a prescription and CAM agent without much concern over drug interactions. Heart-healthy lifestyle changes should be stressed to improve BPH/LUTS and overall health outcomes and to improve the efficacy of BPH medications. Any supplement recommended for BPH should be cost-effective/competitive and have a heart-healthy profile (also known as the first-do-no-harm approach).

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  1. Department of Urology, University of Michigan Medical Center, Ann Arbor, MI, USA

    Mark A. Moyad M.D., M.P.H.

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Moyad, M.A. (2014). Complementary and Alternative Medicine Interventions for BPH/LUTS. In: Complementary & Alternative Medicine for Prostate and Urologic Health. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8492-9_3

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