Saw palmetto (Serenoa repens) and other natural 5-AR inhibitors

See also: Firsthand experiences – Volume X: Saw palmetto & nettle

General

Csikós E, Horváth A, Ács K, et al, on behalf of the Oemonom. Treatment of benign prostatic hyperplasia by natural drugs. Molecules. 2021. doi:10.3390/molecules26237141PubMed • PMC full text

Dhariwala MY, Ravikumar P. An overview of herbal alternatives in androgenetic alopecia. J Cosmet Dermatol. 2019. doi:10.1111/jocd.12930 • PubMed

Gasmi A, Mujawdiya P, Beley N, et al. Natural compounds used for treating hair loss. Curr Pharm Des. 2023. doi:10.2174/1381612829666230505100147 • PubMed

Krishnamoorthi R, Ganapathy AA, Priya VMH, Kumaran A. Future aspects of plant derived bioactive metabolites as therapeutics to combat benign prostatic hyperplasia. J Ethnopharmacol. 2024. doi:10.1016/j.jep.2024.118207PubMed

Nahata A, Dixit VK. Evaluation of 5α-reductase inhibitory activity of certain herbs useful as antiandrogens. Andrologia. 2014. doi:10.1111/and.12115PubMed

Pagano E, Laudato M, Griffo M, Capasso R. Phytotherapy of benign prostatic hyperplasia. A minireview. Phytother Res. 2014. doi:10.1002/ptr.5084PubMed

Srivilai J, Minale G, Scholfield CN, Ingkaninan K. Discovery of natural steroid 5 alpha-reductase inhibitors. Assay Drug Dev Technol. 2019 Feb/Mar. doi:10.1089/adt.2018.870 • PubMed

Zheng RR, Ouyang QX, Liu ZY, Li LN, Yang L, Wang ZT. [Natural 5α-reductase inhibitors in treatment of benign prostatic hyperplasia]. Zhongguo Zhong Yao Za Zhi. 2024. Chinese. doi:10.19540/j.cnki.cjcmm.20231113.601PubMed

Serenoa repens (saw palmetto)

See also: Firsthand experiences – Volume X: Saw palmetto

Safety & pharmacovigilance

Agbabiaka TB, Pittler MH, Wider B, Ernst E. Serenoa repens (saw palmetto): a systematic review of adverse events. Drug Saf. 2009. doi:10.2165/00002018-200932080-00003 • PubMed

Avins AL, Bent S, Staccone S, et al. A detailed safety assessment of a saw palmetto extract. Complement Ther Med. 2008 Jun. doi:10.1016/j.ctim.2007.10.005 • PubMed • PMC full text

Avins AL, Lee JY, Meyers CM, Barry MJ; CAMUS Study Group. Safety and toxicity of saw palmetto in the CAMUS trial. J Urol. 2013 Apr. doi:10.1016/j.juro.2012.10.002 • PubMed • PMC full text

Gallo E, Maggini V, Lombardi N, et al. Serenoa repens induced erectile dysfunction: underdiagnosis and phytovigilance. Br J Clin Pharmacol. 2021 Nov 7. doi:10.1111/bcp.15129 • PubMed

Paulis G, Paulis A, Perletti G. Serenoa repens and its effects on male sexual function. A systematic review and meta-analysis of clinical trials. Arch Ital Urol Androl. 2021 Dec. doi:10.4081/aiua.2021.4.475 • PubMed

Case reports

Gammoudi R, Ameur K, Ouni B, et al. Fixed drug eruption to Serenoa repens: First case report and consideration of the use of herbal medicine. Dermatol Ther. 2020 Nov. doi:10.1111/dth.14247 • PubMed

Sinclair RD, Mallari RS, Tate B. Sensitization to saw palmetto and minoxidil in separate topical extemporaneous treatments for androgenetic alopecia. Australas J Dermatol. 2002 Nov. doi:10.1046/j.1440-0960.2002.00620.x • PubMed

Yeu E, Grostern R. Saw palmetto and intraoperative floppy-iris syndrome. J Cataract Refract Surg. 2007 May. doi:10.1016/j.jcrs.2006.12.032 • PubMed

Pharmacology

Abd Almaksoud HM, El-Hawary SS, Atia MAM, et al. Anti-androgenic potential of the fruit extracts of certain Egyptian Sabal species and their genetic variability studies: a metabolomic-molecular modeling approach. Food Funct. 2022 Jun 29. doi:10.1039/d1fo03930j • PubMed

Abe M, Ito Y, Suzuki A, Onoue S, Noguchi H, Yamada S. Isolation and pharmacological characterization of fatty acids from saw palmetto extract. Anal Sci. 2009 Apr;25(4):553-7. doi:10.2116/analsci.25.553 • PubMed

Pais P, Villar A, Rull S. Determination of the potency of a novel saw palmetto supercritical CO2 extract (SPSE) for 5α-reductase isoform II inhibition using a cell-free in vitro test system. Res Rep Urol. 2016 Apr 21. doi:10.2147/RRU.S96576 • PubMed • PMC full text

Scaglione F, Lucini V, Pannacci M, Caronno A, Leone C. Comparison of the potency of different brands of Serenoa repens extract on 5alpha-reductase types I and II in prostatic co-cultured epithelial and fibroblast cells. Pharmacology. 2008. doi:10.1159/000161128 • PubMed

Clinical trials

Alcaraz A, Castro-Díaz D, Gacci M, […], on behalf of the Qualiprost Study Group. Efficacy and tolerability of 6-month treatment with tamsulosin plus the hexanic extract of Serenoa repens versus tamsulosin plus 5-alpha-reductase inhibitors for moderate-to-severe LUTS-BPG patients: results of a paired matched clinical study. J Clin Med. 2022 Jun 22. doi:10.3390/jcm11133615 • PubMed • PMC full text

Avins AL, Bent S, Staccone S, et al. A detailed safety assessment of a saw palmetto extract. Complement Ther Med. 2008 Jun. doi:10.1016/j.ctim.2007.10.005 • PubMed • PMC full text

Avins AL, Lee JY, Meyers CM, Barry MJ; CAMUS Study Group. Safety and toxicity of saw palmetto in the CAMUS trial. J Urol. 2013 Apr. doi:10.1016/j.juro.2012.10.002 • PubMed • PMC full text

Regulatory reports

Committee on Herbal Medicinal Products (HMPC), European Medicines Agency. Assessment report on Serenoa repens (W. Bartram) Small, fructus. November 24, 2015.

National Center for Complementary and Integrative Health (NCCIH), United States Department of Health and Human Services. Saw Palmetto.


Industry context

Adno M. The strange, booming market of Florida’s palmetto berries. The Guardian. November 23, 2020.