Introduction: The use of complementary and alternative medications has become a multi-million dollar business in the United States and comprises more than half of all filled prescriptions for benign prostatic hyperplasia (BPH) in Europe. For the practicing urologist, understanding the phytotherapeutic agents available, their proposed mechanism of action, the research supporting their use, and their safety profiles has become increasingly important as more patients inquire into their use.
Materials and methods: A comprehensive literature search was conducted to identify pertinent articles pertaining to alternative and complementary treatment options for the management of BPH. Treatments demonstrating adequate clinical data, including Serona repens, Pygeum africanum, and Secale cereal, were selected for in depth review.
Results: Small clinical trials for each of the agents demonstrated mixed results while larger more soundly constructed studies found no significant benefit for the use of phytotherapy in the treatment of BPH.
Conclusions: Based on the available literature, there is no evidence that phytotherapy significantly improves symptoms of BPH against placebo, despite being largely safe for ingestion. In patients with mild BPH symptoms who are reluctant to take standard pharmaceutical medications may try these agents provided that the patient understands their current limitations. Those with moderate or severe BPH should be discouraged from alternative and complementary treatments.