Benign prostatic hyperplasia
Supplements studied for benign prostatic hyperplasia.
Overview
SupplementDEX indexes 11 supplements for benign prostatic hyperplasia (BPH) across 60 studies.
Garlic extract (WA 40) has uncertain benefit from small, non-placebo-controlled studies suggesting possible prostate size and symptom improvements. Saw Palmetto (WA 56; low effect size, very high evidence, medium trust) does not meaningfully improve urinary symptoms in most higher-quality trials, performing less well than prescription medicines.
Lycopene (WA 52; low effect size, high evidence, medium trust) may slow progression in some clinical studies, while milk thistle (WA 44; low effect size, low evidence, medium trust) combination data with tamsulosin or selenium is preliminary. See the heatmap and evidence reviews below for all eleven supplements.
Effect graph
Relevant supplements
Relevant supplements sorted by DEX Score.
| Saw Palmetto | ★★★★★ | Low |
| Lycopene | ★★★★★ | Low |
| Selenium | ★★★★★ | Low |
| Quercetin | ★★★★★ | Low |
| Panax Ginseng | ★★★★★ | Low |
| Milk Thistle | ★★★★★ | Low |
| Melatonin | ★★★★★ | Low |
| Flaxseed | ★★★★★ | Low |
| Garlic | ★★★★★ | Low |
| Reishi | ★★★★★ | Very Low / None |
| Nattokinase | ★★★★★ | Very Low / None |
Studies
Find individual evidence reviews for supplements sorted by DEX Score.
11 supplements for and rated at least stars. All purchase bands. No minimum star filter.
Saw PalmettoView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Research shows that saw palmetto does not meaningfully improve symptoms like frequent urination or weak flow for most men with an enlarged prostate (BPH).
- While a few small, early studies found some benefit, larger and higher-quality research did not find any real improvement over taking a placebo.
- Saw palmetto usually works less well than prescription medicines but may have fewer side effects.
- Supplementation does not seem to help when combined with other herbs or taken with regular BPH medicines.
Browse 43 studies·5 meta-analyses
RCTSerenoa repens for the Treatment of Lower Urinary Tract Symptoms Due to Benign Prostatic Enlargement: An Updated Cochrane Review2024n=4,656
An updated Cochrane review of 27 RCTs in 4656 men found Serenoa repens alone provided little to no benefit for lower urinary tract symptoms due to benign prostatic enlargement vs placebo.
- Effect
- No Benefit
- Population
- Men with lower urinary tract symptoms
- Participants
- 4,656
Open-labelEfficacy and Safety of the Hexanic Extract of Serenoa repens vs. Watchful Waiting in Men with Moderate to Severe LUTS-BPH: Results of a Paired Matched Clinical Study2022n=783
A matched real-world study in 783 men with moderate-to-severe LUTS/BPH found hexanic Serenoa repens extract 320 mg/day for 6 months improved IPSS more than watchful waiting (3.8 vs 2.2 points).
- Effect
- Benefit
- Duration
- 6 months
- Dose
- 320 mg/day
- Population
- Men with lower urinary tract symptoms
- Participants
- 783
Open-labelEfficacy 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-BPH Patients: Results of a Paired Matched Clinical Study2022n=68
In 136 matched men with moderate-to-severe LUTS/BPH, 6 months of tamsulosin plus hexanic Serenoa repens matched tamsulosin plus a 5-ARI for symptom relief but caused fewer adverse events (10.3% vs 26.5%).
- Effect
- Benefit
- Duration
- 6 months
- Dose
- 5 mg/day
- Population
- Men with lower urinary tract symptoms
- Participants
- 68
MetaClinical Efficacy of Serenoa repens Versus Placebo Versus Alpha-blockers for the Treatment of Lower Urinary Tract Symptoms/Benign Prostatic Enlargement: A Systematic Review and Network Meta-analysis of Randomized Placebo-controlled Clinical Trials2021n=8,564
A network meta-analysis of 22 RCTs in 8564 men found Serenoa repens did not produce clinically meaningful improvements in LUTS or peak urinary flow vs placebo.
- Effect
- No Benefit
- Population
- Men with lower urinary tract symptoms
- Participants
- 8,564
Efficacy and tolerability of the hexanic extract of Serenoa repens compared to tamsulosin in moderate-severe LUTS-BPH patients2021n=737
A matched comparison in 737 men with moderate-to-severe LUTS/BPH found hexanic Serenoa repens 320 mg/day and tamsulosin 0.4 mg/day for 6 months improved IPSS similarly, with fewer adverse events on HESr (2.1% vs 14.7%).
- Effect
- Benefit
- Duration
- 6 months
- Dose
- 320 mg/day
- Population
- Men with lower urinary tract symptoms
- Participants
- 737
RCTA double blind, placebo-controlled randomized comparative study on the efficacy of phytosterol-enriched and conventional saw palmetto oil in mitigating benign prostate hyperplasia and androgen deficiency2020n=33
A 12-week double-blind RCT in 99 men aged 40–65 with BPH found β-sitosterol-enriched saw palmetto oil 500 mg/day improved IPSS, flow rates, PSA, and free testosterone vs placebo and conventional oil.
- Effect
- Benefit
- Duration
- 12 weeks
- Dose
- 500 mg/day
- Population
- Men
- Participants
- 33
- Ages
- 40–65
ObservationalClinical Benefit of Tamsulosin and the Hexanic Extract of Serenoa Repens, in Combination or as Monotherapy, in Patients with Moderate/Severe LUTS-BPH: A Subset Analysis of the QUALIPROST Study2020n=709
A 6-month observational subset of 709 men with moderate-to-severe LUTS/BPH found tamsulosin plus hexanic Serenoa repens improved IPSS more than either monotherapy (7.2 vs 5.7 vs 5.4 points).
- Effect
- Benefit
- Duration
- 6 months
- Dose
- 320 mg/day
- Population
- Men with lower urinary tract symptoms
- Participants
- 709
- Ages
- 40+
MetaComparison of Serenoa repens With Tamsulosin in the Treatment of Benign Prostatic Hyperplasia: A Systematic Review and Meta-Analysis2020n=1,080
A meta-analysis of 4 studies in 1080 BPH patients after at least 6 months found Serenoa repens matched tamsulosin for IPSS, quality of life, and flow rate, though tamsulosin reduced prostate volume more.
- Effect
- Benefit
- Duration
- 6 months
- Population
- Men
- Participants
- 1,080
MetaEfficacy and safety of a hexanic extract of Serenoa repens (Permixon® ) for the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH): systematic review and meta-analysis of randomised controlled trials and observational studies2018n=447
A meta-analysis of 27 studies in 5800 LUTS/BPH patients found Permixon hexanic extract 320 mg/day reduced nocturia and improved peak flow vs placebo and matched tamsulosin and short-term 5-ARIs for symptoms.
- Effect
- Benefit
- Duration
- 6 months
- Dose
- 320 mg/day
- Population
- Men with lower urinary tract symptoms
- Participants
- 447
RCTSerenoa repens + selenium + lycopene vs tadalafil 5 mg for the treatment of lower urinary tract symptoms secondary to benign prostatic obstruction: a Phase IV, non-inferiority, open-label, clinical study (SPRITE study)2018n=427
A 6-month non-inferiority RCT in 427 men aged 50–80 found Serenoa repens plus selenium and lycopene was not inferior to tadalafil 5 mg for IPSS and peak flow, with fewer adverse events.
- Effect
- Benefit
- Duration
- 6 months
- Dose
- 5 mg/day
- Population
- Men with lower urinary tract symptoms
- Participants
- 427
- Ages
- 50–80
ObservationalEffects of Serenoa repens Alcohol Extract on Benign Prostate Hyperplasia2017n=40
In 70 men with symptomatic BPH followed 12 months, 40 treated with Serenoa repens alcohol extract had improved urine flow, prostate volume, and IPSS vs 30 untreated controls.
- Effect
- Benefit
- Duration
- 12 months
- Population
- Patients with BPH
- Participants
- 40
- Ages
- 40–79
RCTEfficacy and Safety of Hexanic Lipidosterolic Extract of Serenoa repens (Permixon) in the Treatment of Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: Systematic Review and Meta-analysis of Randomized Controlled Trials2016
A meta-analysis of 12 Permixon RCTs found hexanic Serenoa repens reduced nocturnal voids and improved peak flow vs placebo, matched tamsulosin and finasteride for symptoms, and had less sexual dysfunction.
- Effect
- Benefit
RCTComparison of tamsulosin plus serenoa repens with tamsulosin in the treatment of benign prostatic hyperplasia in Korean men: 1-year randomized open label study2015n=60
A 12-month open RCT in 103 Korean BPH men found tamsulosin plus Serenoa repens 320 mg/day improved storage symptoms more than tamsulosin alone at 6 and 12 months, with similar voiding and flow outcomes.
- Effect
- Benefit
- Duration
- 12 months
- Dose
- 320 mg/day
- Population
- Men with LUTS secondary to BPH
- Participants
- 60
RCTEffects of Difaprost® on voiding dysfunction, histology and inflammation markers in patients with benign prostatic hyperplasia who are candidates for surgical treatment2014n=36
In 36 BPH patients, 3 months of Difaprost (Serenoa, quercetin, beta-sitosterol) before surgery reduced post-void residual volume and showed less prostatic edema versus no pretreatment.
- Effect
- No Benefit
- Population
- Men with benign prostatic hyperplasia awaiting surgery
- Participants
- 36
RCTSerenoa repens, lycopene and selenium versus tamsulosin for the treatment of LUTS/BPH. An Italian multicenter double-blinded randomized study between single or combination therapy (PROCOMB trial)2014n=225
In 225 men with LUTS/BPH, Serenoa repens plus lycopene and selenium combined with tamsulosin significantly improved IPSS, Qmax, and PVR at 6 and 12 months versus monotherapies.
- Effect
- Benefit
- Duration
- 12 months
- Population
- Men
- Participants
- 225
- Ages
- 55–80
RCTA phase II randomised double-blind placebo-controlled clinical trial investigating the efficacy and safety of ProstateEZE Max: a herbal medicine preparation for the management of symptoms of benign prostatic hypertrophy2013n=32
In 57 men with BPH, 3 months of ProstateEZE Max (containing lycopene) significantly reduced IPSS by 36% and daytime urinary frequency versus placebo.
- Effect
- Benefit
- Duration
- 3 months
- Population
- Men
- Participants
- 32
- Ages
- 40–80
RCTDoes the addition of Serenoa repens to tamsulosin improve its therapeutical efficacy in benign prostatic hyperplasia?2013n=297
In 265 men with LUTS/BPH followed about 6 months, tamsulosin plus Serenoa repens did not differ significantly from tamsulosin or Serenoa repens alone on symptom or flow outcomes.
- Effect
- No Benefit
- Duration
- 6 months
- Dose
- 320 mg
- Population
- Patients with low urinary tract symptoms due to benign prostatic
- Participants
- 297
Clinical trialImproving BPH symptoms and sexual dysfunctions with a saw palmetto preparation? Results from a pilot trial2013
An open 8-week pilot in 82 elderly men with BPH found Prostasan saw palmetto 320 mg/day reduced IPSS from 14.4 to 6.9 and improved sexual function scores versus baseline.
- Effect
- Benefit
- Duration
- 8 weeks
- Dose
- 320 mg/day
- Population
- Older adults
ObservationalObservational database serenoa repens (DOSSER): overview, analysis and results. A multicentric SIUrO (Italian Society of Oncological Urology) project2012n=298
A multicenter observational study of 298 Italian men with BPH on 320–640 mg/day Serenoa repens reported symptomatic improvement, though this uncontrolled design limits causal inference.
- Effect
- Benefit
- Duration
- 6 months
- Dose
- 320 mg/day
- Population
- Men with lower urinary tract symptoms
- Participants
- 298
MetaSerenoa repens for benign prostatic hyperplasia2012n=582
A Cochrane systematic review found Serenoa repens extracts had uncertain effects on LUTS in BPH due to heterogeneous products and limited high-quality trial evidence.
- Effect
- No Benefit
- Duration
- 12 months
- Population
- Men with lower urinary tract symptoms
- Participants
- 582
Systematic reviewSerenoa repens monotherapy for benign prostatic hyperplasia (BPH): an updated Cochrane systematic review2012n=2,008
An updated Cochrane review of 17 RCTs (2008 men) found Serenoa repens monotherapy did not significantly improve lower urinary tract symptoms versus placebo, including at escalating doses.
- Effect
- No Benefit
- Duration
- 4–72 weeks
- Dose
- 320 mg/day
- Population
- Men with lower urinary tract symptoms
- Participants
- 2,008
RCTEffect of increasing doses of saw palmetto extract on lower urinary tract symptoms: a randomized trial2011n=369
In 369 North American men with LUTS, escalating saw palmetto to 960 mg/day for 72 weeks did not improve AUASI scores, flow rate, or other urinary outcomes versus placebo.
- Effect
- No Benefit
- Duration
- 72 weeks
- Dose
- 960 mg/day
- Population
- Men with lower urinary tract symptoms
- Participants
- 369
- Avg age
- ~45
RCTEffect of saw palmetto soft gel capsule on lower urinary tract symptoms associated with benign prostatic hyperplasia: a randomized trial in Shanghai, China2008n=46
A 12-week double-blind RCT in 92 Chinese men aged 49–75 with LUTS found Prostataplex saw palmetto improved maximum flow rate (14.1 vs 11.7 mL/s) versus placebo.
- Effect
- Benefit
- Duration
- 12 weeks
- Population
- Men with lower urinary tract symptoms
- Participants
- 46
- Ages
- 49–75
RCTEfficacy and safety of a combination of sabal and urtica extract in lower urinary tract symptoms. A randomized, double-blind study versus tamsulosin2006
A 60-week RCT in 140 men with BPH-related LUTS found PRO 160/120 (sabal plus urtica) non-inferior to tamsulosin 0.4 mg/day, with median IPSS falling 9 points in both groups.
- Effect
- Benefit
- Duration
- 60 weeks
- Dose
- 0.4 mg/day
- Population
- Older adults
RCTSaw palmetto for benign prostatic hyperplasia2006n=225
In 225 men over 49 with moderate-to-severe BPH treated 1 year, saw palmetto 320 mg/day twice daily did not improve AUASI, peak flow, prostate volume, or quality of life versus placebo.
- Effect
- No Benefit
- Dose
- 160 mg 2×/day
- Population
- Men
- Participants
- 225
- Ages
- >49
RCTLong-term efficacy and safety of a combination of sabal and urtica extract for lower urinary tract symptoms--a placebo-controlled, double-blind, multicenter trial2005n=257
In 257 elderly men with BPH, 24 weeks of PRO 160/120 (sabal plus urtica) reduced IPSS more than placebo; open-label extension continued benefit through 48 weeks.
- Effect
- Benefit
- Duration
- 24 weeks
- Dose
- 1473–120 mg
- Population
- Older adults
- Participants
- 257
Not all brands are created equal: a comparison of selected components of different brands of Serenoa repens extract2004
An analysis of 14 commercial Serenoa repens brands found wide variation in free fatty acid and ester content, suggesting product differences may affect clinical efficacy and safety.
- Population
- Men with lower urinary tract symptoms
RCTSerenoa repens extract for benign prostate hyperplasia: a randomized controlled trial2003n=100
In 100 men with BPH over 12 weeks, 320 mg/day Serenoa repens extract did not significantly improve IPSS, peak flow, or erectile function versus placebo.
- Effect
- No Benefit
- Duration
- 12 weeks
- Dose
- 320 mg/day
- Population
- Men with symptoms of BPH
- Participants
- 100
- Ages
- <80
RCTComparison of a phytotherapeutic agent (Permixon) with an alpha-blocker (Tamsulosin) in the treatment of benign prostatic hyperplasia: a 1-year randomized international study2002n=354
In 542 men with symptomatic BPH over 12 months, Permixon 320 mg/day matched tamsulosin 0.4 mg/day for IPSS and flow improvements without reducing prostate volume or PSA.
- Effect
- Benefit
- Duration
- 1 year
- Dose
- 320 mg/day
- Population
- Men with lower urinary tract symptoms
- Participants
- 354
ObservationalWhat is the benefit of combining tamsulosin with serenoa repens versus tamsulosin alone on storage/filling and voiding Lower Urinary Tract Symptoms (LUTS)?2002
Observational evidence compared tamsulosin plus Serenoa repens with tamsulosin alone for storage and voiding LUTS; published abstract details were not available.
- Effect
- Benefit
RCTRandomized trial of a combination of natural products (cernitin, saw palmetto, B-sitosterol, vitamin E) on symptoms of benign prostatic hyperplasia (BPH)2001n=144
A 3-month RCT in 127 men with BPH found a cernitin, saw palmetto, beta-sitosterol, and vitamin E combination reduced nocturia and daytime frequency versus placebo.
- Effect
- Benefit
- Duration
- 3 months
- Population
- Men
- Participants
- 144
RCTRandomized, double-blind, placebo-controlled trial of saw palmetto in men with lower urinary tract symptoms2001n=85
In 85 men with LUTS over 6 months, saw palmetto modestly reduced IPSS versus placebo (16.7 to 12.3 vs 15.8 to 13.6; P=0.038) but did not improve peak flow or sexual function.
- Effect
- Benefit
- Duration
- 6 months
- Population
- Men with lower urinary tract symptoms
- Participants
- 85
- Ages
- 45+
RCTCombined sabal and urtica extract compared with finasteride in men with benign prostatic hyperplasia: analysis of prostate volume and therapeutic outcome2000n=543
In 431 BPH patients, combined sabal and urtica (PRO 160/120) matched finasteride for flow improvement over 24 weeks, with similar benefits regardless of baseline prostate volume.
- Effect
- Benefit
- Duration
- 24 weeks
- Population
- Men with benign prostatic hyperplasia
- Participants
- 543
RCTEffects of a saw palmetto herbal blend in men with symptomatic benign prostatic hyperplasia2000n=44
In 44 men with symptomatic BPH over 6 months, a saw palmetto herbal blend modestly improved clinical parameters and reduced transition-zone epithelium on MRI versus placebo.
- Effect
- No Benefit
- Population
- Men with symptomatic benign prostatic hyperplasia
- Participants
- 44
- Ages
- 45–80
MetaMeta-analysis of clinical trials of permixon in the treatment of symptomatic benign prostatic hyperplasia2000n=2,859
A meta-analysis of 13 Permixon trials (2859 patients) found Permixon increased peak flow by 2.20 mL/s and reduced nocturia by 0.50 episodes versus placebo.
- Effect
- Benefit
- Duration
- 21–180 days
- Population
- Men with lower urinary tract symptoms
- Participants
- 2,859
RCTEfficacy and tolerability of the lipidosterolic extract of Serenoa repens (Permixon) in benign prostatic hyperplasia: a double-blind comparison of two dosage regimens1999
In 100 BPH outpatients over 3 months, Permixon 320 mg once or twice daily similarly improved IPSS, flow rates, and residual urine versus baseline, with good tolerability.
- Effect
- Benefit
- Duration
- 3 months
- Population
- Men with BPH
MetaSaw palmetto extracts for treatment of benign prostatic hyperplasia: a systematic review1998n=10
A systematic review of 18 BPH RCTs (2939 men) found saw palmetto modestly improved urinary symptoms versus placebo, though trial quality and product heterogeneity limited certainty.
- Effect
- Benefit
- Duration
- 4–48 weeks
- Population
- Men with symptomatic benign prostatic hyperplasia (BPH)
- Participants
- 10
RCTComparison of phytotherapy (Permixon) with finasteride in the treatment of benign prostate hyperplasia: a randomized international study of 1,098 patients1996n=1,098
In 1098 men with moderate BPH over 6 months, Permixon 320 mg/day matched finasteride 5 mg/day for symptom relief but did not reduce prostate volume or PSA like finasteride.
- Effect
- No Benefit
- Duration
- 6 months
- Dose
- 320 mg/day Permixon
- Population
- Men with moderate BPH using the International Prostate Symp
- Participants
- 1,098
ObservationalLong-term drug treatment of benign prostatic hyperplasia - results of a prospective 3-year multicenter study using Sabal extract IDS 891996n=435
A 3-year prospective study of 435 men with BPH on Sabal extract IDS 89 reported sustained symptom improvement, higher peak flow, and lower surgery rates than untreated comparators.
- Effect
- Benefit
- Duration
- 3 years
- Population
- Men
- Participants
- 435
RCTComparative effects of alfuzosin versus Serenoa repens in the treatment of symptomatic benign prostatic hyperplasia1995n=32
In 63 BPH patients over 3 weeks, alfuzosin 2.5 mg three times daily reduced symptoms more than Serenoa repens 160 mg twice daily on Boyarsky and flow measures.
- Effect
- No Benefit
- Duration
- 3 weeks
- Dose
- 320 mg/day
- Population
- Men with symptomatic BPH
- Participants
- 32
Clinical trial[Symptomatic treatment of benign hypertrophy of the prostate. Comparative study of prazosin and serenoa repens]1992n=45
In 45 BPH patients over 12 weeks, prazosin controlled irritative symptoms slightly better than Serenoa repens, though both treatments improved flow and symptoms.
- Effect
- Benefit
- Duration
- 12 weeks
- Population
- Men
- Participants
- 45
Controlled trialThe value of permixon in benign prostatic hypertrophy1986
A double-blind trial in BPH patients found Permixon 160 mg twice daily and placebo both improved flow and symptoms, with no significant between-group difference.
- Effect
- No Benefit
- Dose
- 320 mg/day
Clinical trialA double-blind trial of an extract of the plant Serenoa repens in benign prostatic hyperplasia1984
A double-blind trial evaluated Serenoa repens extract for benign prostatic hyperplasia; published abstract details on dose, duration, and outcomes were not available.
- Effect
- Benefit
LycopeneView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Though eating lycopene-rich foods hasn’t been linked to preventing BPH, some clinical studies show that taking lycopene supplements (around 15 mg daily) may help slow BPH progression and improve symptoms like urinary problems.
- In these studies, men taking lycopene had less prostate growth and lower PSA levels, a marker related to prostate health.
- More research is needed to confirm these benefits and the right dose to take.
Browse 5 studies
RCTFruHis significantly increases the anti-benign prostatic hyperplasia effect of lycopene: A double-blinded randomized controlled clinical trial2022n=13
A double-blinded randomized trial in 52 BPH patients comparing 25 mg/day lycopene + 10 mg/day FruHis vs lycopene alone, FruHis alone or placebo for 8 weeks; the lycopene + FruHis group showed greater reductions in IGF-1, total PSA and symptom scores, suggesting FruHis potentiates lycopene’s effects.
- Effect
- No Benefit
- Duration
- 8 weeks
- Dose
- 25 mg/day
- Population
- Men
- Participants
- 13
RCTSerenoa repens, lycopene and selenium versus tamsulosin for the treatment of LUTS/BPH. An Italian multicenter double-blinded randomized study between single or combination therapy (PROCOMB trial)2014n=225
In 225 men with LUTS/BPH, Serenoa repens plus lycopene and selenium combined with tamsulosin significantly improved IPSS, Qmax, and PVR at 6 and 12 months versus monotherapies.
- Effect
- Benefit
- Duration
- 12 months
- Population
- Men
- Participants
- 225
- Ages
- 55–80
RCTA phase II randomised double-blind placebo-controlled clinical trial investigating the efficacy and safety of ProstateEZE Max: a herbal medicine preparation for the management of symptoms of benign prostatic hypertrophy2013n=32
In 57 men with BPH, 3 months of ProstateEZE Max (containing lycopene) significantly reduced IPSS by 36% and daytime urinary frequency versus placebo.
- Effect
- Benefit
- Duration
- 3 months
- Population
- Men
- Participants
- 32
- Ages
- 40–80
RCTLycopene inhibits disease progression in patients with benign prostate hyperplasia2008n=40
In 40 men with BPH, lycopene 15 mg/day for 6 months significantly reduced PSA, prevented prostate enlargement on ultrasound, and improved IPSS symptom scores versus placebo.
- Effect
- Benefit
- Duration
- 12 months
- Dose
- 15 mg/day
- Population
- Older adults
- Participants
- 40
ObservationalIntake of selected micronutrients and the risk of surgically treated benign prostatic hyperplasia: a case-control study from Italy2006n=1,451
In 1,369 surgically treated BPH cases versus 1,451 controls in Italy, higher carotene intake was associated with lower BPH risk; lycopene and lutein/zeaxanthin showed no meaningful associations.
- Effect
- No Benefit
- Population
- Children under 5
- Participants
- 1,451
FlaxseedView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Early research suggests a flaxseed lignan supplement might help improve urinary symptoms in men with enlarged prostate, but there is not enough evidence yet to know how reliable the benefit is.
Browse 1 study
RCTEffects of dietary flaxseed lignan extract on symptoms of benign prostatic hyperplasia2008n=87
In an RCT of 87 men with BPH, 600 mg/day flaxseed lignan (SDG) for 4 months significantly improved International Prostate Symptom Score and quality of life versus placebo.
- Effect
- Benefit
- Duration
- 4 months
- Dose
- 600 mg/day
- Participants
- 87
MelatoninView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- A small study found that taking a controlled‑release form of melatonin, 2 mg each night for 4 weeks, may help reduce nighttime urination in some men with an enlarged prostate.
Browse 1 study
RCTMelatonin pharmacotherapy for nocturia in men with benign prostatic enlargement2004n=20
A 4-week crossover RCT of 20 men with BPE found 2 mg controlled-release melatonin reduced nocturia episodes by 0.32/night (p=0.07) and nocturia bother by 0.51 points (p=0.008) vs placebo.
- Effect
- Benefit
- Duration
- 4 weeks
- Dose
- 2 mg/day
- Population
- Older adults
- Participants
- 20
Milk ThistleView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- It is not clear whether milk thistle helps with symptoms of benign prostatic hyperplasia (BPH).
- One small study found that taking milk thistle extract along with the usual medication tamsulosin improved urinary symptoms and prostate size, but did not change prostate-specific antigen (PSA) levels.
- Another early study found that taking milk thistle with selenium improved urine flow and symptoms, but it is uncertain if this was due to milk thistle, selenium, or both.
- More research is needed.
Browse 2 studies
RCTEvaluation of efficacy of cholecalciferol and silymarin in improving lower urinary tract symptoms of benign prostatic hyperplasia: A double-blind, randomized, controlled trial2024n=80
An RCT of 80 benign prostatic hyperplasia patients found silymarin alone or with cholecalciferol for 3 months improved International Prostate Symptom Score, prostate volume, and post-void residual vs baseline.
- Effect
- Benefit
- Duration
- 3 months
- Dose
- 480 mg/day
- Population
- Men
- Participants
- 80
- Ages
- 50–80
RCTUse of selenium-silymarin mix reduces lower urinary tract symptoms and prostate specific antigen in men2013n=29
An RCT of men with lower urinary tract symptoms found selenium plus silymarin for 6 months improved IPSS, urinary flow, bladder volume, and reduced PSA vs placebo.
- Effect
- Benefit
- Duration
- 6 months
- Dose
- 240 μg/day
- Population
- Men
- Participants
- 29
Panax GinsengView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- It is not clear if taking Panax ginseng helps with urinary symptoms from an enlarged prostate.
- A small study showed that taking a Korean red ginseng extract daily for 12 weeks lowered prostate markers and helped many urinary symptoms like urgency and weak urine flow, but it did not improve the speed or completeness of urination.
Browse 1 study
RCTSafety and Efficacy Assessment of Red Ginseng Oil (RXGIN) in Men with Lower Urinary Tract Symptoms in a Randomized, Double-Blind, Placebo-Controlled Trial2024n=88
A 12-week RCT in 88 men with lower urinary tract symptoms found red ginseng oil improved IPSS scores and related outcomes versus placebo.
- Effect
- Benefit
- Duration
- 12 weeks
- Population
- Adults
- Participants
- 88
- Ages
- 40–75
QuercetinView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- It is unclear if taking quercetin by itself helps with benign prostatic hyperplasia (enlarged prostate).
- One small study found that a supplement containing quercetin, beta-sitosterol, and saw palmetto did not improve symptoms after three months.
- But, because the study didn’t compare to a placebo or other treatment, more research is needed.
Browse 1 study
RCTEffects of Difaprost® on voiding dysfunction, histology and inflammation markers in patients with benign prostatic hyperplasia who are candidates for surgical treatment2014n=36
In 36 BPH patients, 3 months of Difaprost (Serenoa, quercetin, beta-sitosterol) before surgery reduced post-void residual volume and showed less prostatic edema versus no pretreatment.
- Effect
- Benefit
- Population
- Men with benign prostatic hyperplasia awaiting surgery
- Participants
- 36
SeleniumView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- It is not clear if selenium alone helps with benign prostatic hyperplasia (BPH).
- One small study found that taking selenium with silymarin for six months improved urinary symptoms compared to placebo.
- Another study showed that a combination of selenium, saw palmetto, and lycopene taken with tamsulosin improved symptoms more than tamsulosin alone.
- It is unknown whether selenium itself causes these benefits.
Browse 2 studies
RCTSerenoa repens, lycopene and selenium versus tamsulosin for the treatment of LUTS/BPH. An Italian multicenter double-blinded randomized study between single or combination therapy (PROCOMB trial)2014n=225
In 225 men with LUTS/BPH, Serenoa repens plus lycopene and selenium combined with tamsulosin significantly improved IPSS, Qmax, and PVR at 6 and 12 months versus monotherapies.
- Effect
- Benefit
- Duration
- 12 months
- Population
- Men
- Participants
- 225
- Ages
- 55–80
RCTUse of selenium-silymarin mix reduces lower urinary tract symptoms and prostate specific antigen in men2013n=29
An RCT of men with lower urinary tract symptoms found selenium plus silymarin for 6 months improved IPSS, urinary flow, bladder volume, and reduced PSA vs placebo.
- Effect
- Benefit
- Duration
- 6 months
- Dose
- 240 μg/day
- Population
- Men
- Participants
- 29
GarlicView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- It is uncertain whether garlic supplements help men with an enlarged prostate (BPH).
- Some early research suggests that taking garlic extract might reduce prostate size and improve urinary symptoms, but the studies so far have been small and didn’t compare garlic to a placebo, so more research is needed to know if it really works.
Browse 1 study
Consumption of aqueous garlic extract leads to significant improvement in patients with benign prostate hyperplasia and prostate cancer2003
In patients with benign prostatic hyperplasia and prostate cancer, consumption of aqueous garlic extract was reported to produce significant clinical improvement in urinary and prostate-related symptoms.
- Effect
- Benefit
- Population
- Prostate cancer patients
NattokinaseView supplement →
Do not purchase·★★★★★
How we scored this▸
- A clinical study tested soy isoflavones, a natural compound in soy, for relief of urinary symptoms related to an enlarged prostate in men.
- Both those taking soy isoflavones and those taking placebo saw improvements in urine flow, symptoms, and quality of life over a year.
- Soy isoflavones showed a small additional benefit in improving urinary flow and some symptoms compared to placebo.
- They were safe and well tolerated.
- This suggests soy isoflavones might help men with prostate enlargement, but more research is needed.
Browse 1 study
RCTIsoflavones in treating watchful waiting benign prostate hyperplasia: a double-blinded, randomized controlled trial2012
A double-blind pilot RCT in 176 Hong Kong men with BPH found soy isoflavones did not significantly improve lower urinary tract symptoms versus placebo over 12 months.
- Effect
- No Benefit
- Duration
- 12 months
- Population
- ALL patients
ReishiView supplement →
Do not purchase·★★★★★
How we scored this▸
- Small studies suggest reishi mushroom extract taken once daily at 6 mg for up to 12 weeks may help reduce urinary symptoms related to an enlarged prostate or other causes.
- Higher or lower doses do not work better.
- It does not improve urine flow or prostate size, and the overall importance of these effects is unclear.
Browse 2 studies
RCTEffect of an extract of Ganoderma lucidum in men with lower urinary tract symptoms: a double-blind, placebo-controlled randomized and dose-ranging study2008n=14
In men ≥50 with lower urinary tract symptoms, dose-ranging Ganoderma lucidum extract (0.6–60 mg/day) did not clearly improve IPSS scores versus placebo in this small trial.
- Effect
- No Benefit
- Dose
- 60 mg/day
- Population
- Men
- Participants
- 14
RCTRandomized clinical trial of an ethanol extract of Ganoderma lucidum in men with lower urinary tract symptoms2008n=88
In 88 men over 49 with lower urinary tract symptoms over 12 weeks, Ganoderma lucidum extract 6 mg/day did not significantly improve IPSS scores versus placebo.
- Effect
- No Benefit
- Duration
- 12 weeks
- Dose
- 6 mg/day
- Population
- Men with lower urinary tract symptoms
- Participants
- 88
- Ages
- ≥49
Evidence visualised
Same ratings as above, aggregated so you can see coverage and imbalance.
| Supplement | DEX | Studies | Meta-analyses | Share |
|---|---|---|---|---|
| Saw Palmetto | ★★★★★56% | 43 | 5 | 72% |
| Lycopene | ★★★★★52% | 5 | 0 | 8% |
| Milk Thistle | ★★★★★44% | 2 | 0 | 3% |
| Reishi | ★★★★★32% | 2 | 0 | 3% |
| Selenium | ★★★★★44% | 2 | 0 | 3% |
| Flaxseed | ★★★★★44% | 1 | 0 | 2% |
| Garlic | ★★★★★40% | 1 | 0 | 2% |
| Melatonin | ★★★★★44% | 1 | 0 | 2% |
| Nattokinase | ★★★★★32% | 1 | 0 | 2% |
| Panax Ginseng | ★★★★★44% | 1 | 0 | 2% |
| Quercetin | ★★★★★44% | 1 | 0 | 2% |