Phytotherapy. In the United
States, phytotherapy is widely used
for the management of LUTS suggestive
of BPH. Its use in Europe is even
more common.1,45 However, few thorough
scientific studies of medicinal
botanicals have been conducted
because of difficulties such as a lack
of standardized preparations.32
Beta-sitosterol is believed to be the
active component in many of the
botanicals used to manage LUTS. The
two most frequently used botanicals
are extracts from the saw palmetto
berry and African plum tree bark.
Both have shown improvement in
urinary symptoms and urinary flow
rates comparable to that achieved
with finasteride, but without any readily
apparent adverse effects.1 A study
by Berges and colleagues showed a
significant improvement in symptoms
and urinary flow parameters in
subjects receiving -sitosterol 20 mg
three times per day.46 The mechanism
of action of -sitosterol is still
unknown.