Nutraceutical Treatment and Prevention of Benign Prostatic Hyperplasia: A Systematic Review

Abstract

Background: Benign Prostatic Hyperplasia (BPH) is a prevalent condition among aging men, characterized by prostate enlargement leading to lower urinary tract symptoms (LUTS). Conventional treatments, including α-blockers and 5α-reductase inhibitors, are commonly used but may be associated with adverse effects. Nutraceuticals bioactive compounds derived from food sources have garnered attention as potential adjuncts or alternatives in managing BPH due to their anti-inflammatory, antioxidant, and hormonal modulatory properties. Objective: This systematic review aims to evaluate the efficacy and safety of nutraceutical interventions in the treatment and prevention of BPH, focusing on their mechanisms of action, clinical outcomes, and potential integration into therapeutic strategies. Methods: A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and Cochrane Library for studies published between 2011 and 2025. Eligible studies included randomized controlled trials, cohort studies, case control studies, and experimental models investigating nutraceuticals such as saw palmetto, beta-sitosterol, pygeum africanum, pumpkin seed oil, and other plant-based compounds in the context of BPH. Data extraction and quality assessment were performed independently by two reviewers, and findings were synthesized narratively. Results: A total of 22 studies met the inclusion criteria, encompassing preclinical and clinical investigations. Saw palmetto demonstrated modest improvements in urinary symptoms and flow measures, though results were inconsistent across studies. Beta-sitosterol and pygeum africanum showed potential in reducing prostate volume and alleviating LUTS. Other nutraceuticals, including pumpkin seed oil, rye pollen extract, and stinging nettle root, exhibited promising effects on symptom relief and quality of life. However, variability in study design, dosing regimens, and outcome measures limited the ability to draw definitive conclusions. Conclusion: Nutraceuticals present a promising avenue for the management of BPH, offering potential benefits in symptom relief and quality of life. However, the heterogeneity of existing studies necessitates further well-designed, large-scale clinical trials to establish standardized protocols and confirm the efficacy and safety of these interventions.