Supplements and BPH

Beta-Sitosterol (BST)

Beta-sitosterol (BST) is a naturally occurring plant compound found in foods like cereals, fruits, nuts, vegetables, and vegetable oils. It’s been studied for decades for various health benefits, including cholesterol-lowering, anti-inflammatory, and even prostate-supportive effects. Because of its long history of use, BST has “Generally Recognized as Safe” (GRAS) status in the U.S.

Some research suggests BST may help improve urinary symptoms related to BPH. For example, a large placebo-controlled trial showed that men taking BST experienced improved urine flow and reduced post-void residual volume (amount of urine left in the bladder after urination), both common issues with BPH.¹ Experimental research also points to BST for its potential to reduce prostate cell overgrowth and inflammation, though these findings are primarily in lab and animal studies.¹

Caution and considerations: Despite promising results, BST is not without risks. It can interact with certain medicines, so it’s best to check with a healthcare provider before use. Additionally, studies often use specific doses and formulations, which means that over-the-counter supplements may not deliver the same effects as those shown in research.

Pumpkin Seed Extract

Pumpkin seeds are packed with protein, healthy fats, vitamins, minerals, and phytonutrients. They also contain zinc and plant sterols, which are thought to support prostate health and may help inhibit 5α‑reductase, an enzyme associated with prostate growth.

In clinical studies, men taking pumpkin seed extract experienced improved urine flow and decreased post-void residual volume. A 12-week trial demonstrated a 30% reduction in symptom scores, with improvements in quality of life and nocturia (frequent urination at night); longer-term studies spanning 12 to 24 months also reported sustained symptom relief without adverse effects.¹ Two randomized placebo‑controlled trials found contradictory individual results, but overall a pooled benefit in symptom improvement for pumpkin seed extract versus placebo.¹

Caution and considerations: Pumpkin seed extracts are generally safe, but mild gastrointestinal complaints (indigestion, diarrhea) and possible diuretic effects have been reported.² They may not be suitable for men on certain medications, including anticoagulants, due to mild diuretic properties. As with most natural products, quality, formulation, and dose vary widely, and the effects observed in clinical trials might not match those of over‑the‑counter supplements.

Saw Palmetto

Saw palmetto (Serenoa repens) is a small palm native to the southeastern United States, and has been used for centuries, originally by Native Americans, to support urinary and reproductive health. Modern interest in saw palmetto supplements grew in the 1990s, particularly as a natural alternative to pharmaceutical treatments for BPH. In the U.S., it was the 13th top-selling herbal dietary supplement in 2020.³

Claimed symptom benefits of saw palmetto include the regulation of hormones associated with prostate growth and a reduction of inflammation. Some studies suggest saw palmetto may improve urinary symptoms such as nocturia and restricted urine flow. Other studies have found little or no improvement compared with placebo, and some suggest any benefits may take months or even a year to appear.²¯³

Caution and considerations: Saw palmetto is generally considered safe for most people, with minor digestive upset or headaches reported. However, quality and extract type are not standardized across brand formulations, and long-term efficacy is uncertain.

Lycopene

Lycopene is a naturally occurring carotenoid found in red, pink, and orange fruits and vegetables, most notably tomatoes. It is known for its antioxidant properties that protect cells from oxidative damage, and has been studied extensively for potential benefits in prostate health and urinary function.

Lycopene may reduce inflammation and influence hormone signaling and growth factors involved in prostate enlargement.³ Research suggests it can modulate insulin-like growth factor 1 (IGF-1) and reduce the activity of pro-inflammatory cytokines, helping to slow prostate cell overgrowth and improve lower urinary tract symptoms in some men.³

Because lycopene is fat-soluble, its absorption improves when consumed with healthy fats or after cooking, and pureed tomato products, such as sauces or pastes, provide higher bioavailability than raw tomatoes.

Whole-food forms of lycopene may also offer additional benefits over isolated supplements, as the natural mix of carotenoids, flavonoids, and other phytonutrients can work synergistically to support antioxidant and anti-inflammatory activity.

Caution and considerations: Most people tolerate lycopene without any problems. High intake from supplements or tomato-based foods can sometimes cause digestive upset, orange skin discoloration (lycopenodermia), or increased reflux in sensitive individuals. For people with tomato allergies or kidney issues, it’s best to exercise caution with lycopene supplements and consult their physician before adding them to their diet.

Stinging Nettle

Stinging nettle is a perennial herb native to Europe, Asia, North Africa, and North America, and has been historically used for food, textiles, and medicinal purposes. The root extract, in particular, is widely recognized for its role in supporting prostate health and managing urinary symptoms associated with BPH.³

Stinging nettle root contains a variety of bioactive compounds, including sterols, flavonoids, polysaccharides, lectins, and phenolic acids, which collectively exhibit antioxidant, anti-inflammatory, and anti-proliferative effects.⁴ These compounds can reduce oxidative stress, inhibit inflammatory signaling pathways, and interfere with androgen binding to prostate tissue, helping to slow prostate enlargement and improve urinary flow.

In laboratory studies, nettle extracts also demonstrated antibacterial and antiviral activity, highlighting additional systemic benefits.⁵

Clinical studies support the use of stinging nettle for mild to moderate BPH – a large trial with 558 men taking 120 mg of nettle root extract daily for six months showed significant improvements in urinary symptoms.⁵

Caution and considerations: Stinging nettle doesn’t typically cause issues; however, mild digestive upset is the most commonly reported effect, and though rare, allergic reactions, including urticaria (chronic itching) or edema, can occur.⁶ Nettle contains tannins that may reduce the absorption of iron supplements, so spacing administration by at least two hours is recommended. Individuals with allergies or chronic medical conditions should consult their healthcare provider before taking nettle supplements.

Green Tea

Green tea has a long history of use as both a beverage and a medicinal remedy. It’s rich in polyphenols (natural plant compounds), particularly catechins that are credited with antioxidant, anti-inflammatory, anti-proliferative, and hormone-modulating effects that may support prostate health and improve urinary symptoms associated with BPH.⁷

Human clinical studies on the effects of green tea catechins on BPH are limited, with most conducted in laboratories or on animals. However, a small randomized, double-blind trial using a green and black tea blend (500–1000 mg daily for 12 weeks) in men with moderate-to-severe LUTS (lower urinary tract symptoms) and/or BPH showed improvements in urinary symptoms, maximum urine flow, post-void residual volume, and overall quality of life, with no reported adverse effects.⁷

Larger clinical trials are ongoing, including a Phase II study evaluating standardized green tea catechins (Sunphenon® 90D, 405 mg daily) over 24 months to support prostate health in men under active surveillance.⁸

Caution and considerations: For most, green tea is easy on the system, whether consumed as a beverage or a supplement. However, green tea is known to interact with some medications, particularly blood thinners (like warfarin), heart medications (including some beta-blockers), and iron supplements, so check with your healthcare provider before starting green tea supplements.

While some supplements show promise for easing urinary symptoms or supporting prostate health, results are far from universal. Research findings vary, product quality differs, and what works for one person may not help another – the evidence is still evolving.

Because supplements can also interact with medications or health conditions, it’s best to review any new regimen with a qualified healthcare provider, especially before combining products or replacing prescribed treatments. No matter how convincing a study or online claim may sound, talk with a trusted healthcare professional.

References:

1. Stewart, K. L., & Lephart, E. D. (2023). Overview of BPH: Symptom Relief with Dietary Polyphenols, Vitamins and Phytochemicals by Nutraceutical Supplements with Implications to the Prostate Microbiome. International journal of molecular sciences, 24(6), 5486. https://doi.org/10.3390/ijms24065486.
2. Csikós, E., Horváth, A., Ács, K., Papp, N., Balázs, V. L., Dolenc, M. S., Kenda, M., Kočevar Glavač, N., Nagy, M., Protti, M., Mercolini, L., Horváth, G., Farkas, Á., & On Behalf Of The Oemonom (2021). Treatment of Benign Prostatic Hyperplasia by Natural Drugs. Molecules (Basel, Switzerland), 26(23), 7141. https://doi.org/10.3390/molecules26237141.
3. Stewart, K. L., & Lephart, E. D. (2023). Overview of BPH: Symptom Relief with Dietary Polyphenols, Vitamins and Phytochemicals by Nutraceutical Supplements with Implications to the Prostate Microbiome. International journal of molecular sciences, 24(6), 5486. https://doi.org/10.3390/ijms24065486.
4. Csikós, E., Horváth, A., Ács, K., Papp, N., Balázs, V. L., Dolenc, M. S., Kenda, M., Kočevar Glavač, N., Nagy, M., Protti, M., Mercolini, L., Horváth, G., Farkas, Á., & On Behalf Of The Oemonom (2021). Treatment of Benign Prostatic Hyperplasia by Natural Drugs. Molecules (Basel, Switzerland), 26(23), 7141. https://doi.org/10.3390/molecules26237141.
5. Stewart, K. L., & Lephart, E. D. (2023). Overview of BPH: Symptom Relief with Dietary Polyphenols, Vitamins and Phytochemicals by Nutraceutical Supplements with Implications to the Prostate Microbiome. International journal of molecular sciences, 24(6), 5486. https://doi.org/10.3390/ijms24065486.
6. Csikós, E., Horváth, A., Ács, K., Papp, N., Balázs, V. L., Dolenc, M. S., Kenda, M., Kočevar Glavač, N., Nagy, M., Protti, M., Mercolini, L., Horváth, G., Farkas, Á., & On Behalf Of The Oemonom (2021). Treatment of Benign Prostatic Hyperplasia by Natural Drugs. Molecules (Basel, Switzerland), 26(23), 7141. https://doi.org/10.3390/molecules26237141.
7. Stewart, K. L., & Lephart, E. D. (2023). Overview of BPH: Symptom Relief with Dietary Polyphenols, Vitamins and Phytochemicals by Nutraceutical Supplements with Implications to the Prostate Microbiome. International journal of molecular sciences, 24(6), 5486. https://doi.org/10.3390/ijms24065486.
8. Purdue University Center for Research Innovation in Biotechnology. (2025, October 3). Trial | NCT04300855. Purdue.edu. https://cdek.pharmacy.purdue.edu/trial/NCT04300855/.