Skip to main content
Log in

Randomized trial of a combination of natural products (cernitin, saw palmetto, B-sitosterol, vitamin E) on symptoms of benign prostatic hyperplasia (BPH)

  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Because benign prostatic hyperplasia (BPH) is relatively common, it is important to discover safe and effective means to treat this often debilitating perturbation. Accordingly, we examined the effectiveness of a combination of natural products (cernitin, saw palmetto, B-sitosterol, vitamin E) in treating symptoms of BPH. We undertook a randomized, placebo-controlled, double-blind study. Patients were enrolled from 3 urological practices in the USA. 144 subjects were randomized for study. 17 subjects eventually withdrew, leaving 70 patients in the test group and 57 in the placebo group to complete the study. Inclusion criteria consisted of a diagnosis of BPH, no evidence of cancer, and a maximal urinary flow rate between 5 and 15 ml/second. Patients received either placebo or the combined natural products for 3 months. Evaluations were performed via the American Urological Association (AUA) Symptom Index score, urinary flow rate, PSA measurement, and residual bladder volume. Nocturia showed a markedly significant decrease in severity in patients receiving the combined natural products compared to those taking placebo (p < 0.001). Daytime frequency was also lessened significantly (p < 0.04). When the average individual total AUA Symptom Index score in the test group was compared to that in the placebo group at the end of the study, the difference proved highly significant (p < 0.014). PSA measurements, maximal and average urinary flow rates, and residual volumes showed no statistically significant differences. When taken for 3 months, a combination of natural products (cernitin, saw palmetto, B-sitosterol, vitamin E) compared to placebo can significantly lessen nocturia and frequency and diminish overall symptomatology of BPH as indicated by an improvement in the total AUA Symptom Index score. The combination of natural products caused no significant adverse side effects.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Preuss HG, Adderly B. The Prostate Cure. New York, NY: Crown Publishing, 1998; pp 1–106.

    Google Scholar 

  2. Ebeling L. The therapeutic results of defined pollen extract in patients with chronic prostatitis. In: Schmiedt E, Alken JE, Bauer HW (eds), Therapy of Prostatitis. Muchen: Zuckschwerdt Verlag, 1986; pp 154–160.

    Google Scholar 

  3. Becker H, Ebeling L. Conservative treatment of benign prostatic hyperplasia (BPH) with Cernilton N. Results of a placebo-controlled double-blind study. Urologe B 1988; 28: 301–306.

    Google Scholar 

  4. Becker H, Ebeling L. Phytotherapy of BPH with Cernilton N. Results of a controlled clinical study. Urologe B 1991; 31: 113–116.

    Google Scholar 

  5. Buck AC, Cox R, Rees RWM, Ebeling L. Treatment of chronic prostatitis and prostadynia with pollen extract. Br J Urol 1989; 64: 496–499.

    Google Scholar 

  6. Buck AC, Cox R, Rees RWM, Ebeling L, John A. Treatment of outflow tract obstruction due to benign prostatic hyperplasia with the pollen extract, Cernilton. A double-blind, placebocontrolled study. Br J Urol 1990; 66: 398–404.

    Google Scholar 

  7. Ohkoshi M, Kawamura N, Nagakubo I. Evaluation of cernitin in chronic prostatitis. Japanese J Urol 1967; 21: 73–85.

    Google Scholar 

  8. Takeuchi H, Yamauchi AI, Ueda T, Hiraga S. Quantitative evaluation on the effectiveness of Cernilton on benign prostatic hypertrophy. Hinyoki Kiyo 1981; 27: 326–327.

    Google Scholar 

  9. Brauer H. The treatment of benign prostatic hyperplasia with phytopharmacia: a comparative study of Cernilton and beta sitosterol. Therapeiwoche 1986; 36: 1686–1696.

    Google Scholar 

  10. Rugendorff EW, Weidner W, Ebeling L, Buck C. Results of treatment with pollen extract (cernilton N) in prostadynia and chronic prostatitis. Br J Urol 1993; 71: 433–438.

    Google Scholar 

  11. Yasumoto R, Kawanishi H, Tsujino T, Tsujita M, Nishisaki N, Horii A, Kishimoto T. Clinical evaluation of long-term treatment using cernitin pollen extract in patients with benign prostatic hyperplasia. Clinical Therapeutics 1995; 17: 82–87.

    Google Scholar 

  12. Rhodes L, Primka RL, Berman C, Vergu HG, Gabriel M, Pierre-Malice M, Gibelin B. Comparison of finasteride (Proscar), a 5? reductase inhibitor, and various commercial plant extracts in in vitro and in vivo 5? reductase inhibition. The Prostate 1993; 22: 43–51.

    Google Scholar 

  13. Sultan C, Terraza A, Divillier C. Inhibition of androgen metabolism and binding by a liposterolic extract of Serenoa repens B in human foreskin fibroblasts. J Steroid Biochem 1984; 20: 515–521.

    Google Scholar 

  14. Carraro JC, Raynaud J, Koch G, Chisolm GD, DiSilverio F, Teillae P, Da Silva FC, Cauquit J, Chopin DK, Hamdy M, Hanus M, Hauri D, Kalinteris A, Marencak J, Perier A, Perrin P. Comparison of phytotherapy (Permixon) with finasteride in the treatment of benign prostate hyperplasia: a randomized international study of 1,098 patients. The Prostate 1996; 29: 231–240.

    Google Scholar 

  15. Posker GL, Brogden RN. Serenoa repens (Permixon). A review of its pharmacology and therapeutic efficacy in benign prostatic hyperplasia. Drug and Aging 1996; 379–395.

  16. Denis LJ. Editorial review of “Comparison of phytotherapy (Permixon) with finasteride in the treatment of benign prostate hyperplasia: a randomized international study of 1,098 patients”. The Prostate 1996; 29: 241–242.

    Google Scholar 

  17. Braeckman J. The extract of Serenoa repens in the treatment of benign prostatic hyperplasia: a multicenter open study. Curr Therap Res 1994; 56: 776–785.

    Google Scholar 

  18. Champault G, Bonnard AM, Cauquil J, Patel JC. Medical treatment of prostatic adenoma. Controlled trial PA 109 vs placebo in 110 patients. Ann Urol 1984; 18: 407–410.

    Google Scholar 

  19. Klippel KF, Hiltl DM, Schipp B. A multicenter, placebocontrolled, double-blind clinical trial of B-sitosterol (Phytosterol) for the treatment of benign prostatic hyperplasia. Br J Urol 1997; 80: 427–432.

    Google Scholar 

  20. Berges RR, Windeler J, Trampisch HJ, The B Sitosterol Study Group: Randomized, placebo-controlled clinical trial of Bsitosterol in patients with benign prostatic hyperplasia. The Lancet 1995; 345: 1529–1532.

    Google Scholar 

  21. Vahlensieck W, Rutishauser G (Eds). Benign Prostatic Diseases. Stuttgart-New York: Georg Thieme Verlag, 1992; pp 1–207.

    Google Scholar 

  22. McConnell JD, Wilson JD, George FW, Geller G, Walsh PC, Ewing LL, Isaacs J, Soner, E. An inhibitor of 5-alphareductase, MK-906 suppresses prostatic dihydrotestosterone in men with benign prostatic hyperplasia. J Urol 1989; 141: 280 (abstract).

    Google Scholar 

  23. Gormley GJE, Stoner E, Breuskewitz RC, Imperato-McGinley J, Walsh PC, McConnell JD, Andrioli GL. The effect of finasteride in men with benign prostatic hyperplasia. N Eng J Med 1992; 327: 1185–1191.

    Google Scholar 

  24. Leper H. Role of alpha-adrenergic blockers in the treatment of benign prostatic hyperplasia. Prostate 1990; 3 (suppl): 75–84.

    Google Scholar 

  25. Consumers Union. Complete Drug Reference. Yonkers NY: Consumers Union, 1997; p 1540.

    Google Scholar 

  26. Loschen G, Ebeling L. Hemmung der arachindonsaurekaskade durch einen extrakt aus roggenpollen. Arzneimittelforschung 1991; 41: 162–167.

    Google Scholar 

  27. Breu W, Hagenlocher M, Redl K, Tittel G, Stadler F, Watner H. Anti-inflammatory activity of sabel fruit extracts prepared with supercritical carbon dioxide. Arzneim Forsch Drug Research 1992; 42: 547–551.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Preuss, H.G., Marcusen, C., Regan, J. et al. Randomized trial of a combination of natural products (cernitin, saw palmetto, B-sitosterol, vitamin E) on symptoms of benign prostatic hyperplasia (BPH). Int Urol Nephrol 33, 217–225 (2001). https://doi.org/10.1023/A:1015227604041

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1015227604041

Navigation