Saw palmetto is an herbal extract that’s found in many male enhancement pills and testosterone boosters. But it’s a great supplement on its own, with evidence supporting its use for prostate health, hair loss, and sexual wellness in men.
Saw palmetto primarily acts on testosterone, slowing the rate at which it’s converted to dihydrotestosterone, or DHT. DHT contributes to prostate enlargement and hair loss, but doesn’t help with any of the good stuff regular testosterone is useful for (namely, muscle strength, shedding fat, and sexual performance).
Most of the potential benefits of saw palmetto can be traced to this DHT/testosterone mechanism, which is why you’ll find it used for health benefits that are related to testosterone and its derivatives. It’s also why there’s such a wide range of men’s health applications for saw palmetto, which we detail below.
Research
Saw palmetto enefits
1. Saw palmetto can be used to treat an enlarged prostate
One health problem that many older men face is a condition called benign prostate hyperplasia.
This condition is characterized by an enlarged prostate, which causes problems with urination, particularly at night. Traditionally, an enlarged prostate is treated using a prescription medication called finasteride, though this can have negative side effects.
Some men turn to saw palmetto instead to treat an enlarged prostate, and there is some clinical research supporting their choice.
A systematic review article published in 1998 in the Journal of the American Medical Association pooled the results of 18 different studies, which included a total of almost 3000 different men with an enlarged prostate (1).
The review found that saw palmetto supplements were significantly more effective than a placebo, and even compared well to finasteride—some studies found superior results with saw palmetto than with finasteride.
2. Saw palmetto appears to cause fewer sexual side effects than finasteride
One of the frustrating parts of using the prescription medication finasteride, either for hair loss or for prostate health, is that it has the tendency to cause erectile dysfunction.
While fairly rare, somewhere around five percent of men taking finasteride are affected by erectile dysfunction.
According to the same systematic review of saw palmetto for treating an enlarged prostate, the rate of erectile dysfunction among men taking saw palmetto is far lower—only 1.1% of men taking saw palmetto across all the studies reported erectile dysfunction, compared to 4.9% of men taking finasteride (2).
3. Saw palmetto can be used to treat sexual dysfunction
This decrease in the odds of erectile dysfunction is probably related to why some men also use saw palmetto specifically for treating sexual problem.
One study published in the journal Phytotherapy Research demonstrated the utility of using saw palmetto to treat sexual dysfunction in a group of 82 elderly men (3).
The eight-week long study quantified sexual dysfunction using a standardized survey at the start and at the end of the study. The researchers found that the men’s score on the sexual dysfunction inventory decreased by over 50%, indicating a significant improvement in their sexual function.
They interpreted this as evidence that the saw palmetto supplement can effectively be used to treat sexual dysfunction in men, and encouraged future research on the subject.
While this study did not have a control group, and did not “blind” the participants’ knowledge of which treatment they received, the results are still promising for the prospect of using saw palmetto for better sexual wellness in men.
Because of the results of studies like this, it should be no surprise that many male enhancement pills contain saw palmetto as one of their primary ingredients.
4. Saw palmetto can help reverse hair loss
The interest in using saw palmetto for treating hair loss came out of its use in treating benign prostate hyperplasia.
The standard drug that treats an enlarged prostate (finasteride) is also commonly used to treat male pattern balding, and is approved by the FDA for that purpose.
Could saw palmetto be used in the same manner? Some research suggests that this is the case. A study published in the Journal of Alternative and Complementary Medicine used a double-blind placebo-controlled trial to explore saw palmetto’s use in treating hair loss in men (4).
The trial involved men with mild to moderate male-pattern balding, and were randomly assigned to receive either a saw palmetto supplement or a placebo.
Clinical staff at the hair loss center running the study evaluated the men’s baldness at the start and end of the study, but did not know which group the men had been assigned to.
The researchers found that 60% of the men had responded to the saw palmetto supplement, according to the subjective clinical assessment, indicating that saw palmetto could be useful for treating baldness as well as sexual and prostate health.
Saw palmetto side effects
Saw palmetto can cause low libido, gastrointestinal discomfort, and headaches, among other side effects. According to one study published in the Annals of Internal Medicine, the side effects of saw palmetto include constipation, decreased libido, diarrhea, headache, hypertension, nausea, and urine retention (5).
Saw palmetto’s side effects are rare. According to this same study, these side effects are quite rare, and in most studies, very few people drop out because of side effects.
Saw palmetto is not known to interact with testosterone therapy. The same study noted that, while it’s theoretically possible for saw palmetto to interact with medications that affect hormone levels, like testosterone, there are no reports of this actually occurring.
Saw palmetto is not likely to interact with most prescription drugs. A study published in 2004 in the journal Clinical Pharmacology and Therapeutics examined whether saw palmetto has the potential to interact with prescription medications.
They studied its effect on cytochrome P450 enzymes, which are know to be linked to drug-supplement interactions (6).
The researchers found no evidence that saw palmetto caused any biological interaction with these enzymes, and while this does not guarantee safety, it does corroborate the lack of reports of adverse effects linked to saw palmetto and prescription medications interacting.
Saw palmetto should not be taken by women or children. Saw palmetto should not be taken by children, especially female children, as it has been shown to cause some adverse side effects.
Pregnant women and women looking to conceive should also avoid saw palmetto as it may negatively affect the development of the fetus.
Saw palmetto dosage
Aim for around 320 mg per day of saw palmetto extract. By far the most common dose used in clinical research is a 320 mg daily dosage of saw palmetto extract, though specific studies differ when it comes to the precise content of the fatty acids that are thought to contain the active ingredients responsible for the health benefits.
As long as your saw palmetto supplement has at least 320 mg of raw plant material that’s standardized to contain around 50% fatty acids or more, and as long as a substantial portion of this is saw palmetto berry extract, you are likely getting a dosage in the effective range.
Saw palmetto benefit FAQs
Q: What does saw palmetto consist of?
A: Saw palmetto, in its purified extract form, mostly consists of fatty acids and sterols. It also consists of carotenoids, certain sugars, and astringents such as tannin.
Q: Is saw palmetto recommended for all age groups?
A: Saw palmetto is not recommended for all age groups. It is not advisable to administer children who haven’t hit puberty or are in the stage of puberty with saw palmetto. Due to its actions on the sex hormones of the body, saw palmetto can lead to abnormal metabolism of testosterone and estrogen.
Moreover, pregnant women should also avoid the consumption of the herb as it may affect fetal development. This herb should further be avoided by women who are under birth control pills as it may cause the pills to function inefficiently.
Q: How does saw palmetto work in the body?
A: There have been numerous attempts to study the mechanisms of function of saw palmetto. Dihydrotestosterone (DHT) is formed in the body due to the action of 5-alpha-reductase enzyme on testosterone.
Saw palmetto has compounds that inhibit the functions of this enzyme, thus preventing the formation of DHT. The herb is also said to have anti-androgenic and anti-inflammatory effects that are responsible for the treatment of prostate enlargement and prostate cancer in men (7).
Q: Is saw palmetto banned in some countries?
A: Although not entirely banned, the use of saw palmetto is regulated in most countries. For example, Denmark banned the consumption of the plant or its products for recreational use, while allowing the sale and consumption as a medicinal drug.
The Food and Drug Administration (the Federal agency that regulates food and drug safety), does not approve the herb as a medicine due to the lack of strong scientific evidence of its efficiency. However, it is still legal to use the plant in most countries.
Q: Why should you take saw palmetto?
A: Saw palmetto offers effective measures in decreasing prostatic size and dealing with an enlarged prostate, which is also referred to as Benign Prostate Hyperplasia, aka BPH in the medical industry. In addition, it can be helpful in increasing your sperm count, improving your sex drive, handling migraine problems, and more.
Q: Can I get acne issues from using saw palmetto?
A: There is no clear-cut relationship established between the effects of Saw Palmetto and skin conditions. There have been studies that suggest a reduction in sebum levels, the oil secretions that lead to acne.
This could essentially mean that Saw Palmetto could be a potential cure for acne. However, it must also be noted that there have been reports of people using the extracts and having their skin conditions worsened (8).
Q: What is the right dosage for saw palmetto?
A: A daily dosage of 160-320g of saw palmetto, depending on the severity of the condition and purpose of use, has proven to be most effective. Doses, smaller than this, have minimal or no effect on the body.
Doses higher than recommended may induce variations in hormone levels along with other minor side effects. Also, most tests conducted are on adult men, and so are the recommended doses. Hence, it is always a good idea to consult your doctor for appropriate dosing for women (9).
Q: Is it safe for pregnant women to use saw palmetto?
A: No. The consumption of saw palmetto can be dangerous to both the mother and the fetus during pregnancy.
Since it reacts with the sex hormones, there is a possible chance of causing hormonal imbalance in the mother, and impaired growth of the fetal genitalia.
Q: Can saw palmetto enhance breast size?
A: Saw palmetto has been regarded as a breast enlargement herb in the traditional medicine community for centuries.
But there are no scientific reports that support this, as studies have shown that these herbs lack phytoestrogens, the plant-derived estrogenic compounds necessary to enhance the breast size.
It is still not clear why the plant was popularized for this purpose though (10).
Related: Our best saw palmetto picks
Summary
Saw palmetto is an all-natural supplement that shows great promise for treating a wide range of men’s health issues.
The strongest evidence supports its use to treat prostate enlargement without the same level of side effects as other methods of treating an enlarged prostate, but there is also promising evidence for saw palmetto’s ability to be used to improve sexual function and decrease or even reverse hair loss.
