Prostate Health and Supplements: Know the Facts

The prostate is a small, walnut-sized gland that is located below the bladder and wraps around the upper part of the urethra. Its primary function is to produce most of the fluid that comprises semen (1).

Three main conditions can occur in the prostate, including (1, 4, 5, 6):

• Acute or chronic prostatitis. This is characterized by inflammation of the prostate. In some cases, prostatitis is caused by a bacterial infection, while other times the cause is unknown.
• Benign prostatic hyperplasia (BPH). This noncancerous enlargement of the prostate often leads to lower urinary tract symptoms. It’s one of the most common conditions in older men.
• Prostate cancer. This form of cancer develops in the prostate. It’s the fourth leading cause of death in men worldwide.

While the early stages of prostate cancer may be asymptomatic, prostate problems are often accompanied by uncomfortable symptoms, such as (1, 5, 6, 7):

• painful urination
• the frequent urge to urinate
• waking up in the middle of the night to urinate
• painful ejaculation
• erectile dysfunction
• pain in the lower back, hips, or pelvic area

Supplements cannot cure or treat prostate-related issues. However, many claim to help prevent or lessen the symptoms associated with prostate problems, generally by reducing inflammation.

Summary

The prostate gland wraps around the urethra and helps produce fluid in semen. Prostatitis, BPH, and prostate cancer are the most common prostate issues and often lead to lower urinary tract symptoms.

Overall, evidence supporting the effectiveness of supplements for prostate health is weak.

However, limited studies suggest that some ingredients may help lessen some of the uncomfortable symptoms associated with prostate issues.

Still, while some ingredients may help make you more comfortable, others may be ineffective or possibly harmful to prostate health. As such, it’s important to always consult a medical provider before taking prostate supplements.

Saw palmetto

Saw palmetto (Serenoa repens) is one of the most common ingredients in prostate health supplements. It’s a type of palm that’s native to the Southeastern United States (8).

Specifically, saw palmetto berries and extracts are used to help treat urinary tract symptoms associated with BPH. While the exact mechanism is unknown, it’s thought that saw palmetto’s anti-inflammatory effects likely play a role (8, 9, 10).

One study in 165 men with BPH found that taking 160 mg of saw palmetto extract capsules 4 times per day for 12 weeks significantly improved prostate symptom scores, urinary flow rate, and quality of life scores (11).

Similarly, two older studies found improvements in urinary tract symptoms in men after taking saw palmetto supplements daily for 3–6 months (12, 13).

While promising, the research on the effectiveness of saw palmetto for symptoms of BPH in humans is limited. Additionally, study findings on its effectiveness for BPH symptoms have been mixed.

In one review of 17 studies that lasted 4–72 weeks, saw palmetto was found to be no more effective at reducing urinary tract symptoms than a placebo (14).

Furthermore, given that doses vary greatly between studies, the optimal effective dose in individuals with BPH is unclear (9).

Also, keep in mind that most studies only include individuals with diagnosed BPH or other prostate issues, so it’s unclear whether supplements would help prevent prostate-related urinary tract symptoms in healthy adults.

Saw palmetto extract has also been claimed to help protect against prostate cancer. Some evidence from test-tube and animal research suggests that treatment with saw palmetto may help block the spread and growth of prostate cancer cells (15, 16, 17).

However, these protective effects have not been demonstrated in humans.

Overall, more research is needed to confirm the potential benefits and appropriate dosage of saw palmetto extract on prostate health.

Finally, while it’s generally considered to be safe, saw palmetto may not be well tolerated by some individuals. The most commonly reported side effects include headache, dizziness, nausea, constipation, and allergic reaction (8).

Beta-sitosterol

Beta-sitosterol is a commonly occurring plant compound that belongs to a larger group of substances called phytosterols. Produced by plants, phytosterols are natural steroids that have been linked to several health benefits, including lower cholesterol (18).

Beta-sitosterol, in particular, has been shown to have potent antioxidant and anti-inflammatory properties (18, 19).

Also present in saw palmetto, beta-sitosterol has been studied for its potential to reduce inflammation associated with urinary tract symptoms of BPH and possibly protect against prostate cancer (18, 19, 20).

While limited test-tube and animal studies have shown beta-sitosterol to have potential anticancer effects, more research is needed in humans (19, 20).

One review study on the dietary intake of phytosterols, including beta-sitosterol, and cancer risk found that overall phytosterol intake was linked to a reduced risk of cancer (21).

However, it’s uncertain whether phytosterol supplements would have the same protective effect.

As for its role in BPH, one study in 91 men with symptomatic BPH compared the effect of saw palmetto oil enriched with beta-sitosterol to saw palmetto oil on its own (22).

The study observed that the enriched oil was significantly more effective at reducing the severity of urinary tract symptoms over 12 weeks, compared with saw palmetto oil on its own or a placebo (22).

Again, despite promising results, much more research is needed on the effectiveness and optimal dosage of beta-sitosterol for prostate health.

Flower pollen extracts

Chronic prostatitis is a painful condition that involves inflammation of the prostate. Common in men under the age of 50, the condition is often characterized by pelvic pain, sexual dysfunction, and painful urination and ejaculation (23, 24).

While anti-inflammatory medications like aspirin and ibuprofen are often used to help reduce inflammation and pain, there has been an increased interest in using flower pollen extracts as a natural alternative to these medications (23).

One study in 65 people with chronic prostatitis found that the daily intake of capsules containing 1 gram of pollen extract and several B vitamins for 3 months significantly improved chronic prostatitis symptoms scores (24).

Additionally, the pollen extract group was found to have significantly lower levels of interleukin 8 (IL-8), a marker of inflammation that has been found to be higher in people with chronic prostatitis (24, 25).

Similarly, a review of 10 studies observed that flower pollen extracts significantly improved quality of life and symptom scores in individuals with diagnosed chronic prostatitis (23).

In particular, the most common pollen extract blend used in these clinical trials was Graminex, a mixture of standardized extracts of ryegrass pollen (Secal cereal), corn pollen (Zea mays), and timothy pollen (Phleum pratense) (23).

The review also found flower pollen extracts to be safe without any serious reported side effects (23).

Pygeum

An herbal extract from the bark of the African cherry tree (Prunus africana), pygeum is another common ingredient found in prostate supplements.

Limited test-tube and human studies have shown that pygeum extract may reduce inflammation associated with prostatitis and protect against the growth of cancerous cells (26, 27).

An older review of 18 studies looked at the benefits of pygeum supplements on improving symptoms associated with BPH, compared with a placebo (28).

The review found that pygeum supplements significantly improved urinary flow measures. Additionally, men taking pygeum were more than twice as likely to report an improvement in overall symptoms (28).

However, it’s worth noting that the studies included in the review were small and short. They also only compared pygeum with a placebo, so it’s unclear how its effectiveness compares with standard medical interventions for BPH.

While research on the effectiveness of pygeum supplements is limited, so far it appears to be safe with minimal reported side effects (28).

Nettle root

Nettle (Urtica dioica) root is a flowering plant that’s commonly used in alternative medicine to help reduce pain and inflammation (29).

It has been shown to contain several plant compounds with potent antioxidant, anti-inflammatory, and antimicrobial effects. It’s commonly found in supplements used for urinary tract and bladder infections (29).

Limited animal and human studies have noted that it may also help reduce lower urinary tract symptoms associated with BPH (30, 31, 32, 33).

One older, 6-month study in 558 adult men with symptomatic BPH found that taking 120 mg of nettle root extract three times per day significantly improved lower urinary tract symptoms, compared with a placebo (30).

Additionally, test-tube and animal studies have suggested that nettle root may have anticancer effects. However, no research currently exists to support its ability to help prevent prostate cancer in humans (34, 35).

Despite promising results, the majority of research on nettle root extract for prostate health is limited and dated. More large-scale studies are needed to assess its ability to reduce symptoms associated with BPH, as well as its role in prostate cancer.

Pumpkin seed oil

Due to its high concentrations of anti-inflammatory compounds, pumpkin seed oil is another common ingredient in prostate supplements (36).

By reducing inflammation, pumpkin seed oil is thought to help improve urinary tract symptoms associated with BPH and chronic nonbacterial prostatitis (37, 38, 39).

In one study of 60 men with BPH, consuming 500 mg of an oil-free hydroethanolic pumpkin seed extract — corresponding to 350 mg of native pumpkin seed oil extract and equivalent to 10 grams of pumpkin seeds — significantly reduced symptoms over 12 weeks (39).

Specifically, taking the pumpkin seed extract supplement was found to reduce International Prostate Symptom Scores by an average of 30% (39).

Still, research on the effectiveness and optimal dosage of pumpkin seed oil for prostate issues is generally limited.

Vitamin D

Vitamin D is an essential nutrient that’s needed for several vital processes in your body, including immune function and bone health (40, 41).

Several observational studies have also suggested a link between low vitamin D levels and an increased risk of prostate cancer (42, 43, 44).

Still, the research on whether supplementing with vitamin D can protect against prostate cancer is inconclusive. In fact, one review even found an increased risk of prostate cancer in individuals with high circulating levels of vitamin D (45, 46, 47).

While taking vitamin D supplements may benefit men who are deficient in vitamin D or have low levels of it, supplementing with high doses is not currently recommended for prostate health.

Zinc

Zinc is an essential mineral that plays an important role in cell growth and DNA repair. It has also been found to be present in high amounts in prostate tissue (48).

Interestingly, research has found that zinc concentration in the prostate is significantly reduced in people with prostate cancer. Consequently, there’s ongoing research into zinc’s potential role in preventing or slowing the growth of prostate cancer (48).

While some studies have shown high zinc intake to be associated with a reduced risk of advanced prostate cancer, others have found it to be linked to an increased risk of developing prostate cancer (49, 50, 51, 52).

Overall, the research on zinc and the risk of prostate cancer is inconclusive. Therefore, unless zinc supplements are prescribed by a healthcare provider, they’re not recommended for prostate health.

Vitamin E

Vitamin E is another essential nutrient that’s commonly found in prostate supplements.

Some older studies have suggested that the antioxidant properties of vitamin E may protect against prostate cancer. However, more recent studies have linked vitamin E supplements to an increased risk of prostate cancer (53, 54, 55, 56).

The Selenium and Vitamin E Cancer Prevention Trial (SELECT) was a large study in which 35,533 men were randomized to one of 4 treatments —200 mcg of selenium per day, 400 IU of vitamin E per day, 400 IU of vitamin E plus 200 mcg of selenium per day, or a placebo (55).

At the end of the study, men taking the vitamin-E-only supplement had a significant, 17% greater risk of developing prostate cancer over 7 years (55).

While research on the potential link between vitamin E and prostate cancer is ongoing, vitamin E supplements are not currently recommended to decrease prostate cancer risk.

Men should avoid supplementing with vitamin E unless advised to do so by their healthcare provider.

Selenium

Selenium is another essential mineral that has attracted some controversy regarding its safety and effectiveness for prostate health.

In two large reviews, higher levels of selenium in the body were associated with a reduced risk of prostate cancer, particularly in current and former smokers (57, 58).

Yet, one study in 4,459 men found that selenium supplementation after being diagnosed with prostate cancer was associated with an increased risk of prostate cancer mortality (59).

Another study also raised concerns around selenium supplementation, as taking a daily supplement of 200 mcg of selenium was found to increase the risk of developing prostate cancer in men with high baseline selenium levels prior to taking the supplements (60).

However, it’s worth noting that selenium supplements were not found to have a significant effect — positive or negative — on prostate cancer risk in those with low baseline selenium levels (60).

Overall, more research is needed on the safety and efficacy of selenium supplements, especially in populations with high baseline selenium levels and those already diagnosed with prostate cancer.

Other common ingredients

In addition to the ones listed above, many other ingredients commonly found in prostate supplements include:

• Lycopene. Studies have found a weak link between high dietary lycopene intake from tomato products and a reduced risk of prostate cancer. Still, more research is needed to confirm this effect for lycopene supplements (61, 62, 63, 64).
• Pomegranate extract. Test-tube and animal studies show that pomegranate extract may slow the growth and spread of prostate cancer cells. Yet, studies in humans have not found a significant improvement in cancer progression (65, 66, 67).
• Green tea extract. A high intake of green tea has been linked to a reduced risk of prostate cancer. Additionally, compounds in green tea may have anticancer properties. Yet, more conclusive research is needed (68).
• Soy isoflavones. Limited animal and observational human studies have found soy isoflavones to be protective against prostate cancer, while others have found no significant effect. More high quality studies in humans are needed (69, 70)

While it’s safe to obtain these ingredients through whole foods in your diet, more research is needed to confirm whether consuming them in supplement form will have a beneficial and meaningful effect on your prostate health.

Summary

Several ingredients commonly found in prostate supplements may help ease urinary tract symptoms associated with prostate issues, while others may be ineffective or possibly harmful. Overall, more research is needed.

Numerous prostate supplements on the market claim to help support prostate health.

While some ingredients may relieve urinary tract symptoms that are associated with prostate issues, the research on their effectiveness is generally limited.

Furthermore, as some supplements may contain ingredients like vitamin E or zinc, which could be potentially harmful to prostate health, it’s important to pay close attention to what’s in the product you’re buying.

When purchasing supplements, always be sure to choose products from a reputable company. To ensure quality and accuracy, look for products that have been third-party certified by organizations like NSF International or United States Pharmacopeia (USP).

Finally, as supplements cannot treat or cure prostate issues, it’s important to discuss any concerns that you have about your prostate health with a medical provider. In particular, any signs of prostate cancer should be addressed with your doctor as soon as possible.