If you Google prostate health, the first page that pops up lists a long line of prostate supplements. Many men take these supplements to reduce their risk of prostate cancer or to relieve symptoms of benign prostatic hyperplasia (BPH), a condition of aging that can tarnish men’s golden years.

BPH is an overgrowth of prostate tissue. As the prostate increases in size, it obstructs the flow of urine out of the bladder, causing urination to become more frequent and incomplete bladder emptying. Waking up to urinate every few hours at night, having a very weak or intermittent urine stream, feeling an urgent need to urinate, and not feeling relieved after urinating are all common symptoms. By age 60, about 60 percent of men will have BPH. After age 70, the number is 80 to 90 percent.

Prostate cancer causes the same symptoms, but may also cause blood in the urine or semen, weight loss, bone pain, and erectile dysfunction. Prostate cancer is the most common cancer in men other than skin cancer, and only lung cancer is more deadly. It’s not surprising that prostate health supplements are a booming business.

Research findings

Prostate health supplements may have active ingredients that include herbs, vitamins, minerals, or plant chemicals. Many of these have been studied in clinical trials, and, although there has been some support, no supplement has been approved or recommended by any expert source like the U.S. Food and Drug Administration, the American Cancer Society, or the American Urological Association.

Another concern is safety. A review of 27 prostate health supplements, published in Urology, identified a total of 58 active ingredients. Most of the supplements had about eight. Only 17 supplements had at least one ingredient with some research support, but all of the supplements had ingredients that were not supported by research or had no research at all. The review concluded that prostate health supplements do not have adequate evidence to support their effectiveness or safety.

Promising Supplements

There are lots of prostate health supplement reviews online from reliable sources like Harvard University, the Cleveland Clinic, the National Institutes of Health, and the Center for Complementary and Alternative Health. These sources suggest some supplements that may have benefits and others to avoid:

  • Saw palmetto, an extract from a shrub, is probably the most commonly used and studied supplement. Some studies have found that it may shrink an enlarged prostate and reduce symptoms of poor urine flow, but the largest review of studies, involving over 5,000 men, found that the benefits were not better than a placebo. On the plus side, this supplement appears to be safe and does not interfere with other medications. Mild side effects may include indigestion or headache.
  • Pygeum africanum (African plum tree) extract has been used in traditional African medicine to reduce inflammation. Although it has not been studied as much as saw palmetto, a review of studies on this supplement in 2015 and in 2012 both found some benefits for improving symptoms of BPH, although the studies were small and short. Other than occasional and mild side effects like headache, nausea, diarrhea, or constipation, this supplement seems to be safe.
  • Urtica dioica (stinging nettle) has shown benefits in small trials. The supplement is safe, although it may produce mild indigestion and may reduce the effects of iron supplement treatment.
  • Beta-sitosterol. A 2020 study found that it may improve BPH symptoms when combined in a supplement with saw palmetto.

Before trying any supplement, check the ingredients label and look for ingredients with some research support. Avoid supplements that have many ingredients or ones that have more risks than benefits. If in doubt, ask your health-care provider.

What works

There is plenty of solid research accumulated over many years to support effective medical and surgical treatments for both BPH and prostate cancer. The survival rate for prostate cancer treated in an early stage is excellent. If you have symptoms that suggest BPH or prostate cancer, don’t try to treat them on your own with a supplement: Talk to your physician about tried-and-true treatments. Supplements may have a place in an overall care plan, but they do not replace medical advice.

Risky Supplements

Some supplements may have more risks than benefits:

  • Lycopene. There are too few trials, and they are not of sufficient size or quality to make a judgment about lycopene for prostate health, but lycopene may cause some serious side effects, including low blood pressure and an increased risk for bleeding.
  • Zinc is common in prostate cells and may play a role in prostate health, but zinc supplements have not shown any benefits, and some evidence suggests that too much zinc may actually increase the risk of prostate cancer. Zinc may also interfere with several medications.
  • Selenium has some evidence for reducing prostate cancer risk but also evidence that it increases the risk of death in men who get prostate cancer.
  • Vitamin E supplements have no benefits for prostate health and may increase the risk of prostate cancer.

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