The most popular agent has been an extract of Serenoa repens (saw palmetto berry) The Natural Prostate Cure. Numerous clinical trials have been performed and have indicated its efficacy and potential adverse side effects, which have been few.
Each year just in USA alone, about 40 000 men have their cancerous prostates surgically removed or radiated, often within just hours of the diagnosis. This may eliminate an immediate problem, BUT in most cases it will also result in reduced quality of life later.
There are risks connected with the surgery: bleeding and need for transfusion, injury to nearby tissues and nerves, blood clots in the legs that can travel to the lungs, wound infection.
Lower urinary tract symptoms (LUTS) are frequently associated with benign prostatic hyperplasia (BPH), a non-malignant enlargement of the prostate that occurs predominantly in men over age 60 years. Medical therapies, to include 5-reductase inhibitors, blockers and phytotherapeutic agents offer an alternative to surgery and are becoming increasing popular.
The lipido-sterolic extract of Serenoa repens, Permixon, is the most extensively prescribed and studied phytotherapeutic agent approved in Europe as a medical treatment for symptomatic BPH. The clinical efficacy of Permixon in the medical management of BPH has been clinically demonstrated in a placebo-controlled trial. Permixon 320 mg per day was shown to have an equivalent efficacy to finasteride 5 mg over 6 months and to tamsulosin 0.4 mg over 12 months to relieve LUTS associated with BPH. Permixon has anti-androgenic, anti-proliferative and anti-inflammatory activities.
Dr. Frans Debruyne and colleagues report their comparative trial of Permixon and Tamsulosin in patients with severe BPH symptoms in the June 2004 issue of European Urology.
This study of a subset analysis from the PERMAL BPH trial suggests that patients with more severe symptoms of LUTS do well with either Permixon or tamsulosin. Both are well tolerated. A limitation of the trial is the fact that the decrease during the run-in period of the trial was not taken into consideration in this PERMAL study. Furthermore, this was a subset analysis and lacks some of the more rigorous methodologic aspects of larger studies. Otherwise it suggests that Permixon is an alternative to tamsulosin in the treatment of patients with BPH.
PermixonŽ is the original liposterolic extract of saw palmetto berries (Serenoa repens) created by the pharmaceutical division of Pierre Fabre in France. The hexane extract is comprised of free (90%) and esterified (7%) fatty acids, sterols, polyprenic compounds, and flavonoids. This particular extract was the template for current liposterolic extracts manufactured using either ethanol or CO2 extraction. As is the case with all liposterolic extracts, the therapeutic dose is 320 mg daily. Therapeutic results should be expected in six to eight weeks but it is important to remember that the new rule of thumb for determining clinical efficacy with BPH is six months or longer. As has been reported in previous reviews on saw palmetto, the liposterolic extract is largely devoid of the side effects noted for prescription BPH drugs.
