Dietary supplements and phytotherapeutics, sabal palm fruit extracts (local classification)
ATC code: A11JA-SAW-PALMETTO (Saw palmetto (Serenoa repens) – local code)
Brand names – drugs
Permixon, Prostagutt
Brand names – supplements
Saw Palmetto Now Foods
Supplements are not tested in clinical trials and are not registered as medications.
Saw palmetto is the extract of dwarf palm Serenoa repens fruit. Active components include free fatty acids, phytosterols, and flavonoids. Cellular models describe weak inhibition of 5α-reductase types 1 and 2, antiandrogenic effects, and anti-inflammatory activity. In humans, the effect on serum dihydrotestosterone is less pronounced than with pharmacological 5α-reductase inhibitors (finasteride, dutasteride).
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
Not recommended
Over the past 10 years saw palmetto has been marketed as a «natural finasteride» for androgenetic alopecia. Five to seven small RCTs (Prager 2002, Rossi 2012) totaling about 350 participants show modest hair density gains of 20-40 hairs/cm² at 6-12 months. Head-to-head comparisons with finasteride (Rossi 2012, n=100) show finasteride is substantially more effective. and BAD guidelines for androgenetic alopecia do not include saw palmetto.
Not recommended
Saw palmetto has been marketed for decades as a herbal remedy for benign prostatic hyperplasia. The largest Cochrane update 2012 (Tacklind, 32 RCTs, n=5666) showed no significant benefit over placebo on urinary symptoms (IPSS score), post-void residual urine volume, or maximum flow rate. STEP (n=225) and CAMUS (n=369) trials also showed no effect. AUA 2021 guidelines classify saw palmetto as «failed to demonstrate efficacy» – not recommended. EAU 2023 guidelines permit Permixon extract as an option for mild symptoms.
Opens the checker prefilled with this drug. Pick the second one from your regimen.
Contraindicated in pregnancy: antiandrogenic effect is potentially harmful to the male fetus.
Not recommended during breastfeeding.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Saw palmetto (Serenoa repens) is evaluated for the following indications with varying evidence strength: Androgenetic alopecia (evidence tier D), Benign prostatic hyperplasia (evidence tier D). See the full indication matrix with dosing and citations above on this page.
Common side effects of Saw palmetto (Serenoa repens) (≥ 1 in 100): GI discomfort, nausea, Headache, Decreased libido (rare). See the Safety section for uncommon and serious reactions.
FDA category X. Contraindicated in pregnancy: antiandrogenic effect is potentially harmful to the male fetus.
Not recommended during breastfeeding.
Saw palmetto (Serenoa repens) is contraindicated in: Pregnancy; Breastfeeding; Age under 18; Hypersensitivity; Liver disease. Full list in the Safety section.