Benign prostatic hyperplasia
Adjunct
Nettle root is an over-the-counter herbal remedy used for BPH in Germany for decades. The double-blind RCT by Sokeland (BJU Int 2000) in 543 men compared a combination of nettle root and saw palmetto extract with finasteride 5 mg/day: at 48 weeks IPSS and urinary flow improvements were comparable in both groups, with better tolerability of the combination, but the study lacked placebo control and was sponsored. The Safarinejad RCT (2005) in 620 men using nettle root alone 120 mg twice daily for 6 months showed modest IPSS reduction (-3.4 vs -0.8 with placebo) and improved quality of life. HMPC 2012 recognises nettle root as a traditional-use medicinal product for BPH symptoms, based on 30 years of use rather than RCTs. EAU 2024, AUA 2023 and AEU 2022 recommend alpha-blockers and 5-alpha-reductase inhibitors for moderate-severe BPH; herbal products are mentioned as an option for mild symptoms or as add-on. If nettle root is being considered, discuss with a urologist and have a PSA test. Check the label for Urtica dioica radix (not folium).
Sources
- EMA HMPC: Community herbal monograph on Urtica dioica L., radix (2010)
- Phytomedicine: Stinging nettle root extract (Bazoton-uno) in long-term treatment of benign prostatic syndrome: a randomized, double-blind, placebo-controlled multicenter study (2004)
- BJU Int (Sokeland): Combined sabal and urtica extract compared with finasteride in men with benign prostatic hyperplasia (2000)
- J Herb Pharmacother (Safarinejad): Urtica dioica for treatment of benign prostatic hyperplasia: a prospective, randomized, double-blind, placebo-controlled, crossover study (2005)
- AUA: Management of benign prostatic hyperplasia (BPH) – AUA guideline (2023)
- EAU: EAU Guidelines on Management of Non-Neurogenic Male LUTS (2024)