A Cochrane review [Abstract] 1 included 32 studies lasting 4 to 72 weeks with a total of 5 666 subjects. Serenoa repens was not superior in improving International Prostate Symptom Score (IPSS) compared to placebo (MD 0.40 mL/s, 95% CI -0.30 to 1.09).
For nocturia, Serenoa repens was not significantly better than placebo.
Comparing prostate size (mean change from baseline), one high quality 12-month trial (N = 225) reported no significant difference between SR and placebo (MD -1.22 cc, 95% CI -3.91 to 1.47).
Adverse effects were mild and infrequent.
Comment: The quality of evidence is downgraded by inconsistency (variability in results across studies and heterogeneity in interventions and outcomes), and by imprecise results (wide confidence intervals).
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