Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Triterpenes, a diverse class of phytochemicals found in many plants, have some scientific evidence supporting their use in the management of Benign Prostate Hyperplasia (BPH). The best-documented triterpenes in this context are those derived from Serenoa repens (saw palmetto), whose lipidosterolic extract contains significant amounts of triterpenes along with fatty acids and phytosterols. Clinical trials and meta-analyses (e.g., Wilt et al., Cochrane Database Syst Rev, 2012) have evaluated saw palmetto extracts for BPH symptoms, with mixed results; some studies show modest improvements in urinary symptoms and flow measures, while others find no significant benefit compared to placebo.

Mechanistically, triterpenes are proposed to exert anti-inflammatory effects and possibly inhibit 5-alpha-reductase, the enzyme responsible for converting testosterone to dihydrotestosterone (DHT), a key mediator in prostate enlargement. Additionally, certain triterpenes from Pygeum africanum (African plum tree) have also shown modest efficacy in reducing nocturia and improving urinary flow in BPH patients.

Despite some positive findings, the overall quality of evidence is moderate, with systematic reviews noting heterogeneity in study design, extract standardization, and outcome measures. There is sufficient scientific rationale for the modest use of triterpene-rich extracts for BPH, but they do not consistently outperform placebo in high-quality studies. Triterpenes may be considered as adjunctive therapy, but are not first-line treatments according to major urological guidelines.

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