How to Choose the Right Serenoa repens Extract

Context: Herbal medicines are complex mixtures of various compounds. Standardisation is essential to ensure a consistent biological effect. Objective: This article reviews findings related to herbal medicines with a specific focus on Serenoa repens, which is available in a number of different forms. Evidence acquisition: This article is based primarily on material presented at a satellite symposium entitled, "Inflammation and Prostatic Diseases: From Bench to Bedside," held during the 2015 annual meeting of the European Association of Urology in Madrid, Spain. Current data regarding the link between inflammation and benign prostatic hyperplasia (BPH) were reviewed. Evidence synthesis: A review of the available literature indicated that many natural products are being used in therapeutic settings such as cardiology, neurology, oncology, psychology, and urology. The need to standardise these products to ensure a consistent clinical effect is a prerequisite for good medical practice. In the case of Serenoa repens, which is used in the symptomatic treatment of BPH, best evidence has been published for the n-hexane lipidosterolic extract of the dwarf American palm. Conclusions: This literature review highlighted the variability in the composition of the various brands of Serenoa repens. Serenoa repens hexanic extract is considered by the European Medicines Agency to be a "well-established medical use product" for symptomatic treatment of BPH. Patient summary: Standardisation of herbal medicines is essential to ensure a consistent level of clinical activity and safety. In the case of Serenoa repens, the n-hexane lipidosterolic extract is the only formulation currently considered by the European Medicines Agency to be a "well-established medical use product.".