Original title: Effects of Serenoa repens extract on sexual function in patients with benign prostatic hyperplasia: a systematic review and meta-analysis
Ce Dong, Junbin Zheng, Yucheng Jiang · September 2026
Benign prostatic hyperplasia is a condition where an enlarged prostate causes urinary problems. Men often use an herbal remedy made from Serenoa repens extract as a gentler alternative to prescription drugs. However, past studies disagreed on whether this herbal extract affects sexual health. Researchers gathered and analyzed six randomized trials that compared the plant extract directly against a dummy pill, known as a placebo, to see how it works in men with this condition. They tracked the patients' sexual function and their general quality of life. The researchers found that the extract did not significantly improve sexual function compared with placebo. It also failed to show any real improvement in overall quality of life. Because the combined studies measured sexual health in very different ways, the results varied widely, and the certainty of the overall evidence was very low.
Imagine deciding whether a pinch of salt actually improves a stew. You cook two identical pots, add salt to one, and ask everyone to taste, but the tasters disagree and the answers keep pointing in opposite directions. In this paper, researchers combined six such tests of a plant extract for an enlarged prostate, and the combined result was too mixed to say the extract helped sexual function or quality of life more than a placebo.
Men with an enlarged prostate often try plant extracts to avoid the sexual side effects of prescription drugs. This review pooled six randomized trials and found no reliable improvement in sexual function or quality of life over placebo, and the certainty of the evidence is very low. Patients and clinicians should not assume this supplement protects sexual function; better, larger trials are still needed.
The abstract does not establish that Serenoa repens extract is harmful or that it has no effect at all; the confidence interval is wide and the prediction interval includes meaningful benefits and harms. The overall analysis combined different sexual-function questionnaires, and the certainty of evidence is very low. Only six trials were included, and the review does not report details of dosing, preparation, or duration. The IIEF-restricted subgroup had lower heterogeneity but still no significant effect, and the abstract does not provide a full risk-of-bias assessment.
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Effects of Serenoa repens extract on sexual function in patients with benign prostatic hyperplasia: a systematic review and meta-analysis — Ce Dong, Junbin Zheng, Yucheng Jiang — Sexual medicine — doi:10.1093/sexmed/qfag088
Abstract licence: CC BY
Explanation generated by Synthesis from the abstract — it is not the original paper.