Defining an enlarged prostate
The enlarged prostate is a problem commonly seen in older men – studies show that the condition is present in 50% of men aged 50 and almost all 80 year old men .
Symptoms of an enlarged prostate include poor or weak urine flow, a frequent need to urinate, especially at night, an urgent need to find a toilet when the bladder feels full and dribbling at the end of urination.
If these symptoms are familiar to you and you think you (if you are a man) or your partner (if you are a woman) may be suffering from an enlarged prostate, it is important that an appointment is made with your doctor to have the diagnosis confirmed and to exclude other problems with the prostate.
 Madersbacher S, Studer U E. Benige Prostatahyperplasie. Schweiz Med Forum. Nov 2002; 45: 1068-73
Men with an enlarged prostate may also experience sexual problems
Apart from the enlarged prostate, it is well-known that the older man can also suffer a decline in sexual function such as loss of libido or difficulty obtaining an erection. These problems are usually seen as part and parcel of growing older and often accepted as such.
Causes may include:
- Decreased blood flow to the vital areas of the body as a result of ‘narrowing of the arteries’
- The consequence of underlying illnesses such as diabetes, hypertension, high cholesterol levels, declining liver function, or other chronic conditions
- Side effects of prescribed medication
- An enlarged prostate
What has become more obvious recently is that the most significant factor and predictor of sexual dysfunction is whether or not you have an enlarged prostate.
For instance, men are nearly 4 times more likely to develop erection problems 2 years after the noticing symptoms of an enlarged prostate. Other studies show that men aged between 30 and 80 have a 72% chance of erection problems if they have an enlarged prostate, compared to 38% if they don’t. 
In addition, if you suffer from an enlarged prostate, your doctor may prescribe certain types of medicines to try, before considering the use of surgery. These medicines, however, have a tendency to give rise to side effects affecting sexual function. [4,5]
 Rosen RC, et al. Sexual dysfunction and lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). Eur Url 2005; 47(6): 824-837
 Carbone DJ, Hodges S. Medical therapy for benign prostatic hyperplasia: sexual dysfunction and impact on quality of life. Int J Impot Res 2003; 15(4): 299-306
 Erdemir F, et al. 5-alpha reductase inhibitors and erectile dysfunction; the connection. J Sex Med 2008; 5(12): 2917-2924.
Saw palmetto herb for an enlarged prostate
Saw palmetto is one of the most well-researched herbs around. It is clear from scientific data that the herb can help improve symptoms in men with mild to moderate cases of the enlarged prostate. [6, 7, 8, 9]
At the same time, if you were to browse references to the herb in old herbal textbooks, you will find that one of the uses of Saw palmetto many years ago was to treat sexual problems in men, such as loss of libido and impotence.
For example, one herbalist’s account of a patient reported that Saw palmetto was helpful for the enlarged prostate as well as improving libido. It ends with the patient not only restored to his normal ‘vigour’ but complaining that the law made it illegal for him to have more than one wife… 
 Iglesias-Gato D, et al. androgen-independent effects of Serenoa repens extract (Prostasan®) on prostatic epithelial cell proliferation and inflammation. Phytother Res. 2011; doi 10.1002/ptr3537
 Wilt T, et al. Serenoa repens for benign prostatic hyperplasia. Cochrane Database Syst Rev. 2002(3);Cd001423.doi: 10.1002/14651858.CD001423
 Tacklind J, et al. Serenoa repens for benign prostatic hyperplasia. Cochrane Database Syst Rev. 2010(2); CD001423.doi:10.1002/14651858.CD001423.pub2.
 Riedi E, et al. Natural treatment for BPH. Ars Medici, 2005,2:3.
 Dr A. L Davidson,Mount Pleasant,Utah, 1896, Traditional Use of Saw Palmetto
New research on Saw Palmetto
However, until recently, the use of Saw palmetto herb to treat sexual problems older men (also suffering from an enlarged prostate) had not been proven with science.
A study, published in April 2012, is the first to provide us with the scientific proof we need. The clinical trial recruited 69 men with enlarged prostate symptoms who were also experiencing problems with sexual function. 
The researchers found that bladder symptoms improved by 51% during the 8 week study – this was in line with other research data proving the effectiveness of the herb.
However, the study was also able to show that during the 8 week period of the trial, ability to achieve and maintain an erection improved by 64% and problems with lack of drive improved by 54%.
This is, of course, only one study and others will be needed to provide further evidence of this benefit. However, for herbalists and people who use Saw palmetto, it is a good start – this is the first time that it has been shown scientifically that the sexual symptoms in men with an enlarged prostate can also be improved using the herb.
It can only be good news to the many men who suffer from an enlarged prostate. And their partners.
 Suter A et al. Phytother Res. 2012 Apr 23. doi: 10.1002/ptr.4696