Herbs for Prostate and Urinary Symptoms: Saw Palmetto, Nettle Root, Pygeum

Get medical help promptly for blood in your urine, pain when you pee, not being able to pee at all, or a fever or chills with urinary symptoms. The NHS lists blood in the pee, pain when peeing and being unable to pee as reasons to ask for an urgent appointment. [1] Urinary symptoms can also come from conditions other than an enlarged prostate, including prostate cancer, so they should be checked before a herb is tried. [1] This page is information only. It does not tell anyone what to take.

What this page covers

Two different problems are often mixed together. An enlarged prostate (benign prostatic hyperplasia, or BPH) mostly causes a weak or slow stream, needing to pee often or at night, and a feeling the bladder is not empty. It usually develops slowly. [1] A urinary tract infection (UTI) is an infection of the bladder, urethra or kidneys, and the NHS says it may be treated with antibiotics. [2] Herbs are studied differently for each, so they are kept apart below. For the wider picture see Saw palmetto and prostate supplements and urinary symptoms and enlarged prostate.

How to read the labels on this page

Traditional use means a herb has been used for a long time for a purpose. It is not proof that it works. The European Union herbal committee labels some products "traditional herbal medicinal products", meaning their use in the stated condition is based exclusively on long-standing use. [3] Research findings come from trials and reviews, and we say how strong they are: established, promising but limited, mixed, insufficient evidence or no good evidence of benefit.

Enlarged prostate (BPH)

Saw palmetto (Serenoa repens, the berries; family Arecaceae). [4]

• Research: A 2023 Cochrane review pooled 27 studies with 4,656 participants and concluded that saw palmetto alone provides little to no benefit for men with urinary symptoms from an enlarged prostate. [5] NCCIH reaches the same view, and found that hexane-extracted products did not differ from other products. [6] Evidence label: no good evidence of benefit for the herb used alone. Combinations with other plants are more uncertain. [5]


• Official status: The European Medicines Agency's herbal committee concluded in 2016 that a hexane extract can be used for BPH symptoms (a "well-established use" category), and an ethanol extract on the basis of long-standing use, noting that trial evidence for the ethanol extract was insufficient. [7] That summary was published before the 2023 Cochrane update, so the two should not be read as a single agreed verdict.


• Safety: NCCIH describes saw palmetto as well tolerated, with mild effects such as digestive upset, dizziness and headache. It does not appear to change PSA readings, and it may be unsafe in pregnancy or breastfeeding. [6] Ask a clinician or pharmacist before combining it with any prostate or other medicine.

Nettle root (Urtica dioica, the root; family Urticaceae). [4] Nettle leaf and nettle root are different products, and this section is about the root.

• Traditional/official use: The EU herbal committee's 2025 monograph lists nettle root as a traditional herbal product for lower urinary tract symptoms from BPH, after a doctor has ruled out serious conditions, based only on long-standing use. [3]


• Research: One 6-month trial of 620 men reported that 81% of those given nettle root extract said their symptoms improved, compared with 16% on placebo. The author said more trials were needed before calling it effective. [8] Evidence label: promising but limited. We did not find a Cochrane review for nettle root in the sources we read. For the plant itself see stinging nettle.

Pygeum (Prunus africana, the bark; family Rosaceae). [4]

• Research: A Cochrane review (published 2002) found 18 randomized trials in 1,562 men and judged a standardized extract might be useful, but the studies were small and short, with varied preparations. [9] Evidence label: promising but limited, and the main review is old.


• Official status: The EU committee's 2016 monograph lists it as a traditional product for BPH symptoms, for men only. [10] See pygeum.

Urinary tract infections

Cranberry (Vaccinium macrocarpon, the fruit; family Ericaceae). [4]

• Research: NCCIH says cranberry products may lower the risk of recurrent symptomatic UTIs in women by about 25 percent, but findings are inconsistent. [11] Results in some higher-risk groups were mixed, and it is not recommended as a treatment for an existing UTI. [11] Evidence label: mixed, for prevention only. NCCIH also notes that processing into tablets or capsules can reduce the active compounds. [11]


• Safety: Evidence on cranberry and warfarin is conflicting, so people on blood thinners should ask a pharmacist. [11] See cranberry.

Uva ursi (Arctostaphylos uva-ursi, the leaf; family Ericaceae). [4]

• Official status: The EU committee lists it as a traditional product for mild, recurrent bladder-infection symptoms in women, after a doctor has excluded serious causes. [12] Its monograph says it is not recommended for men or for anyone under 18, is not for use longer than one week, lists kidney disorders as a contraindication, and advises against use in pregnancy and breastfeeding. [12]


• Research: Proper evidence not found in the sources we read: we read the EU monograph but not trial data for uva ursi, so we cannot rate it. See uva ursi.

When a UTI needs more than self-care

The NHS says men, people aged 65 or older, people with diabetes, pregnant people, anyone with a catheter, and anyone getting repeated UTIs (2 in 6 months or 3 in 12 months) should seek an urgent appointment. Blood in the pee, back or lower belly pain, or symptoms that do not improve within 2 days also need prompt help. Untreated kidney infection can be serious and can lead to sepsis. [2] Do not use a herb instead of treatment for an infection. [11]

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