Saw Palmetto for PCOS: does it really work?

Saw palmetto is a fruit extract supplement commonly used for prostate gland enlargement symptom improvement. More recently, the anti-androgen effects of saw palmetto are being considered potentially for improving PCOS symptoms. PCOS is often linked with acne, oily skin, hirsutism and excess hair growth which are linked to excess androgen levels.

In this article, we discuss what saw palmetto is, whether it can help symptoms of PCOS, the evidence and the side effects. Keep reading to learn more about saw palmetto for PCOS.

What is PCOS?

PCOS is an endocrine disorder (a hormonal condition) that impacts 1 in 10 people in the UK. There are various symptoms of PCOS including acne, oily skin, excess hair on the face, chest and back, hair loss on the head, irregular periods and trouble conceiving.

>> Read more: PCOS 101 | A beginner’s guide to PCOS

What is saw palmetto?

Saw palmetto is a fruit extract supplement made from the fruit of the Serenoa repens tree (commonly known as saw palmetto). It is commonly used with the intention of improving symptoms of benign prostatic hyperplasia (more commonly known as prostate gland enlargement) in people assigned male at birth.

Saw palmetto is a dwarf palm tree native to North America and is seen in Florida, Georgia, the Bahamas and Cuba. It has a long traditional history of use by Native Americans for a wide variety of ailments including coughs and colds, asthma, sore throat, chronic pelvic pain and more.

More recently, there saw palmetto has been increasing in popularity as a supplement to support people with PCOS due to its potential anti-androgenic effects.

Saw palmetto and PCOS: can it help?

Considering saw palmetto is claimed to have anti-androgen effects, no wonder it has been considered a potential supplement to help manage symptoms of PCOS. One of the diagnostic criteriums for PCOS is excess androgen levels, measure biochemically (via blood tests) or noted clinically (symptoms physically seen by a doctor).

Androgens are a group of sex hormones that play a role in reproductive health and body development including testosterone. Whether you are assigned female or male at birth, you have androgens in the body but those assigned male at birth have higher levels.

People with PCOS often have androgen excess which is commonly associated with symptoms like acne, excess hair growth in “unexpected areas” and hair loss on the head (hirsutism).

Saw palmetto is claimed to help with three aspects of androgen excess: hirsutism, acne and oily skin.

Saw palmetto appears to reduce testosterone levels by preventing the conversion of testosterone into dihydrotestosterone (DHT), therefore preventing the binding of DHT in the body. Out of all of the androgens, DHT is the most potent hormone. It is considered a “pure” androgen as it cannot convert into oestrogen.

Saw palmetto for hirsutism

Saw palmetto is often suggested for hirsutism treatment by naturopaths and functional medicine doctors but, unfortunately, there is no evidence to support whether it works or not for excess hair growth.

Read our article on excess hair growth on the face for evidence-based advice for managing hirsutism including IPL cosmetic hair removal.

Saw palmetto for acne and oily skin

Androgen excess is associated with oily skin. This is because androgens like testosterone stimulate the production of sebum. Sebum is an oily secretion that makes skin prone to acne.

There is one small study of just twenty people carried out in 2007 that found that a topical extract made from saw palmetto, sesame seeds and argon oil reduced sebum levels in the majority of participants. Of course, this study was not just on saw palmetto alone, and was a very small study, so more research is needed for saw palmetto to be recommended for acne.

How much saw palmetto should I take for PCOS?

Both dried and raw saw palmetto berries have been eaten for centuries, but their safety and efficacy are still not properly researched. Saw palmetto is usually taken orally in the form of eating the berries whole, steeping the berries to make a tea or as a dried or liquid extraction supplement.

There is no formally recognised dosage but most studies use doses of between 160 – 320mg. If you choose to take saw palmetto for PCOS, know that there is no dosage specified for efficacy because more research is needed.

Side effects of saw palmetto

Side effects of saw palmetto are usually mild and may include diarrhoea, nausea, headaches and dizziness.

If you have any signs of an allergic reaction such as hives, difficulty breathing, or swelling of your face, lips, tongue or throat get emergency medical help. If you have any of the following, stop using saw palmetto and seek emergency medical help:

  • easy bruising or bleeding
  • any bleeding that will not clot or stop
  • bloody stool or coughing up blood
  • pancreatic problems like severe stomach pain, fast heart rate or vomiting
  • liver problems like nausea, upper stomach pain, jaundice or dark urine

As with all supplements or medication, consult with your healthcare team before taking saw palmetto.

Saw palmetto precautions

Saw palmetto can be taken orally or rectally. If taken orally (by mouth) it is likely to be safe for use for up to 3 years. Whereas if it is taken rectally, it is likely to be safe for up to 30 days.

Saw palmetto should not be taken by the following groups:

People who are pregnant or breastfeeding

Saw palmetto should not be taken by those who are pregnant or breastfeeding. This is because saw palmetto may impair foetal genital development because of its effect on androgen and oestrogen metabolism. There isn’t enough information on saw palmetto and breastfeeding. Therefore, this supplement should be avoided if breastfeeding.

People who are undertaking surgery

A report found that saw palmetto is connected with increased bleeding time during surgery. Generally, dietary supplements should be avoided before surgery to be safe.

People who are taking blood thinners or hormone medications

Those who are taking blood thinning medication like warfarin, clopidogrel or aspirin should speak to their doctor because saw palmetto increases the risk of bleeding. Similarly, if you are taking hormone medications like birth control, you should speak to your doctor or healthcare provider to ensure it is safe for you to take saw palmetto because it can make birth control less effective.

Final takeaways: saw palmetto for PCOS

In summary, evidence suggests that saw palmetto may have anti-androgen effects but more research is needed to understand whether the fruit extract can help improve PCOS symptoms like acne and hirsutism. Insufficient research has been carried out and it is not endorsed by most doctors as an effective treatment for hirsutism or acne.

Taken according to manufacturers’ instructions, saw palmetto is unlikely to be harmful unless you are in one of the precautionary groups, discussed above. Always speak to a healthcare provider before taking a new supplement. It is unadvisable to spend too much time or money on this supplement as the evidence just isn’t strong enough yet.

Alex Okell ANutr Founder and Editor

Founder and Editor | Registered Associate Nutritionist


Founder of Be The Collective LTD [The PCOS Collective & The Endo Collective] Alex Okell ANutr is a London-based reproductive health nutritionist with experience in research, private practice and digital media. She holds a Master’s degree in Nutrition from King’s College London and has co-authored papers with the University of Cambridge, King’s College London, The Food Foundation and the Food Standards Agency. Alex offers 1:1 PCOS support in our virtual PCOS clinic.

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