Q. My husband has been taking saw palmetto for many, many years, but it does not seem to have been helpful. What we HAVE noticed, though, is a considerable decrease in his sexual desire. Does saw palmetto adversely affect the libido? Also, after he had problems with urinating frequently during the night, his doctor prescribed Cardura. Since he has taken the Cardura, we have noticed an INCREASE in his sexual desire. Have you had reports on this as a side effect? What can you tell of about long-term use of Cardura?

A. Your husband’s usage of saw palmetto and Cardura demonstrates a typical pattern. Here’s why:

As men get older they commonly experience changes in both their erections and voiding patterns. When a man has slow stream and needs to get up at night to urinate, his doctor often blames the prostate. That’s because the prostate often enlarges with age, placing pressure on the urine flow as it passes through the urethra (the tube that carries urine out of the body). Such pressure causes changes in the bladder, and the man feels a decrease in his stream and more frequent voids. To combat such changes, doctors often prescribe Cardura. This drug is a muscle relaxer for the prostate that causes a decrease in the tension of the prostate and better flow. However, it has no effect on libido.

To stop the increase in growth and size of the prostate, many men use saw palmetto. This is a plant estrogen that might cause decreased libido — such as you have noticed — and less frequent erections. There is no scientific basis for its use, and the clinical studies show that it doesn’t shrink the prostate. It is not FDA-approved, so there are no restrictions on its production, mixing or marketing. That means you should be careful to read the ingredients of your formula; often, over-the-counter prostate supplements include many compounds mixed together.

If your husband has an enlarged prostate, then his doctor can prescribe Proscar (finasteride) which has been scientifically tested and shown to shrink the prostate.

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