Referee Report: Exploring the Use of Phytotherapy in Benign Prostatic Hyperplasia (BPH): A Systematic Review

The systematic review examines the use of phytotherapy in managing benign prostatic hyperplasia (BPH), analyzing 84 studies on plant-based treatments like saw palmetto, Pygeum africanum, and beta-sitosterol. These treatments show potential in reducing BPH symptoms by inhibiting 5-alpha-reductase and exhibiting anti-inflammatory properties. While some studies indicate benefits, the efficacy varies, necessitating further research to confirm safety and effectiveness. The review underscores the need for more rigorous studies to understand the mechanisms and optimal use of phytotherapy in BPH management, highlighting its potential as a safer, cost-effective alternative, especially in regions with limited access to advanced medical care.