Saw palmetto is generally associated with prostate health including the urinary track. Saw palmetto extract (SP) is from the fruit of serenoa repens, which is rich in fatty acids and phytosterols. SP is used in alternative medicine for different conditions but primarily for benign prostatic hyperplasia. It has also been used as an energy tonic and treatment of urinary and reproductive system disorders. Other historical applications include treating infertility in women, PMS and as an appetite stimulant. Results of scientific reviews of studies are mixed but differing results may be due to the forms and dosages. One major review concluded: "The evidence suggests that SP (Serenoa repens) provides mild to moderate improvement in urinary symptoms and flow measures comparable to common drug therapy with less side effects”. On that note, few side effects or allergic reactions are related to the use of SP. The most common adverse reactions are gastrointestinal, which may be attenuated by consuming the extract with meals. Although rare, SP may increase the risk of bleeding or affect sex hormones. Simultaneous use of other drugs with like-actions/mechanisms should be avoided.