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Saw Palmetto For Women’s Hair Loss: Benefits vs Risks
Dr Ahmad Moussa (FRCS)
Medically reviewed by
Dr Ahmad Moussa (FRCS)
Updated on September 19, 2024

At this time, there is insufficient research to determine the safety and efficiency of saw palmetto for women with female pattern baldness. But since 55% of women experience hair loss during their lifetime [1], it is normal to seek effective natural remedies and this plant extract can look promising.

However, doctors warn that saw palmetto may work through a similar mechanism as Finasteride, which can affect your hormonal balance and cause birth defects. That means it may be unsafe for premenopausal women to take this supplement.

If you are interested in the best hair loss treatments for women, there are safe and proven alternatives to saw palmetto that you can try. You can choose natural options or medications such as Minoxidil. If your hair loss is more advanced, you may also be a good candidate for a female hair transplant.

Keep reading this article to learn more about:

  • What saw palmetto is and how it works against hair loss
  • What the evidence says about saw palmetto efficiency in female pattern hair loss
  • Potential risks of saw palmetto in women
  • Safe and effective alternatives to saw palmetto for women
Table of Contents

What is saw palmetto?

Saw palmetto (Serenoa repens) is a species of dwarf palm tree often found in the West Indies Islands, but also the Southeastern U.S.A. Traditionally, the indigenous population prepared extracts of its fruit to use as natural remedies against infections, inflammation, pulmonary, digestive, urinary, sexual and reproductive issues [35][46] 

Nowadays, a special interest has been taken in saw palmetto extract for its promising effects against prostate enlargement and male lower urinary tract symptoms. Recent studies show that it could provide an effective alternative to conventional medication in mild-to-moderate forms of these conditions [5][6]. 

Recently, this supplement has begun to be studied for potential benefits against androgenic alopecia, with promising results. While it is not as potent as Finasteride or Dutasteride, this plant extract appears to have components which work as natural DHT blockers, reducing male pattern baldness. Unfortunately, very few women with female pattern baldness have been included in human saw palmetto trials, so it is difficult to assess its effectiveness for this condition.

Saw palmetto is available under multiple forms – dried berries (to be eaten as is or made into tea), capsules filled with oil or powder, or an oily liquid extract.   

How does saw palmetto work against alopecia

Benefits of saw palmetto against women’s hair loss

At this time, there is not enough scientific evidence to confirm any saw palmetto benefits for women’s hair. That is not to say it cannot help curb female pattern baldness, but no specific studies have been conducted to determine under what circumstances and to what extent.  

There is promising evidence of this plant extract’s effectiveness against male pattern baldness [7]. Some small clinical studies have shown that while saw palmetto isn’t as effective as Finasteride, it can reduce hair loss and increase hair density in patients with this type of alopecia. However, the findings do not automatically translate to female pattern baldness as well, because women have a different hormonal makeup than men.

Woman with female pattern baldness

How might saw palmetto work in female pattern baldness?

There are not enough studies to confidently say we understand how saw palmetto works against hair loss. However, it is hypothesised that some of its components (certain phytosterols and fatty acids) can inhibit the activity of an enzyme called 5- alpha-reductase [7][4]. This enzyme transforms some of your testosterone into a different androgen hormone called dihydrotestosterone (DHT)

DHT Impact On Hair

If you are experiencing androgenetic alopecia, it means you have too much DHT in your blood, which binds to androgen receptors in your hair follicles. This causes them to shrink and produce smaller, finer hair until they stop producing any strands at all [10]. So what saw palmetto does is play a role in decreasing the amount of DHT that your body produces, thus curbing your hair shedding.

Scientists studying clinical trial results of saw palmetto

What are the clinical trial results of saw palmetto for women?

Unfortunately, almost no clinical trials using this plant extract have been performed on women. Only very few saw palmetto studies included female participants. The ones that did report promising results, but this is while using combinations of this supplement and many other ingredients that could affect hair growth, such as curcumin, castor oil, phytosterols from pine extract, wheat germ oil, etc [12][13]. 

Presently, only one clinical trial included female participants treated with only a standardised saw palmetto oil, with no other added substances [14]. However, its sample was comprised of both men and women and the authors failed to specify the male-to-female ratio or any gendered differences in their results.

However, when it comes to nutrient complexes that include saw palmetto alongside several other substances with potential impact on hair loss, the results are rather promising:

Study details

  • A clinical trial with 80 participants of both genders (half of them representing the control group), with mild to moderate androgenetic alopecia was held. After 16 weeks of treatment, participants who received oral saw palmetto oil experienced a 29% improvement in hair shedding and a 5.17% increase in hair density, while those who received topical saw palmetto experienced 22.19% less hair loss and 7.61% greater hair density. However, there is no data regarding how many participants were women and whether they experienced similar results to those of the men.
  • One study performed on 40 women with hair thinning reports that a proprietary formula containing saw palmetto showed a 10.8% increase in hair count after 6 months of treatment. However, the formula they used contained 20 other ingredients besides saw palmetto [15][16].
  • A different small study was conducted on 15 men and 15 women of various ages and hair conditions (androgenetic alopecia, severe telogen effluvium and diet-induced hair loss). They were administered 2 daily capsules each containing 300 mg of a nutrient complex that included saw palmetto, borage oil, linseed oil, wheat germ oil, rye extract and phytosterols from pine extract. After 6 months, 83% of all subjects experienced an increase in hair density. When it comes to subjective assessment, over half (60%) of the 15 female participants reported a moderate or high increase in hair density. 84% of women participants also reported a decrease in hair loss and approximately 90% experienced an improvement in hair strength and a reduction in greasiness. 

The samples in most human trials for hair loss that include saw palmetto are very small and it is impossible to tell the extent to which component of the nutrient complexes taken contributed to these results. The combination of active ingredients used in these clinical trials, along with their small sample sizes and various methodological flaws [17] make it difficult to assess the effect of saw palmetto on female pattern baldness.

This data insufficiency is not surprising, considering that at this time, there is not enough evidence to prove the efficacy of 5-alpha-reductase inhibitors in general against female pattern hair loss [18][19]. While some of the existing data is encouraging, clinical trials with female participants are few and their findings can be contradictory.    

Other potential health benefits of saw palmetto for women

While more research is needed to identify the potential uses of saw palmetto in women’s health, some doctors believe that it may have positive effects on [20]:

  • Bladder disorders
  • Regulating testosterone production 
  • Reducing unwanted facial hair
  • Treating acne
  • Reducing menopause symptoms
  • Improving the symptoms of polycystic ovarian syndrome
Identifying the risks of saw palmetto for women

What are the risks of saw palmetto for women?

So far, no specific studies have been performed to test the safety of saw palmetto on pre-menopausal, pregnant or breastfeeding women. The few clinical trials performed on female participants reported no side effects [21][15]. However, it must be kept in mind that in most cases, the women included in the samples were post-menopausal and/or the saw palmetto was used in small quantities, mixed with other ingredients. 

Researchers warn that since it likely works by reducing the DHT levels in your blood, “this plant may cause irreversible damage to the fetus or lead to miscarriage” [4] and it is thus contraindicated to women who may become pregnant [13]. It is also believed that saw palmetto may make oral contraceptives less effective, increasing the risk of unplanned pregnancy [22]. 

Studies conducted on men show that this plant extract is normally safe, as patients experienced very few and minor side effects. These include [23][4]: 

  • abdominal pain
  • diarrhoea 
  • nausea
  • fatigue
  • dizziness 
  • headaches 
  • decreased libido
  • rhinitis

The rates of these reported saw palmetto side effects were similar to those experienced by people in the placebo group. 

However, it must be taken into consideration that the small sample sizes used in saw palmetto studies can be insufficient to fully explore its potential side effects in the general population. 

Who should not take saw palmetto?

There are some categories of women who are the most vulnerable to saw palmetto side effects, according to physicians [22][20]. Those are:

  • Pregnant or breastfeeding women
  • Women who are trying to conceive
  • Women who have or are at risk of developing hormone-sensitive conditions
  • Women who have digestive or liver conditions
  • Women who are undergoing hormone replacement therapy 
  • Women who are taking blood thinners

Potential medication interactions

Healthcare providers warn that you should always discuss your intention to take saw palmetto with your healthcare provider if you have a preexisting condition or are taking any medication. That is because it can interact with certain types of drugs, such as [22]:

  • Certain blood thinners (e.g. warfarin, clopidogrel, aspirin)
  • Oral contraceptives
  • Hormone replacement therapy medication
  • Certain types of hair loss medication (e.g. finasteride, dutasteride)

Are saw palmetto benefits worth the risks for women?

Examining the evidence we have at this time, both the risks and benefits of this natural extract remain unclear. We don’t have enough human trials with female participants to tell if if saw palmetto can help with female pattern hair loss (or any other type of alopecia). But there are also no severe side effects associated with this herbal supplement in men [26][27].

However, many scientists advise against all types of 5-alpha reductase inhibitors (which likely include saw palmetto) in premenopausal women. So if you are a woman who has not yet undergone menopause, the risks of birth defects or hormonal imbalances may outweigh the uncertain benefits of this supplement. This may also apply if you are among the categories of women for whom saw palmetto is not recommended.

Natural hair growth alternatives to saw palmetto 

If you are looking for a scientifically proven way to grow thicker hair naturally, there are some better alternatives to saw palmetto you can try. Here are some of the best options:

Pumpkin seed oil for hair

Pumpkin seed oil 

Pumpkin seed oil for hair is another excellent option. Studies performed on women with female pattern hair loss show that applying it topically can produce an increase in hair regrowth and a decrease in strand miniaturisation after only 3 months of constant use [25].

Rosemary oil reduces hair loss

Rosemary oil 

Rosemary oil for hair growth can help reduce pattern hair loss and increase its density. That is why it is known as one of the best essential oils for hair growth. Research shows that it can be as effective as Minoxidil in treating androgenetic alopecia [28]. And since it is used topically on your scalp, there is no risk of systemic side effects.

However, just like in the case of saw palmetto, no specific studies have been conducted to determine the effect of rosemary oil on female pattern hair loss.

Black seed oil

Black seed oil

While it isn’t known to treat female pattern hair loss, black seed oil for hair has been found to have a good effect on regulating your hair growth cycle. That means it can help your hair remain in the growth phase longer and reduce telogen effluvium. This hair growth oil is safe and has no known risks when applied topically other than a potential allergic reaction if you have a particular sensitivity to it.

Safe and effective hair loss treatments and therapies

If you are experiencing hair loss, there are several treatments which have been scientifically tested and have proven themselves safe and effective for women. Here are some of the best choices:

Alternatives to saw palmetto for women

Minoxidil 

This is the most recommended hair loss treatment for women and it yields very good results in female pattern hair loss, but can also help treat other conditions, such as telogen effluvium or alopecia areata [26]. It works by dilating the blood vessels in your scalp, allowing increased blood flow to reach your hair follicles. The additional oxygen and nutrients can help your hair grow thicker and improve its density.

Red light therapy for hair growth

Red light therapy for hair growth 

This form of low-level laser therapy involves using focused beams of red or near-infrared light to increase mitochondrial activity in your cells and increase the amount of energy that reaches your hair follicles. Research shows that this therapy can improve several types of alopecia, such as female pattern hair loss, telogen effluvium, alopecia areata and chemotherapy hair loss [29][30][31].

And you can get it comfortably in your own home, using a laser hair growth cap to regrow your hair. One study shows this kind of device can produce a 51% increase in hair count for women with female pattern hair loss after only 17 weeks of daily 30-minute sessions [32].

Derma-rolling for hair growth

Derma-rolling

Also known as microneedling, this therapy involves using a small tool covered in fine needles to create microscopic wounds in your scalp. While this is not painful, it triggers your body’s healing process, stimulating your follicles for hair growth [33]. Moreover, using Minoxidil and a derma roller together can enhance both their effects, as microneedling increases the absorption rate of topical Minoxidil [34].  

Hair transplant

If you are experiencing more advanced hair loss, you may be a good candidate for a hair transplant. This procedure is safe and highly effective and you don’t need any hospitalisation time.

The surgeon simply harvests some healthy hair follicles from the back of your head using a FUE or FUT technique and implants them in your thinning spots. The world-class Wimpole Clinic surgeons have excellent results, which you can see for yourself in our before and after hair transplant gallery. And since a hair transplant is permanent, you never have to worry about finding the right hair loss treatment again after getting one.

However, the best way to make sure you are getting the right treatment for your specific hair loss problems is to book a consultation with a trichologist. They will examine your scalp and hair and perform all the necessary tests (e.g. a dermoscopy, a scalp biopsy or blood tests for hair loss) to determine the exact reason your hair is falling out. Then, they will make personalised recommendations based on your condition, needs and preferences.  

Saw Palmetto For Women’s Hair Loss: Benefits vs Risks, Wimpole Clinic

Frequently asked questions

The answers to these frequently asked questions may give you a better idea of the link between saw palmetto and women’s hair loss:

No specific studies have been conducted to compare the effectiveness of different forms of saw palmetto administration. In most human studies conducted so far, researchers used capsules that were taken orally.

There were also some clinical trials that used topical lotions, but they contained several other ingredients besides saw palmetto. So at this point, the dose of topical saw palmetto needed to achieve hair growth in women has not been determined.

There are insufficient studies to reveal the most effective dose of saw palmetto that women need to take in order to experience the most hair loss benefits. The fact that most human studies use saw palmetto in combination with other ingredients makes it even more difficult to estimate the impact of various doses on female hair loss.

It may be safe to take saw palmetto alongside medication such as Minoxidil or remedies such as essential oils for hair growth (although more research is needed to confirm this). However, it may interact with Finasteride, Dutasteride and other 5-alpha reductase inhibitors, causing an excessive lowering of your blood DHT. It is best to discuss with a healthcare provider before taking saw palmetto alongside any other medication.

No, saw palmetto is not reccomended to children. That is because there are no studies that can demonstrate its safety when taken by minors.

If your child is experiencing hair loss, it is best for her to see a hair doctor who can diagnose it and make personalised recommendations. 

Sources:
  1. Female Pattern Hair Loss: An Overview with Focus on the Genetics
  2. Natural Hair Supplement: Friend or Foe? Saw Palmetto, a Systematic Review in Alopecia
  3. Uses of Saw Palmetto (Serenoa repens, Arecaceae) in Florida
  4. The Use of Serenoa Repens (Saw Palmetto) in Hair Care Products
  5. Contraindicated use of 5‐alpha‐reductase inhibitors in women
  6. The Use of Serenoa Repens (Saw Palmetto) in Hair Care Products
  7. Natural Hair Supplement: Friend or Foe? Saw Palmetto, a Systematic Review in Alopecia
  8. Rethinking the Role of Saw Palmetto Extract for Men with Lower Urinary Tract Symptoms in North America
  9. A double blind, placebo-controlled randomized comparative study on the efficacy of phytosterol-enriched and conventional saw palmetto oil in mitigating benign prostate hyperplasia and androgen deficiency
  10. Androgenetic Alopecia
  11. Effect of gelatin-cystine and serenoa repens extract on free radicals level and hair growth
  12. Efficacy of a Nutritional Supplement, Standardized in Fatty Acids and Phytosterols, on Hair Loss and Hair Health in both Women and Men
  13. Saw Palmetto
  14. Oral and Topical Administration of a Standardized Saw Palmetto Oil Reduces Hair Fall and Improves the Hair Growth in Androgenetic Alopecia Subjects – A 16-Week Randomized, Placebo-Controlled Study
  15. A Six-Month, Randomized, Double-Blind, Placebo-Controlled Study Evaluating the Safety and Efficacy of Nutraceutical Supplement for Promoting Hair Growth in Women with Self-Perceived Thinning Hair
  16. A Novel Multi-Targeting Approach to Treating Hair Loss, Using Standardized Nutraceuticals
  17. Androgenetic Alopecia From A to Z
  18. Female Pattern Hair Loss and Androgen Excess: A Report From the Multidisciplinary Androgen Excess and PCOS Committee
  19. Female pattern hair loss: Current treatment concepts
  20. Top 6 Benefits of Saw Palmetto For Women
  21. Beneficial effect of skin micro-needling in the treatment of alopecia areata and its clinical assessment
  22. Saw palmetto
  23. Serenoa repens (Saw Palmetto) A Systematic Review of Adverse Events
  24. A Detailed Safety Assessment of a Saw Palmetto Extract
  25. Pumpkin seed oil vs. minoxidil 5% topical foam for the treatment of female pattern hair loss: A randomized comparative trial
  26. Minoxidil and its use in hair disorders: a review
  27. A detailed safety assessment of a saw palmetto extract
  28. Rosemary oil vs minoxidil 2% for the treatment of androgenetic alopecia: a randomized comparative trial
  29. Low-level laser therapy for the treatment of androgenetic alopecia in Thai men and women: a 24-week, randomized, double-blind, sham device-controlled trial
  30. Low-level laser (light) therapy (LLLT) for treatment of hair loss
  31. Low-level light therapy and hair loss
  32. Novel Approach to Treating Androgenetic Alopecia in Females With Photobiomodulation (Low-Level Laser Therapy)
  33. Beneficial Effects of Saw Palmetto Fruit Extract on Urinary Symptoms in Japanese Female Subjects by a Multicenter, Randomized, Double-Blind, Placebo-Controlled Study
  34. Efficacy and safety of combinational therapy using topical minoxidil and microneedling for the treatment of androgenetic alopecia: a systematic review and meta-analysis
Dr Ahmad Moussa (FRCS)
Medically reviewed by Dr Ahmad Moussa (FRCS)Updated on September 19, 2024
The Wimpole Clinic offers FUE Hair, Beard & Eyebrow Transplants & Trichology.
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