Benign prostatic hyperplasia (BPH) is one of the most common diseases in elderly men

the incidence of which gradually increases with age and leads to lower urinary tract symptoms (LUTS)

which seriously affects the quality of life of patients. Chinese herbal medicines (CHMs) are widely used for the treatment of BPH in China and some other countries. To explore the molecular mechanisms of CHMs for BPH

we conducted a review based on peer-reviewed English-language publications in PubMed and Web of Science databases from inception to December 31

2023. This article primarily reviewed 32 papers on the use of CHMs and its active compounds in the treatment of BPH

covering animal and cell experiments

and identified relevant mechanisms of action. The results suggest that the mechanisms of action of CHMs in treating BPH may involve the regulation of sex hormones

downregulation of cell growth factors

anti-inflammatory and antioxidative effects

inhibition of cell proliferation

and promotion of apoptosis. CHMs also exhibit α-blocker-like effects

with the potential to relax urethral smooth muscle and alleviate LUTS. Additionally

we also reviewed 4 clinical trials and meta-analyses of CHMs for the treatment of BPH patients

which provided initial evidence of the safety and effectiveness of CHMs treatment. CHMs treatment for BPH shows advantages as a multi-component

multi-target

and multi-pathway therapy

which can mitigate the severity of the disease

improve LUTS

and may become a reliable treatment option in the future.