Serenoa repens, commonly known as saw palmetto, is the sole species currently classified in the genus Serenoa. The plant is a low shrubby palm that is native of West Indies, and it grows in the coastal lands of North America and other European mediterranean countries. Its fruits contain high concentrations of fatty acids and phytosterols. S. repens extracts have been studied for the symptomatic treatment of benign prostatic hyperplasia. Recently, they have been proposed to treat androgenic alopecia and other hair disorders. We report a new case of hot flashes in a 10-year-old girl using a food supplement containing the extract of S. repens for the treatment of hirsutism. When the girl discontinued the treatment, the hot flashes stopped. A ‘rechallenge' of the supplement was tried and symptoms reappeared. About 4 months after starting therapy, the girl experienced menarche. Exposure to the plant-derived product could be responsible for the appearance of menarche. In our opinion, use of phytotherapeutic agents in pediatric patients should be associated to a better evaluation of benefit/risk profile taking in account the physiological changes that occurs at different ages in this subgroup of population.

1.
Tacklind J, Macdonald R, Rutks I, Stanke JU, Wilt TJ: Serenoa repens for benign prostatic hyperplasia. Cochrane Database Syst Rev 2012;12:CD001423.
2.
MacDonald R, Tacklind JW, Rutks I, Wilt TJ: Serenoa repens monotherapy for benign prostatic hyperplasia (BPH): an updated Cochrane systematic review. BJU Int 2012;109:1756-1761.
3.
Murugusundram S: Serenoa repens: does it have any role in the management of androgenetic alopecia? J Cutan Aesthet Surg 2009;2:31-32.
4.
Miroddi M, Carnì A, Mannucci C, Moleti M, Navarra M, Calapai G: Hot flashes in a young girl: a wake-up call concerning serenoa repens use in children. Pediatrics 2012;130:e1374-e1376.
5.
Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA, Janecek E, Domecq C, Greenblatt DJ: A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther 1981;30:239-245.
6.
Shanafelt TD, Barton DL, Adjei AA, Loprinzi CL: Pathophysiology and treatment of hot flashes. Mayo Clin Proc 2002;77:1207-1218.
7.
Wang Y, Dinse GE, Rogan WJ: Birth weight, early weight gain and pubertal maturation: a longitudinal study. Pediatr Obes 2012;7:101-109.
8.
Currie C, Ahluwalia N, Godeau E, Nic Gabhainn S, Due P, Currie DB: Is obesity at individual and national level associated with lower age at menarche? Evidence from 34 countries in the health behaviour in school-aged children study. J Adolesc Health 2012;50:621-626.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.