Waking up twice, three times, sometimes four times a night to urinate wears you down. If you’ve been searching for a natural fix, you’ve probably seen two supplements come up over and over: pumpkin seed oil and saw palmetto. Both have been used for decades to manage prostate-related urinary problems. But which one actually helps with nighttime urination?

I spent a lot of time going through the clinical research on pumpkin seed oil vs saw palmetto, and the answer isn’t as straightforward as supplement companies would like you to believe. There’s one head-to-head trial, a handful of solid studies on each, and some genuinely surprising differences between the two. Here’s what I found.

Why You’re Getting Up at Night

Before comparing these supplements, it helps to understand why nocturia happens in the first place. In men over 50, the most common culprit is benign prostatic hyperplasia (BPH), where an enlarged prostate squeezes the urethra and irritates the bladder. This leads to frequent urination, weak stream, and those frustrating middle-of-the-night bathroom trips.

But nocturia isn’t always about the prostate. Overactive bladder can cause it in both men and women. So can nocturnal polyuria, where your body produces too much urine while you sleep. Medications, heart conditions, and even drinking too much fluid in the evening all play a role.

Both pumpkin seed oil and saw palmetto target the prostate pathway specifically. So if your nighttime urination stems from something else, neither supplement is likely to do much for you.

Pumpkin Seed Oil: What the Research Shows

Pumpkin seed oil comes from Cucurbita pepo (or sometimes Cucurbita maxima), and it’s been used in European medicine for prostate complaints since at least the 1970s. Germany’s health authority actually approved pumpkin seed as a treatment for BPH-related symptoms back in 1985.

The evidence is moderately encouraging. The largest trial to date, the GRANU study, enrolled 1,431 men and followed them for 12 months. Men who took whole pumpkin seed (10 g daily) saw a clinically relevant drop in their International Prostate Symptom Score (IPSS) compared to placebo. The responder rate was 58.5% for pumpkin seed versus 47.3% for placebo 1.

One interesting wrinkle: in that same trial, concentrated pumpkin seed extract capsules didn’t outperform placebo. The whole seed worked, but the extract didn’t. That matters if you’re choosing between different pumpkin seed products on the shelf.

For nighttime urination specifically, a 2014 study tested pumpkin seed oil (10 g/day) in 45 people with overactive bladder symptoms. After 12 weeks, both daytime and nighttime urinary frequency dropped significantly 2. The sample was small and there was no placebo group, so the results need to be taken cautiously, but it’s the best direct evidence for pumpkin seed oil and nocturia we have.

My take: The GRANU study is genuinely impressive due to its size. But the fact that concentrated extracts failed while whole seed worked raises questions about which pumpkin seed oil products would actually replicate those results.

For more on pumpkin seed oil’s full range of benefits, see our detailed pumpkin seed oil article.

Saw Palmetto: What the Research Shows

Saw palmetto (Serenoa repens) is probably the most popular prostate supplement in the world. It’s been studied far more extensively than pumpkin seed oil, which makes the picture both clearer and more complicated.

The good news first. A 1998 meta-analysis in JAMA pooled 18 trials involving 2,939 men and found that saw palmetto improved urinary symptoms and reduced nighttime urination compared to placebo. It also matched finasteride (a prescription BPH drug) for symptom relief while causing fewer side effects 3.

A more recent meta-analysis focused on Permixon, a specific hexanic saw palmetto extract, found it reduced nocturia by an average of 0.64 fewer bathroom trips per night versus placebo. Maximum urinary flow also improved. The analysis covered 27 studies and roughly 5,800 participants 4.

Now the bad news. A 2012 Cochrane review looked at the evidence more skeptically and concluded that saw palmetto was no better than placebo for reducing lower urinary tract symptoms. This held true even at double and triple the standard dose 5.

How can the research be this contradictory? It comes down to which saw palmetto product was tested. The Permixon extract shows consistent benefits. Other extracts, processed differently, don’t. Not all saw palmetto supplements are the same, and the cheaper ones on store shelves may not contain the same active compounds as the ones used in positive trials.

Reality check: Saw palmetto has more research behind it than pumpkin seed oil. But that research is a mess of conflicting results, largely because “saw palmetto” can mean very different products depending on how the extract was prepared.

Pumpkin Seed Oil vs Saw Palmetto: The Only Head-to-Head Trial

There’s exactly one study that directly compared pumpkin seed oil vs saw palmetto in the same trial. Hong and colleagues randomized 47 Korean men with BPH into four groups: pumpkin seed oil alone (320 mg/day), saw palmetto oil alone (320 mg/day), a combination of both, or placebo. They followed them for 12 months 6.

The results were interesting:

Both pumpkin seed oil and saw palmetto improved symptom scores by 3 months
Pumpkin seed oil improved urinary flow rate faster, reaching statistical significance at 6 months
Saw palmetto took longer, reaching significance at 12 months
The combination group was the only one that reduced PSA levels
Both had similar safety profiles with no significant side effects

The study is small, so I wouldn’t draw sweeping conclusions. But it’s the only direct comparison we have, and pumpkin seed oil held its own against saw palmetto. The faster improvement in flow rate for pumpkin seed oil was unexpected.

How They Work Differently

One of the more surprising findings in the research is that saw palmetto and pumpkin seed oil appear to work through different mechanisms, despite both being used for the same symptoms.

Saw palmetto was long believed to shrink the prostate by blocking 5-alpha reductase, the same enzyme that finasteride targets. But a 1994 trial found that saw palmetto extract had no effect on serum DHT levels, meaning it doesn’t actually work the same way as finasteride 7. Its benefits likely come from anti-inflammatory and smooth muscle-relaxing effects within the prostate itself.

Pumpkin seed oil, meanwhile, is rich in beta-sitosterol and other phytosterols. A systematic review of beta-sitosterol trials found it improved IPSS by nearly 5 points compared to placebo and increased urinary flow significantly 8. The delta-7-sterols in pumpkin seeds may also have weak anti-androgenic effects at the prostate tissue level.

What this means practically: because they work differently, there’s a reasonable argument for taking both together. The Hong et al. study above tested this combination, and while the sample was tiny, the combination group showed PSA reduction that neither supplement achieved alone 6.

Side Effects and Safety

This is where pumpkin seed oil has a clear advantage over saw palmetto.

In the trial comparing pumpkin seed oil to tamsulosin (a prescription medication), pumpkin seed oil produced zero reported side effects. Tamsulosin, by contrast, caused dizziness in 5.9% of users and retrograde ejaculation in 2.9% 9.

A 24-month observational study of pumpkin seed extract confirmed this safety profile. After two years of daily use, there were no negative effects on sexual function, which was assessed with validated questionnaires 10.

Saw palmetto is also generally safe, but it does cause mild gastrointestinal symptoms in about 3.8% of users 4. Rare cases of liver damage have been reported, though causation is debated. A trial comparing saw palmetto plus nettle root to finasteride found the herbal combination had significantly better tolerability 11.

Neither supplement is likely to cause serious harm in most people. But if minimizing side effect risk is your priority, pumpkin seed oil has the cleaner track record.

Dosage: What the Trials Used

Getting the dose right matters. Here’s what worked in clinical trials:

Pumpkin seed oil: 320 mg to 1,000 mg daily of oil, or 10 g daily of whole pumpkin seeds. The GRANU study used whole seeds at 10 g twice daily. The head-to-head trial used 320 mg/day of oil.

Saw palmetto: 320 mg daily of standardized extract. The Permixon studies, which showed the most consistent results, used a hexanic lipidosterolic extract at 320 mg/day.

One important note I keep coming back to: in the GRANU study, concentrated pumpkin seed extract capsules at 500 mg twice daily failed to beat placebo, while whole seeds at 10 g daily worked 1. And saw palmetto results vary wildly depending on which extract was tested. With both supplements, the specific product matters as much as the supplement itself.

Pumpkin Seed Oil or Saw Palmetto: Who Should Take Which?

Based on what the research shows, here’s my honest assessment of who each supplement suits better:

Pumpkin seed oil may be a better fit if you:

Want something with a very clean side effect profile
Are a woman dealing with overactive bladder symptoms (it’s been studied in women too 2)
Prefer the option with faster flow rate improvement based on the head-to-head data
Can commit to taking whole pumpkin seeds or high-quality oil rather than cheap capsules

Saw palmetto may be a better fit if you:

Want the supplement with the larger body of evidence behind it
Can find a hexanic extract (like Permixon or equivalent) rather than a generic product
Have already tried pumpkin seed oil without results
Your doctor recommends it specifically for your BPH management plan

Both together may be worth considering, given the Hong et al. trial showed complementary effects, though the evidence for the combination is preliminary 6.

When to See a Doctor

Supplements are fine for mild symptoms, but you should see a doctor if:

You’re waking up more than twice per night regularly
You notice blood in your urine (this can signal bladder cancer or other conditions)
You have difficulty starting urination or your stream stops and starts
You experience pain or burning when urinating (dysuria)
Your symptoms get worse despite taking supplements for 8-12 weeks
You have a complete inability to urinate (this is a medical emergency called acute urinary retention)

Nocturia can also be caused by diabetes, heart failure, or sleep apnea, none of which will respond to prostate supplements. Getting a proper diagnosis rules out conditions that need actual medical treatment.

Frequently Asked Questions

Can you take pumpkin seed oil and saw palmetto together?

Yes. The only head-to-head trial tested a combination group and found it was safe over 12 months. The combination was actually the only group to reduce PSA levels, suggesting complementary effects 6. However, talk to your doctor before combining supplements, particularly if you take blood thinners or hormonal medications.

How long does pumpkin seed oil take to work for nighttime urination?

Most trials show measurable improvement starting at 6 to 12 weeks. The head-to-head trial found pumpkin seed oil improved urinary flow rate significantly by 6 months 6. Don’t expect overnight results. Give it at least 3 months before deciding whether it’s working.

Why does saw palmetto get mixed reviews in studies?

The conflicting evidence comes down to product quality. The hexanic extract (Permixon brand) consistently performs well in trials. Cheaper ethanolic or CO2 extracts used in other studies showed little benefit 5. When you see “saw palmetto doesn’t work,” the study probably tested a lower-quality extract.

Is pumpkin seed oil better than saw palmetto for women?

Pumpkin seed oil has been studied in women with overactive bladder symptoms and showed positive results for reducing both daytime and nighttime urinary frequency 2. Saw palmetto targets prostate tissue specifically, so it’s not applicable for women. For women with nocturia or OAB, pumpkin seed oil is the clear choice between these two.

Do pumpkin seed oil supplements work as well as whole pumpkin seeds?

Possibly not. The largest BPH trial (GRANU study, n=1,431) found that whole pumpkin seeds reduced symptoms versus placebo, but concentrated extract capsules did not 1. This might be because the whole seed contains fiber, minerals, and other compounds that work together. If choosing capsules, look for ones that specify the oil content and phytosterol levels.

The Bottom Line

Pumpkin seed oil and saw palmetto both have legitimate research supporting their use for nighttime urination related to prostate enlargement. Neither is a miracle cure, and neither has the kind of bulletproof evidence that would make a urologist pound the table.

If I had to pick one? Pumpkin seed oil has the slight edge based on the head-to-head data showing faster flow improvement, a cleaner safety profile, and the bonus of working in women too. But saw palmetto’s hexanic extract (not the generic stuff) has a deeper body of evidence from larger meta-analyses.

The honest answer is that both supplements for nighttime urination are modest in their effects. Expect fewer bathroom trips, not zero bathroom trips. And whichever you choose, get a quality product, because the research consistently shows that generic versions of both pumpkin seed oil and saw palmetto underperform their standardized counterparts.

References

Pumpkin seed for benign prostatic hyperplasia (GRANU study) - Urology International (2015) Link
Pumpkin seed oil for human overactive bladder - Journal of Traditional and Complementary Medicine (2014) Link
Saw palmetto for benign prostatic hyperplasia (systematic review) - JAMA (1998) Link
Serenoa repens hexanic extract meta-analysis - BJU International (2018) Link
Serenoa repens for benign prostatic hyperplasia (Cochrane) - BJU International (2012) Link
Pumpkin seed oil vs saw palmetto head-to-head - Nutrition Research and Practice (2009) Link
Finasteride vs Serenoa repens on 5-alpha reductase - European Urology (1994) Link
Beta-sitosterol for benign prostatic hyperplasia (systematic review) - BJU International (1999) Link
Pumpkin seed oil vs tamsulosin for LUTS/BPH - BMC Urology (2021) Link
Cucurbita pepo 24-month observational study - World Journal of Urology (2022) Link
Sabal plus urtica extract vs finasteride - BJU International (2000) Link