I've been taking saw palmetto capsules for about a week now with a good amount of success in lessening POIS symptoms. If I take one 540mg capsule I have a window of time that starts about 20-30 min after I take the pill in which I can have an orgasm with much less POIS afterwards. The window lasts for about 2 to 3 hrs.
The way it reduces my POIS seems to be by lessening inflammation. It help reduce my POIS symptoms in these areas: digestion, pain during bowel movements & urination, general muscle & joint pains all over, energy, scalp irritation/itchyness/dryness.
I'm not sure how much it affects brain fog since my physical pains generally overshadow my cognitive problems, but I'm pretty sure saw palmetto helps at least a little with brain fog since after taking it thinking doesn't hurt nearly as much as during unaided POIS.
The exciting thing for me though is the fact that it almost completely eliminates my scalp irritation. Before I started saw palmetto I had gotten to the point where my scalp was so itchy and dry that I had started a bad habit of pulling individual hairs out of my head, because it oddly satisfied the itchy feeling (I think prozac caused this somehow, because after taking it for a month one spot on my scalp became much worse). Saw palmetto is supposed to reduce the prostate by stopping testosterone from being converted to DHT (Dihydrotestosterone) and is also somewhat known to slow male hair loss by this same mechanism.
I still take fenugreek + garlic most days. When compared to saw palmetto it seems to help more with brain fog, energy, muscle & joint pain, constipation, anxiety & mood, general sensitivity to pain and other stimuli, and my facial irritation and burning eyes.
I've been cycling between them rather than taking both fenugreek and saw palmetto at the same time.