Pygeum is an evergreen tree found in the higher elevations of central and southern Africa. The bark is used medicinally. Wild pygeum is environmentally threatened and efforts are being made to grow pygeum on plantations and control harvesting in the wild.
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3 Stars Reliable and relatively consistent scientific data showing a substantial health benefit.
2 Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
1 Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.
Benign Prostatic Hyperplasia
50 to 100 mg of an herbal extract standardized to contain 13% total sterols twice per day
Safe and effective for men with mild to moderate BPH, pygeum contains compounds that have anti-inflammatory activity and help rid the prostate of any cholesterol deposits.
In many parts of Europe, herbal supplements are considered standard medical treatment for BPH. Although herbs for BPH are available without prescription, men wishing to take them should be monitored by a physician.
Pygeum , an extract from the bark of the African tree, has been approved in Germany, France, and Italy as a remedy for BPH. Controlled studies published over the past 25 years have shown that pygeum is safe and effective for men with BPH of mild or moderate severity.1 These studies have used 50 to 100 mg of pygeum extract (standardized to contain 13% total sterols) twice per day. This herb contains three compounds that may help the prostate: pentacyclic triterpenoids, which have a diuretic action; phytosterols, which have anti-inflammatory activity; and ferulic esters, which help rid the prostate of any cholesterol deposits that accompany BPH.
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In a preliminary trial, men with chronic prostatitis who were given pygeum extract saw improvement of symptoms and laboratory evaluation of the prostate and urinary tract.
In a small preliminary trial, men with chronic prostatitis or BPH were given 200 mg per day of pygeum extract for 60 days, resulting in some improvement of symptoms and laboratory evaluation of the prostate and urinary tract.2 The extract used in this study was standardized to contain 14% beta-sitosterol and 0.5% n-docosanol. Other preliminary trials have also reported improvement of prostatitis symptoms with pygeum.3
The powdered bark was used as a tea for relief of urinary disorders in African herbal medicine. European scientists were so impressed with reports of pygeum’s actions, they began laboratory investigations into the active constituents in the bark. This led to the development of the modern lipophilic (fat-soluble) extract used today.
Chemical analysis and pharmacological studies indicate the lipophilic extract of pygeum bark has three categories of active constituents: 1) Phytosterols, including beta-sitosterol, have anti-inflammatory effects by interfering with the formation of hormone-like substances in the body (prostaglandins) that tend to accumulate in the prostate of men with benign prostatic hyperplasia (BPH); 2) pentacyclic terpenes have an anti-edema, or decongesting, effect; 3) ferulic esters indirectly control testosterone activity in the prostate, which may reduce the risk of BPH.4 While these effects have been shown in test tube studies, human studies are still needed to confirm these effects in the body. Pygeum alone has been shown in some double-blind trials to help men with BPH by improving urinary flow and other symptoms of BPH.5 , 6 It has also been used successfully in combination with nettle root to treat BPH.7 Long-term BPH studies (six months or greater) on pygeum are lacking, however.
The accepted form of pygeum used in Europe for treatment of BPH is a lipophilic extract standardized to 13% total sterols (typically calculated as beta-sitosterol).8 Men with mild to moderate BPH sometimes take 50–100 mg two times per day. A double-blind trial found that 100 mg once daily was as effective as 50 mg twice per day.9 Pygeum should be monitored over at least a six-month period to determine efficacy. Men with BPH who are using pygeum should be supervised by a doctor.
Side effects from the lipophilic extract of pygeum are rare. In clinical trials, there were reports of mild gastrointestinal upset in some men.
1. Andro MC, Riffaud JP. Pygeum africanum extract for the treatment of patients with benign prostatic hyperplasia: a review of 25 years of published experience. Curr Ther Res 1995;56:796–817.
2. Carani C, Salvioli V, Scuteri A, et al. Urological and sexual evaluation of treatment of benign prostatic disease using Pygeum africanum at high doses. Arch Ital Urol Nefrol Androl 1991;63:341–5 [in Italian].
3. Menchini-Fabris GF, Giorgi P, Andreini F, et al. New perspectives on treatment of prostato-vesicular pathologies with Pygeum Africanum. Arch It Urol 1988;LX:313–22 [in Italian].
4. Murray MT. The Healing Power of Herbs. Rocklin, CA: Prima Publishing, 1995, 286–93.
5. Barlet A, Albrecht J, Aubert A, et al. Efficacy of Pygeum africanum extract in the treatment of micturational disorders due to benign prostatic hyperplasia. Evaluation of objective and subjective parameters. A multicenter, randomized, double-blind trial. Wein Klin Wochenschr 1990;102:667–73.
6. Andro M-C, Riffaud J-P. Pygeum africanum extract for the treatment of patients with benign prostatic hyperplasia: A review of 25 years of published experience. Curr Ther Res 1995;56:796 [review].
7. Krzeski T, Kazón M, Borkowski A, et al. Combined extracts of Urtica dioica and Pygeum africanum in the treatment of benign prostatic hyperplasia: Double-blind comparison of two doses. Clin Ther 1993;15:1011–20.
8. Murray MT. The Healing Power of Herbs. Rocklin, CA: Prima Publishing, 1995, 286–93.
9. Chatelain C, Autet W, Brackman F. Comparison of once and twice daily dosage forms of Pygeum africanum extract in patients with benign prostatic hyperplasia: a randomized, double-blind study, with long-term open label extension. Urology 1999;54:473–8.
Last Review: 11-07-2012
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