How It Works
Bottom Line: Pygeum africanum may relieve the symptoms of benign prostatic hypertrophy (BPH), but it is uncertain how safe it is to take for long periods of time.
Pygeum africanum is a tree bark extract. In laboratory experiments, several chemicals in this herb have been found to reduce inflammation by stopping the production of prostaglandins, a major inflammatory signal in the body. These chemicals also work synergistically to reduce levels of testosterone in the prostate. This is why this herb is used to treat benign prostatic hypertrophy (BPH), in which growth of the prostate is enhanced by testosterone.
Purported Uses
To treat benign prostatic hypertrophy (BPH)
Several clinical trials show that Pygeum africanum is effective in improving urination symptoms and flow in patients with BPH. Few of these clinical trials have studied the use of pygeum for longer than two months, however, so the long-term effectiveness and safety of this herb is not certain.
To reduce inflammation
Laboratory studies show that chemicals in pygeum have anti-inflammatory effects, but there is no proof from clinical trials that this effect occurs in humans.
To improve sexual performance
No scientific evidence supports this use. Pygeum africanum might actually counter the effects of testosterone in the body.
Research Evidence
Benign prostatic hypertrophy (BPH):
A meta-analysis, which is a systematic review of all of the clinical trials that have been performed with a therapy, looked at the use of Pygeum africanum to treat benign prostatic hypertrophy (BPH). In six out of the 18 randomized, controlled trials that were analyzed, Pygeum africanum was more effective at relieving urinary symptoms than a placebo pill, with no major side effects. For example, nocturia (needing to urinate at night) was reduced by 19% and urine flow increased by 23%.
A clinical trial studied the effects of pygeum extract on 209 men with benign prostatic hypertrophy (BPH). The men were randomly assigned to take either 50 mg of pygeum twice a day or 100 mg once a day. After two months, both groups had improvements in prostate symptoms, quality of life, and nocturia (needing to urinate at night). However, this study does not have a control group taking a placebo pill to which the researchers could compare these results.
In a clinical trial conducted at many different hospitals, 263 men with benign prostatic hypertrophy (BPH) were given either 50 mg of pygeum twice a day or a placebo pill. After two months, men taking pygeum had a significant improvement in urination symptoms and flow compared to men taking the placebo.
Warnings
This product is regulated by the FDA as a dietary supplement. Unlike approved drugs, supplements are not required to be manufactured under specific standardized conditions. This product may not contain the labeled amount or may be contaminated. In addition, it may not have been tested for safety or effectiveness.
Side Effects
Nausea
Stomach upset
Special Point
When used for benign prostatic hypertrophy (BPH), it may take several weeks for you to see any beneficial effects.
Scientific Name
Pygeum africanum, Prunus africana
Common Name
African plum tree
Brand Name
Tadenan®
Clinical Summary
Derived from the bark of the tree. Traditionally used to manage benign prostatic hypertrophy (BPH). Several chemicals contribute to the action of this product. Clinical studies have suggested improvement in urinary symptoms associated with BPH with adverse events comparable to those of placebo, such as headache and gastrointestinal symptoms
(4) (5) (6). Oral preparations should be standardized to 14% triterpenes and 0.5% n-docosanol. Doses range between 50-200 mg daily. Clinical improvement may take several weeks to occur.
Purported uses
- Benign prostatic hypertrophy (BPH)
- Inflammation
- Sexual performance
Constituents
Triterpenes (14%): Oleanolic, crataegolic, and ursolic acids
Ferulic acid
Phytosterols: Beta-sitosterol, beta-sitosterone and campesterol
Tannins
(1)
Mechanism of Action
The phytosterols compete with androgen precursors and also inhibit prostaglandin biosynthesis thereby reducing inflammation. The triterpenes exhibit anti-inflammatory activity in vitro. The ferulic acid esters reduce the level of cholesterol in the prostate, thereby limiting androgen synthesis. The phytosterols and the triterpenes appear to work synergistically to improve the symptoms of BPH.
(2)
Adverse Reactions
Reported: Nausea and GI upset
Herb-Drug Interactions
None reported
Literature Summary and Critique
Ishani A, et al. Pygeum africanum for the treatment of patients with benign prostatic hyperplasia: a systematic review and quantitative meta-analysis. Am J Med 2000;109:654-64. A total of 18 randomized, controlled trials involving 1,562 men were analyzed. Seventeen of the studies were double-blind. The mean study duration was 64 days. Compared with placebo in 6 studies,
Pygeum africanum provided a moderately large improvement in the combined outcome of urologic symptoms and flow measures. Nocturia was reduced by 19% and residual urine volume by 24%; peak urine flow increased by 23%. Adverse effects due to
Pygeum africanum were similar to those of placebo.
Brackman F, et al. 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.In a randomized, double-blind, placebo-controlled study of 209 men with BPH, once and twice daily dosages of pygeum were evaluated. The results showed that both dosages significantly decreased International Prostate Symptom Scores (IPSS), nocturia, and improved quality of life by approximately 44%, 12%, and 36%, respectively. No differences in clinical efficacy were observed.
Barlet A, et al. Efficacy of Pygeum africanum extract in the medical therapy of urination disorders due to benign prostatic hyperplasia: evaluation of objective and subjective parameters. A placebo-controlled double-blind multicenter study. Wien Klin Wochenshr 1990;102:667-73.A multi-center, randomized, double-blind, placebo-controlled study of 263 patients with baseline uroflow of 13.5 to 14 cc/second. Results showed that pygeum 50 mg twice a day for 60 days produced a significant improvement in both quantitative and qualitative parameters. Micturition improved in 66% of patients taking pygeum and in 31% of the placebo group.
References
