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Pygeum (Pygeum africanum) (Rhizome)

Also known as: Pygeum africanum, Prunus africana, Pygeum, African cherry, African plum

Overview

Pygeum africanum is an extract derived from the bark of the African cherry tree, traditionally used to manage lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH). It is primarily used as a phytotherapeutic agent to improve urinary symptoms such as nocturia, urinary flow, and residual urine volume. The extract contains bioactive compounds including atraric acid and N-butylbenzene-sulfonamide, which have been identified as androgen receptor antagonists and have anti-inflammatory and antiproliferative properties relevant to prostate health. The extract is derived from the bark, often from the rhizome. The research on Pygeum africanum is relatively mature, with multiple randomized controlled trials (RCTs) and systematic reviews/meta-analyses conducted, particularly focusing on its efficacy in BPH symptom management. The quality of evidence is moderate to high, based on well-conducted RCTs and meta-analyses published in peer-reviewed journals.

Benefits

Pygeum africanum demonstrates significant improvement in overall urinary symptoms in men with BPH, with a relative risk (RR) of symptom improvement of 2.1 (95% CI: 1.4 to 3.1) compared to placebo. It reduces nocturia by approximately 19% and decreases residual urine volume by about 24%. Furthermore, it increases peak urine flow rate by approximately 23%. Secondary benefits include mild anti-inflammatory effects, likely contributing to symptom relief, and potential antiproliferative effects on prostate cells, which may contribute to long-term prostate health. Benefits have been demonstrated primarily in men with symptomatic BPH. The improvements in urinary symptoms and flow measures are statistically significant and clinically relevant, with moderate effect sizes. Clinical benefits typically manifest after several weeks of continuous use, often around 4 to 8 weeks.

How it works

Pygeum africanum exerts its effects through multiple biological pathways. It has anti-inflammatory action by inhibiting 5-lipoxygenase metabolite production, reducing inflammation in the prostate and urinary tract. Compounds such as atraric acid and N-butylbenzene-sulfonamide act as androgen receptor antagonists, blocking androgen receptors, which play a role in prostate growth and BPH development. It also exhibits antiproliferative and apoptotic effects by downregulating transforming growth factor beta 1 (TGF-β1) and inhibiting fibroblast growth factor 2 (FGF-2) signaling, reducing prostate fibroblast proliferation. Additionally, it may have antimicrobial effects by inhibiting IL-7 mRNA expression, contributing to bactericidal and fungicidal activity. Absorption and bioavailability details are less well characterized but oral formulations of standardized extracts are commonly used.

Side effects

Pygeum africanum is generally well tolerated. Common side effects (greater than 5%) include mild gastrointestinal symptoms such as nausea and stomach upset. Uncommon side effects (1-5%) include rare allergic reactions or skin rash. Rare side effects (less than 1%) include no serious adverse events reported in high-quality trials. No significant drug interactions have been reported, but caution is advised with other medications affecting prostate or hormonal pathways. Contraindications are not well established; caution is advised in patients with known allergies to related plant species. Safety in pregnant or breastfeeding women is not established; it is primarily studied in adult men with BPH.

Dosage

The typical minimum effective dose is around 50 mg of standardized extract daily. Most studies used 50-100 mg daily of standardized Pygeum africanum extract. There is no well-defined maximum safe dose; doses up to 100 mg daily are commonly used without increased adverse effects. Benefits usually appear after 4-8 weeks of daily use. Standardized bark extract capsules or tablets are the common forms. Taking it with food may improve tolerability. No specific required cofactors have been identified.

FAQs

How long before effects are seen?

Several weeks, often 4-8 weeks of consistent daily use, are typically required before noticeable improvements in urinary symptoms are observed.

Is Pygeum safe long-term?

Studies up to 3-4 months show good safety; however, longer-term data are limited, so caution is advised with extended use.

Can Pygeum replace conventional BPH medications?

It may be useful for mild to moderate symptoms but is not a substitute for prescription drugs in severe cases of BPH.

Are there any serious side effects?

Serious side effects are rare; mild gastrointestinal upset is the most commonly reported adverse effect.

Can women use Pygeum?

It is primarily studied in men; safety and efficacy in women have not been established, so use is not recommended.

Research Sources

  • https://pubmed.ncbi.nlm.nih.gov/11099686/ – This meta-analysis included 18 RCTs with 1562 men with symptomatic BPH and found that Pygeum africanum significantly improved urinary symptoms, reduced nocturia, residual urine, and increased peak urine flow. Adverse effects were mild and comparable to placebo, suggesting a favorable safety profile. The study highlights the potential of Pygeum as a treatment for BPH symptoms.
  • https://www.mdpi.com/1422-0067/25/15/8298 – This systematic review confirmed the anti-inflammatory potential of Pygeum africanum bark extract in BPH patients. It supported improvements in urologic symptoms and flow measures consistent with previous meta-analyses, reinforcing the biological plausibility of anti-inflammatory mechanisms. The review provides further evidence for the use of Pygeum in managing BPH.
  • http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?ID=12001000049 – This independent systematic review corroborates the efficacy and safety profile of Pygeum africanum in BPH. It highlighted the need for larger, longer-term RCTs comparing Pygeum to standard BPH medications and confirmed mild adverse effects and good tolerability. The review supports the use of Pygeum but calls for more extensive research.
  • https://experts.umn.edu/en/publications/pygeum-africanum-for-benign-prostatic-hyperplasia – This resource provides an overview of Pygeum africanum's use in treating benign prostatic hyperplasia. It summarizes the benefits, potential side effects, and dosage recommendations based on available research. It serves as a helpful guide for understanding Pygeum's role in managing BPH symptoms.
  • https://www.mskcc.org/cancer-care/integrative-medicine/herbs/pygeum – This Memorial Sloan Kettering Cancer Center resource offers information on Pygeum, including its uses, potential benefits, and side effects. It provides a summary of the scientific evidence supporting its use and highlights safety considerations. This resource is useful for patients and healthcare providers seeking information on Pygeum as a complementary therapy.