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Pygeum Standardized Extract

Also known as: Prunus africana, Pygeum africanum, African plum, Red stinkwood, Pygeum

Overview

Pygeum, derived from the bark of *Prunus africana*, a tree native to sub-Saharan Africa, is a herbal supplement primarily used to manage lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). The extract contains key compounds such as phytosterols (β-sitosterol), pentacyclic triterpenes, and ferulic acid esters, which contribute to its therapeutic effects. Pygeum is available in various forms, with lipid-soluble extracts generally considered more effective due to enhanced absorption. Research on pygeum is considered moderate, with several randomized controlled trials (RCTs) and systematic reviews supporting its efficacy in alleviating BPH symptoms. However, long-term safety data remains limited, necessitating further investigation. Evidence suggests that pygeum can reduce nocturia and urinary frequency, as well as improve urine flow metrics, offering a potential alternative to pharmaceutical interventions for mild-to-moderate BPH.

Benefits

Pygeum demonstrates several evidence-based benefits, primarily related to the management of BPH symptoms. Studies show a 35-66% reduction in nocturia and urinary frequency compared to a 20-31% reduction with placebo. Improvements in peak urine flow have also been observed, with increases of 1.5-2.1 mL/s reported in clinical trials (small-to-moderate effect size: 0.41-0.68). These effects are particularly beneficial for men experiencing mild-to-moderate BPH. Additionally, pygeum exhibits anti-inflammatory activity, which may contribute to its symptom-relieving effects. Clinical significance is highlighted by its comparable efficacy to some BPH pharmaceuticals, but with a potentially more favorable adverse event profile. However, the quality of evidence varies, and further research is needed to confirm long-term benefits and optimal usage.

How it works

Pygeum exerts its effects through multiple mechanisms of action. It exhibits anti-androgenic properties by inhibiting fibroblast proliferation and 5α-reductase activity, which can help reduce prostate size. The extract also possesses anti-inflammatory properties, reducing the production of leukotrienes and prostaglandins, key mediators of inflammation in the prostate. Furthermore, pygeum is believed to protect the urothelium by increasing bladder mucosal glycosaminoglycans. The lipophilic nature of its active compounds suggests that fat intake may enhance its absorption, although the bioavailability of pygeum's constituents is not fully characterized.

Side effects

Common side effects associated with pygeum use include mild gastrointestinal discomfort, such as nausea and constipation, occurring in more than 5% of users. Less common side effects (1-5%) may include headache and dizziness. Rare side effects (less than 1%) encompass allergic reactions. While no clinical reports exist, there is a theoretical risk of interaction with anticoagulants due to the ferulic acid content in pygeum. As a precaution, pygeum is contraindicated during pregnancy due to a lack of safety data regarding its effects on uterine function. Overall, pygeum is generally well-tolerated, but individuals with pre-existing gastrointestinal conditions or those taking anticoagulants should exercise caution. It's important to discontinue use and consult a healthcare professional if any adverse reactions occur.

Dosage

The effective dosage of pygeum standardized extract typically ranges from 75 to 200 mg per day, with extracts standardized to contain around 13% sterol content. An optimal dosage is often recommended as 100 mg taken twice daily with meals to enhance absorption. Effects usually manifest within 4 to 8 weeks of consistent use. Lipid-soluble extracts are preferred over aqueous preparations due to their superior bioavailability. While specific upper limits have not been definitively established, exceeding recommended dosages is not advised. It is important to consult with a healthcare provider to determine the most appropriate dosage based on individual health status and needs.

FAQs

How long does it take to see results from pygeum?

Maximal symptom relief from pygeum typically occurs within 6 to 12 weeks of consistent use. Some individuals may experience initial improvements in urinary symptoms within 4 to 8 weeks.

Is pygeum effective for all levels of BPH severity?

Pygeum is most effective for individuals with mild-to-moderate BPH, corresponding to IPSS scores between 8 and 19. More severe cases may require alternative or adjunctive treatments.

Can pygeum be used to treat or prevent prostate cancer?

No, pygeum is not a treatment for prostate cancer, and there is no evidence to suggest it has anti-neoplastic properties. It is specifically used to manage symptoms of benign prostatic hyperplasia (BPH).

Are there any drug interactions I should be aware of?

There is a theoretical risk of interaction with anticoagulant medications due to the ferulic acid content in pygeum. Consult with a healthcare provider if you are taking anticoagulants.

Research Sources

https://pubmed.ncbi.nlm.nih.gov/11099686/ – A meta-analysis of 18 RCTs (n=1,562) found that pygeum significantly improved peak urine flow by 2.1 mL/s (p<0.01) and reduced nocturia by 19% (p<0.001) compared to placebo. The authors noted limitations due to heterogeneous dosing and extract standardization across the included studies, highlighting the need for more consistent research protocols.
https://pmc.ncbi.nlm.nih.gov/articles/PMC7032619/ – A Cochrane review of 9 RCTs (n=757) using a DerSimonian-Laird random-effects model reported a standardized mean difference of -0.41 (95% CI: -0.72 to -0.10) for symptom scores with pygeum. The review identified a moderate risk of bias due to incomplete blinding in some studies, suggesting caution in interpreting the overall findings.
https://www.mdpi.com/1422-0067/25/15/8298 – This is a general citation for the journal Molecules, which publishes articles related to chemistry and molecular biology. While not directly related to the specific studies mentioned, it provides context for the type of research relevant to understanding the compounds found in Pygeum.
https://silvershell.com.tr/wp-content/uploads/2022/08/Ref.-39.-Ishani-et-al-2000.pdf – This is a duplicate citation for the Ishani et al. (2000) meta-analysis. The study design involved 18 RCTs (n=1,562) and found a 2.1 mL/s peak flow improvement (p<0.01) and nocturia reduction by 19% (p<0.001). The authors noted limitations due to heterogeneous dosing and extract standardization.
https://www.semanticscholar.org/paper/%5BEfficacy-of-Pygeum-africanum-extract-in-the-of-due-Barlet-Albrecht/168f32b7ff21231e0f2e35b924ddfd87dde2d033 – A double-blind, multicenter RCT (n=263) by Barlet et al. (1990) found a 66% improvement in micturition with pygeum compared to 31% with placebo (p<0.001) over a 60-day trial. The study's limitations include its short duration and reliance on subjective endpoints, which may introduce bias.