• Benign Prostatic Hyperplasia (Prostate Enlargement)
The pygeum tree (pronounced pie-jee-um) is a tall evergreen native to central and southern Africa. Its bark has been used since ancient times to treat problems with urination.
What Is Pygeum Used for Today?
Today, pygeum is primarily used as a treatment for benign prostatic hyperplasia (BPH) , or prostate enlargement. This use is supported by scientific evidence about as strong as that for the more famous natural BPH remedy, saw palmetto. However, saw palmetto is probably the better treatment to use. The pygeum tree has been so devastated by collection for use in medicine that some regard it as a threatened species. Saw palmetto is cultivated rather than collected in the wild.
What Is the Scientific Evidence for Pygeum?
At least 17 double blind trials of pygeum for BPH have been performed, involving a total of almost 1000 individuals and ranging in length from 45 to 90 days. 3-7,17 Many of these studies were poorly reported and/or designed. Nonetheless, overall the results make a meaningful case that pygeum can reduce symptoms such as nighttime urination, urinary frequency, and residual urine volume.
The best of these studies was conducted at 8 sites in Europe and included 263 men between 50 and 85 years of age. 8 Participants received 50 mg of a pygeum extract or placebo twice daily. The results showed significant improvements in residual urine volume, voided volume, urinary flow rate, nighttime urination, and daytime frequency.
We don't really know how pygeum works. Unlike the standard drug finasteride, it does not appear to work by affecting the conversion of testosterone to dihydrotestosterone. 9 Rather it is thought to reduce inflammation in the prostate, and also to inhibit prostate growth factors, substances implicated in inappropriate prostate enlargement. 10,12
The usual dosage of pygeum is 50 mg twice per day (occasionally 100 mg twice daily) of an extract standardized to contain 14% triterpenes and 0.5% n-docosanol. A dose of 100 mg once daily appears to be as effective as the most common dosage of 50 mg twice daily. 13
Pygeum appears to be essentially nontoxic, both in the short and long term. 16 The most common side effect is mild gastrointestinal distress. However, safety in young children, pregnant or nursing women, or those with severe liver or kidney disease has not been established.
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 [in Italian]. Arch Ital Urol Nefrol. 1991;63:341–345.
7. Bassi P, Artibani W, De Luca V, et al. Standardized extract of Pygeum africanum in the treatment of benign prostatic hypertrophy. Controlled clinical study versus placebo [in Italian]. Minerva Urol Nefrol. 1987;39:45–50.
8. Barlet A, Albrecht J, Aubert 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 [translated from German]. Wien Klin Wochenschr. 1990;102:667–673.
9. Rhodes L, Primka RL, Berman C, et al. Comparison of finasteride (Proscar), a 5-alpha reductase inhibitor, and various commercial plant extracts in in vitro and in vivo 5-alpha reductase inhibition. Prostate. 1993;22:43–51.
13. 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;54:473–478.
14. Hartmann RW, Mark M, Soldati F. Inhibition of 5 alpha-reductase and aromatase by PHL-00801 (Prostatonin), a combination of PY 102 (Pygeum africanum) and UR 102 (Urtica dioica) extracts. Phytomedicine. 1996;3:121–128.
15. Krzeski T, Kazon 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;15:1011–1020.
Last reviewed October 2007 by EBSCO CAM Review Board
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