Pygeum

Parts used and where grown: 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.

Pygeum has been used in connection with the following conditions (refer to the individual health concern for complete information):

Rating	Health Concerns
	Benign prostatic hyperplasia (BPH)
	Prostatitis (CBP, NBP)
Reliable and relatively consistent scientific data showing a substantial health benefit. Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit. An herb is primarily supported by traditional use, or the herb or supplement has little scientific support and/or minimal health benefit.

Historical or traditional use (may or may not be supported by scientific studies): 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.

Active constituents: 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.¹ 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.² ³ It has also been used successfully in combination with nettle root to treat BPH.⁴ Long-term BPH studies (six months or greater) on pygeum are lacking, however.

How much is usually taken? 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).⁵ 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.⁶ 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.

Are there any side effects or interactions? Side effects from the lipophilic extract of pygeum are rare. In clinical trials, there were reports of mild gastrointestinal upset in some men.

At the time of writing, there were no well-known drug interactions with pygeum.

References:

1. Murray MT. The Healing Power of Herbs. Rocklin, CA: Prima Publishing, 1995, 286–93.

2. 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.

3. 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].

4. 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.

5. Murray MT. The Healing Power of Herbs. Rocklin, CA: Prima Publishing, 1995, 286–93.

6. 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.

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The information presented in Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over-the-counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2003.