Pygeum
A meta-analysis of 18 short trials in 1,562 men with an enlarged prostate reports more symptom improvement than placebo, 19% less nighttime urination and 23% higher peak urine flow. Trials averaged 64 days and only one reported allocation concealment. No trial against standard prostate drugs was found. Adverse effects were mild and similar to placebo.
- Status
- Dietary supplement in the US. Not approved by the FDA as a drug for any use.
- Also called
- Pygeum africanum, Prunus africana, African plum tree, African cherry, Tadenan
- Taken for
- prostate health, enlarged prostate, urinary symptoms, nighttime urination, prostatitis
Strong several reviews agree · Moderate one review or consistent trials · Limited one or a few small studies · Untested no study in people, listed with what it rests on
Shown to help1
Reported risks0
No risks sourced yet.
What people take it for, and what was found
Shown to help1
Urinary symptoms from an enlarged prostate
Shown to improve urinary symptoms and flow in men with an enlarged prostate, with twice as many reporting overall improvement, in short trials.
The numbers and sources
- Effect
- In a meta-analysis of 18 RCTs (1,562 men), pygeum improved the combined outcome of urologic symptoms and flow measures against placebo (effect size -0.8 SD, 95% CI -1.4 to -0.3, 6 studies). Men were more than twice as likely to report improved overall symptoms (RR 2.1, 95% CI 1.40 to 3.1). Nighttime urination fell 19%, residual urine volume fell 24%, and peak urine flow rose 23% [1]. In 209 men comparing 50 mg twice a day with 100 mg once a day for 2 months, symptom scores improved 38% and 35%, with no difference between doses [2].
- Population
- Men with symptomatic benign prostatic hyperplasia [1][2].
- Sources
- [1], [2]
- Caveats
- Mean trial length was 64 days (range 30 to 122). Only 1 of 18 studies reported allocation concealment, many could not be pooled, and preparations varied, including combinations with other plant extracts [1]. Trial [2] had no placebo group. No trials compared pygeum with alpha blockers or 5-alpha reductase inhibitors [1].
Claimed, not studied in people1
Prostatitis
Not studied in people. In lab and animal work its plant sterols block prostaglandin production in the prostate, which a review links to the inflammation of chronic prostatitis.
No study in people. This rests on lab studies, animal studies, how it acts in the body, documented traditional use.
The numbers and sources
- Effect
- A 2023 review of the literature from 1971 to 2021 reports that pygeum bark has been taken traditionally as a decoction for enlarged prostate and urinary and kidney diseases. It attributes most of its activity to phytosterols, mainly beta-sitosterol compounds, which inhibit prostaglandin production in the prostate, and links this to suppressing inflammatory symptoms of enlarged prostate and chronic prostatitis. It reports anti-inflammatory and antimicrobial activity in lab and animal studies [3].
- Population
- Lab and animal studies and ethnobotanical records, reviewed [3].
- Sources
- [3]
- Caveats
- A narrative review of lab, animal and traditional-use evidence. No trial of pygeum in men with prostatitis was located.
Doses studied
The dose comparison trial used 100 mg of extract a day, given as 50 mg twice a day or 100 mg once a day, for 2 months, followed by 10 months of 100 mg once a day [2].
Risks
Checked, no increase found1
Adverse effects in trials
Side effects were mild and about as common on pygeum as on placebo, with dropout 13% against 11%.
The numbers and sources
- Effect
- Adverse effects were mild and similar to placebo. Dropout was 13% on pygeum, 11% on placebo and 8% on other controls [1]. Safety profiles were similar across doses over 12 months [2].
- Population
- Men in RCTs [1][2].
- Sources
- [1], [2]
- Caveats
- Trials were short, and harms beyond 12 months were not studied [1][2].
Sources
- Ishani A, MacDonald R, Nelson D, et al. Pygeum africanum for the treatment of patients with benign prostatic hyperplasia: a systematic review and quantitative meta-analysis. The American Journal of Medicine. 2000. https://doi.org/10.1016/S0002-9343(00)00604-5
- 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. https://doi.org/10.1016/S0090-4295(99)00147-8
- Rubegeta E, Makolo F, Kamatou G, et al. The African cherry: A review of the botany, traditional uses, phytochemistry, and biological activities of Prunus africana (Hook.f.) Kalkman. Journal of Ethnopharmacology. 2023. https://doi.org/10.1016/j.jep.2022.116004