Pygeum (Prunus africanum, Pygeum africanum)

 
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Pygeum
Pygeum

Background

The  Pygeum africanum  (African plum) tree is a tall evergreen of the family Rosaceae found in central and southern Africa. Its bark has been used medicinally for thousands of years. Traditional African healers have used the bark to treat bladder and urination disorders, particularly symptoms associated with benign prostatic hypertrophy (BPH), which is an enlarged prostate. Historically, the bark was powdered and used to make a tea, which was taken by mouth for these conditions.

 

The African plum tree has become endangered due to the demand for its bark to process  P. africanum  extract.

 

The majority of trials conducted since the 1970s report improvements in BPH symptoms with the administration of  P. africanum  bark extract, including frequency of nighttime urination, urine flow rate, and left over urine volume. This research has led some credibility to the common use of this agent in Europe for BPH. The herb is less commonly used in the United States, where prescription drugs or the herb saw palmetto is more commonly used.

 

Synonyms

African plum tree, African prune tree, African  P. africanum  extract, alumty, iluo, kirah, Natal tree, Pigeum africanum, Pigenil®, Pronitol®, Provol®, prunier d'afrique,  Pygeum africana , Rosaceae (family), Tadenan®, V1326, vla, wotangue.

 

Evidence

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Uses based on scientific evidence Grade*
Benign prostatic hypertrophy/BPH symptoms

Pygeum ( P. africanum bark extract) has been observed to moderately improve urinary symptoms associated with enlargement of the prostate gland or prostate inflammation. Numerous human studies report pygeum to significantly reduce the number of nighttime urinary episodes, urinary hesitancy, urinary frequency, and pain with urination in men who experience mild-to-moderate symptoms. However, pygeum does not appear to reduce the size of the prostate gland or reverse the process of BPH. It is unclear how pygeum compares to the effectiveness or safety of other medical therapies, such as prescription drugs (eg. alpha-adrenergic blockers or 5-alpha reductase inhibitors), surgical approaches, or other herbs/supplements such as saw palmetto.There is ongoing study in this area. Patients with urinary symptoms or BPH shouldspeak with their healthcare professional about the various available treatment options.

B

 

*Key to grades
A: Strong scientific evidence for this use;
B: Good scientific evidence for this use;
C: Unclear scientific evidence for this use;
D: Fair scientific evidence against this use;
F: Strong scientific evidence against this use.

 

Grading rationale

Uses based on tradition or theory
The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Aphrodisiac, bladder sphincter disorders, fever, impotence, inflammation, kidney disease, malaria, male baldness, partial bladder outlet obstruction, prostate cancer, prostatic adenoma, prostatitis, psychosis, sexual performance, stomach upset, urinary tract health.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older):
Capsules: For treating benign prostatic hypertrophy, 75 to 200 milligram capsules of standardized pygeum extract taken daily by mouth either as a single dose or divided into two equal doses have been studied. One clinical human trial has shown that  Pygeum africanum  (25 milligrams) and stinging nettle ( Urtica dioica ) (30 milligrams), when used in combination, was efficient in treating benign prostatic hypertrophy and its symptoms.

 

Children (younger than 18 years):
There are not enough scientific data to recommend pygeum for use in children and there are potential side effects.

 

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies
People with known allergies to pygeum should avoid this herb.

 

Side Effects and Warnings
Pygeum has been well tolerated in most studies, with adverse effects similar to placebo (sugar pill). Some people may experience stomach discomfort, including diarrhea, constipation, stomach pain or nausea. Stomach upset is usually mild and does not typically cause people to stop using pygeum.

 

Safety of use beyond 12 months has not been reliably studied.

 

Pregnancy and Breastfeeding
Pygeum cannot be recommended during pregnancy or breast-feeding because of a lack of scientific information and possible hormonal effects.

 

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs
Use of pygeum with other drugs commonly used to treat symptoms of prostate enlargement, called 5-alpha-reductase inhibitors, such as terazosin (Hytrin®) or finasteride (Propecia®, Proscar®), may increase beneficial effects, although this is not well studied.

 

In theory, pygeum may interact with estrogen or other hormones.

 

Interactions with Herbs and Dietary Supplements
Pygeum may result in increased beneficial effects for the prostate if used with saw palmetto ( Serenoa repens ) or stinging nettle ( Urtica dioica ). Combination products are available containing both stinging nettle and pygeum.

 

Pygeum may interact with herbs/supplements containing chemicals with estrogen-like effects ("phytoestrogens").