Introduction:
Pygeum (Pygeum africanum) or the African plum tree is often made into an herbal extract from the bark of the tree. The extract has been used with success for benign prostatic hyperplasia (BPH) which occurs when cells of the prostate develop hyperplasia and nodular enlargement. This process may eventually compresses the urethra and causes symptoms of urinary retention, prolonged/incomplete bladder emptying, thin urine stream, frequent need to urinate, painful urination, urge to urinate at night, and urgency to void. The BPH disease process is known to begin early since about half of all men over 50 and most men over 70 will have evidence of BPH that can be detected in the cells of the prostate.
Pygeum africanum dosage and BPH symptoms:
A dose of 100 mg Pygeum africanum (bark) extract once daily appears to be as effective as the more common dosage of 50 mg twice daily. For 2 months, 209 study subjects took either 50 mg of pygeum twice daily (group A) or 100 mg once daily (group B). Then, 174 of the subjects continued taking the second preparation for 10 months. Both treatments had similar efficacy. The International Prostate Symptom Score improved by 38% in group A and 35% in group B. Quality of life improved by 28% in both groups. Maximum urinary flow rate increased by 16% in group A and 19% in group B. After 12 months, the IPSS had improved by 46% in the 174 patients who continued the study. (1)
Pygeum africanum, BPH and urine flow:
Pygeum africanum extract can safely and effectively help to reduce the symptoms of benign prostatic hyperplasia (BPH), enlarged prostate. Eighty-five men aged 50-75 years old with mild to moderate BPH were given 50 mg of pygeum twice daily for 2 months. The study participants demonstrated a 40% decrease in the International Prostate Symptom Score, an assessment of the severity of symptoms of BPH. Pygeum-supplemented men also reported a 32% decrease in frequency of night-time urination (nocturia) and a 31% improvement in quality of life. After the supplementation with pygeum ended, the patients were followed for one additional month. The benefits from Pygeum therapy for a month after supplementation had ended. (2)
A Cochrane Database Systematic Review on Pygeum africanum:
A review of 18 randomized trials looked at 1562 men with BPH found that Pygeum africanum may reduced the symptoms of lower urinary symptoms in men with BPH. Study duration ranged from 30 to 122 days (average was 64 days) and used a standardized dose of Pygeum africanum extract between 75 and 200 mg daily. Compared to men receiving placebo, men taking Pygeum africanum were more than twice as likely to report an improvement in overall symptoms: night-time urination was reduced by 19%, residual urine volume by 24% and peak urine flow increased by 23%. Side-effects were mild and similar in both groups. (3)
Summary and Conclusion: Pygeum africanum
- Pygeum africanum taken at an oral dose of 50 mg twice per day or 100 mg oral once per day up to one year has been studied. It may reduce the symptoms of lower urinary symptoms in men with BPH and treatment effects may last for one month after stopping the supplement.
- Side-effects were mild and similar to placebo in the research reviewed. This agent has not be studied enough to ensure safety and more research is needed. Allergy to Pygeum africanum or to this family of plants is a contraindication to taking this agent.
References:
1.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. http://www.ncbi.nlm.nih.gov/pubmed/10475357
2.Breza J, Dzurny O, Borowka A, et al. Efficacy and acceptability of tadenan (Pygeum africanum extract) in the treatment of benign prostatic hyperplasia (BPH): a multicentre trial in central Europe. Curr Med Res Opin. 1998;14(3):127-39. http://www.ncbi.nlm.nih.gov/pubmed/9787978
3.Wilt T, Ishani A, MacDonald R, et al. Pygeum africanum for benign prostatic hyperplasia. Cochrane Database Syst Rev. 2002;(1):CD001044. http://www.ncbi.nlm.nih.gov/pubmed/11869585