Pygeum
Prunus africana (syn. Pygeum africanum)
Bark extract of the African cherry tree, used in Europe for decades for benign prostatic hyperplasia, with a Cochrane review supporting modest improvements in urinary symptoms.
At a Glance
- Best known for
- Improves urinary symptoms of enlarged prostate (BPH), Reduces nighttime urination (nocturia), Anti-inflammatory effect on prostate tissue
- Evidence
- Moderate
- Typical dose
- 50 mg standardized extract 2x daily
- Type
- Herb
What is Pygeum?
Pygeum is a lipophilic extract of the bark of Prunus africana, a tall evergreen tree native to the mountain forests of central and southern Africa. Traditional healers used the powdered bark for bladder discomfort and 'old man's disease'. A standardized extract (Tadenan) has been prescribed in France and other European countries since the late 1960s for lower urinary tract symptoms due to benign prostatic hyperplasia. Demand has made the species vulnerable to over-harvesting, and it is listed under CITES Appendix II, so sustainably sourced products matter.
Known Health Benefits
How It Works
Pygeum works through several complementary actions on the prostate and bladder. Its phytosterols, especially beta-sitosterol, reduce prostaglandin synthesis and inflammation within prostate tissue. The pentacyclic triterpenes inhibit enzymes involved in inflammation and reduce edema. Ferulic acid esters lower prolactin and reduce cholesterol uptake in the prostate, which may limit androgen-driven growth. In laboratory studies pygeum inhibits proliferation of prostatic fibroblasts stimulated by growth factors and improves bladder contractility and compliance in obstructed bladders. Unlike saw palmetto, it has only weak effects on 5-alpha-reductase.
What Research Says
A Cochrane systematic review (updated 2002) pooled 18 randomized trials with 1,562 men and found that pygeum improved overall urologic symptoms about twice as often as placebo, reduced nocturia by roughly 19%, increased peak urine flow by about 23%, and reduced residual urine volume by 24%. Side effects were mild and comparable to placebo. The reviewers cautioned that trials were short (mostly 6–12 weeks), small, and used different preparations, and that there were no comparisons with standard drugs such as alpha-blockers. A large open-label trial of 50 mg twice daily versus 100 mg once daily found both equally effective at 2 months, with improvement maintained for a year. Combination studies with nettle root suggest additive benefit. No trial has shown pygeum reduces prostate size or the risk of acute urinary retention, and there is no evidence for prostate cancer prevention.
Active Compounds
Phytosterols (beta-sitosterol), pentacyclic triterpenes (ursolic and oleanolic acids), ferulic acid esters (n-docosanol, n-tetracosanol)
Forms & Bioavailability
The clinically tested preparation is a lipid-soluble (chloroform or hexane) extract, which concentrates the sterols and ferulic esters; water or alcohol extracts and raw powder do not replicate the studied product. Fat-soluble constituents are better absorbed with food. Symptom improvement typically takes 4–8 weeks of consistent use.
Dosage Guidance
| Use Case | Dosage |
|---|---|
| BPH urinary symptoms (standard) | 50 mg standardized extract 2x daily |
| BPH (once-daily) | 100 mg standardized extract daily |
| Maintenance | 100 mg daily |
| Combination with nettle root | 100 mg pygeum + 300 mg nettle root daily |
Always consult a healthcare provider for personalized dosing.
Natural Food Sources
- Not found in food; the bark is used medicinally only
Potential Side Effects
Generally well tolerated; mild nausea, stomach upset, constipation, or diarrhea in a small minority
Who Should Avoid It
- Undiagnosed urinary symptoms — prostate cancer must be excluded first; pygeum can mask symptoms without affecting the disease
- Pregnancy and breastfeeding (no relevant use or safety data)
- Children (no data)
- Known allergy to Prunus (stone fruit) species — theoretical cross-reactivity
Pregnancy & Lactation
Not applicable for its main indication and not recommended; there are no safety data for pregnancy or lactation.
Known Drug Interactions
No well-documented drug interactions; theoretical additive effect with alpha-blockers and 5-alpha-reductase inhibitors; may mask symptoms that warrant prostate evaluation
Evidence Classification
Supported by cohort studies, case-control studies, or multiple observational studies with consistent findings.
Frequently Asked Questions
How does pygeum compare with saw palmetto?
Both are used for BPH symptoms. Saw palmetto has far more trials, but the large, high-quality ones (such as the 2006 NEJM trial and 2012 Cochrane update) found little benefit over placebo, whereas the smaller pygeum trials have been more consistently positive. The two have different mechanisms, so many prostate formulas combine them. Neither shrinks the prostate the way finasteride does.
How long before I notice a difference?
Most trials measured outcomes at 6–8 weeks, and that is a reasonable trial period. Nocturia (getting up at night) is often the first symptom to improve. If nothing changes after 3 months, it is unlikely to help and you should discuss other options with your doctor.
Does pygeum affect PSA readings?
Unlike finasteride, pygeum does not appear to lower PSA, so it should not interfere with prostate cancer screening. Still, tell your doctor what you are taking so results can be interpreted correctly.
Is it sustainably sourced?
Over-harvesting of wild Prunus africana bark has threatened the species in parts of Africa, and it is regulated under CITES. Look for products that state sustainable or plantation sourcing. Harvesting bark properly (strips from opposite sides of the trunk) allows trees to recover.
References
- Pygeum africanum for benign prostatic hyperplasia. Wilt T, Ishani A, Mac Donald R, Rutks I, Stark G. Cochrane Database of Systematic Reviews (2002)View study
- Efficacy and safety of the extract of Pygeum africanum (Tadenan) in the treatment of benign prostatic hyperplasia: a dose-comparison study. Chatelain C, Autet W, Brackman F. Urology (1999)
- Pygeum. Examine.comView study
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This entry is for educational purposes only. It is not medical advice. Always consult a qualified healthcare provider before starting, stopping, or changing any supplement regimen, especially if you take medications or have health conditions.