Pygeum
Prunus africana
TL;DR
Pygeum africanum bark extract at 100-200 mg/day modestly improves urinary flow and nocturia in benign prostatic hyperplasia. A Cochrane review found roughly a 19% improvement in peak urine flow and two fewer night-time voids per week — real, but smaller than alpha-blockers and unlikely to change prostate volume.
Ideal For
- Men with mild to moderate BPH symptoms who have had a urological workup
- Men whose main complaint is nocturia rather than obstructive symptoms
- Those who did not tolerate alpha-blockers because of dizziness or ejaculatory effects
- Men wanting an adjunct alongside standard therapy, with their clinician informed
Avoid If
- You have not had prostate cancer excluded by a clinician
- You have acute urinary retention or blood in the urine — these need urgent assessment
- You are relying on it instead of proven therapy for severe symptoms
- You cannot verify sustainable, CITES-compliant sourcing
Frequently Asked Questions
How much improvement should I expect?
Does pygeum lower PSA?
Pygeum or saw palmetto?
Is the sourcing a problem?
Overview
Prunus africana bark has been used in African traditional medicine for urinary complaints and has been a registered BPH treatment in France and Italy for decades. The Cochrane review pooling 18 randomised trials in over 1,500 men found consistent, modest symptomatic benefit: improved peak and mean urinary flow, reduced residual volume and fewer nocturia episodes, with adverse-event rates similar to placebo. What it does not do is shrink the prostate or alter PSA, which distinguishes it mechanistically from 5-alpha-reductase inhibitors and means it cannot mask a rising PSA on screening. Most trials are short, run before modern symptom-score standardisation, and used a lipophilic bark extract that is not consistently replicated across retail products. The other complication is ecological: wild harvesting drove Prunus africana onto CITES Appendix II, so sourcing matters. Treat pygeum as a reasonable adjunct for mild to moderate lower urinary tract symptoms after a urological assessment, not as a substitute for one.
How It Works
- Phytosterols including beta-sitosterol inhibit prostaglandin synthesis in prostatic tissue
- Pentacyclic triterpenes reduce oedema and inflammation at the bladder neck
- Ferulic acid esters reduce cholesterol availability for local androgen synthesis
- Inhibits fibroblast growth factor activity implicated in stromal proliferation
- Restores bladder contractility in models of outlet obstruction
- No measurable effect on serum testosterone, DHT or PSA
Quick Facts
- Traditional prostate remedy
- Improves urinary symptoms
- Reduces prostate inflammation
- Supports urinary flow
- Anti-inflammatory effects
Supporting Research4 studies
Pygeum africanum for benign prostatic hyperplasia
Wilt T, Ishani A, Mac Donald R +2 more
Across 18 randomised trials Pygeum africanum improved urologic symptoms and peak urine flow versus placebo, with adverse events comparable to placebo.
Pygeum africanum for the treatment of patients with benign prostatic hyperplasia: a systematic review and quantitative meta-analysis
Ishani A, MacDonald R, Nelson D +2 more
Men taking Pygeum africanum were more than twice as likely to report improved overall symptoms, with reduced nocturia and residual urine volume.
Comparison of once and twice daily dosage forms of Pygeum africanum extract in patients with benign prostatic hyperplasia: a randomized, double-blind study
Chatelain C, Autet W, Brackman F
Both 100 mg once daily and 50 mg twice daily reduced IPSS by about 38 percent with benefit maintained one month after withdrawal.
Efficacy and acceptability of tadenan (Pygeum africanum extract) in the treatment of benign prostatic hyperplasia: a multicentre trial in central Europe
Breza J, Dzurny O, Borowka A +4 more
Two months of Tadenan 50 mg twice daily reduced IPSS by 40 percent with benefit largely sustained after a one month washout.
Safety Information
Potential Side Effects
Generally well tolerated. Mild gastrointestinal upset, nausea and abdominal pain are the most reported effects and occur at rates close to placebo in pooled trials.
Contraindications
Undiagnosed lower urinary tract symptoms, suspected prostate malignancy, acute urinary retention.
Drug Interactions
- No established pharmacokinetic interactions
- Additive symptomatic effect with alpha-blockers such as tamsulosin — not a safety issue but confounds assessment
- Theoretical additive effect with 5-alpha-reductase inhibitors, though mechanisms differ
Pregnancy & Breastfeeding
Pregnancy: Not enough evidence to judge
Breastfeeding: Not enough evidence to judge
Dosage Guidelines
Dosage Used in Studies
50-200 mg
Best Time to Take
With meals, split morning and evening
Best Form
Standardised lipophilic bark extract at 13% sterols, 100 mg/day
Bioavailability
The active fraction is lipophilic and absorption improves with dietary fat. Human pharmacokinetics are poorly characterised, and standardisation to sterol content is the only practical quality marker.
Dosing by Goal
| Goal | Dose | Notes |
|---|---|---|
| Standard | 100 mg/day, either as one dose or 50 mg twice daily | |
| Timing | With food to reduce gastrointestinal upset | |
| Trial duration | Most positive trials ran 30-90 days | |
| Assessment | Re-score IPSS at 8 weeks and discontinue if unchanged | |
| Upper range | 200 mg/day used in some trials with no added toxicity |
Forms Compared
Standardised lipophilic bark extract
13% total sterols, 0.5% n-docosanol — the specification used in trials
50 mg twice-daily capsules
The most common trial regimen
100 mg once-daily capsules
Equivalent daily exposure with better adherence
Pygeum plus saw palmetto combinations
Popular, but effect attribution between the two becomes impossible
Raw bark powder
Unstandardised sterol content; not a therapeutic form
Food & Timing
With meals; taking the evening dose after dinner suits nocturia-dominant symptoms
Medical Disclaimer
The information provided on this website is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any supplement regimen.
Individual results may vary. The statements on this website have not been evaluated by the Food and Drug Administration. Products and information are not intended to diagnose, treat, cure, or prevent any disease.