Botanical names: Prunus africanum, Pygeum africanum.  Pygeum is an evergreen tree found in the higher elevations of central and southern Africa. The bark is used medicinally. Wild pygeum is environmentally threatened and efforts are being made to grow pygeum on plantations and control harvesting in the wild.

Pygeum has been used in connection with benign prostatic hyperplasia (BPH), and prostatitis (CBP, NBP).

The powdered bark was used as a tea for relief of urinary disorders in African herbal medicine. European scientists were so impressed with reports of pygeum’s actions, they began laboratory investigations into the active constituents in the bark. This led to the development of the modern lipophilic (fat-soluble) extract used today.

Active constituents: Chemical analysis and pharmacological studies indicate the lipophilic extract of pygeum bark has three categories of active constituents: 1) Phytosterols, including beta-sitosterol, have anti-inflammatory effects by interfering with the formation of hormone-like substances in the body (prostaglandins) that tend to accumulate in the prostate of men with benign prostatic hyperplasia (BPH); 2) pentacyclic terpenes have an anti-edema, or decongesting, effect; 3) ferulic esters indirectly control testosterone activity in the prostate, which may reduce the risk of BPH.  While these effects have been shown in test tube studies, human studies are still needed to confirm these effects in the body. Pygeum alone has been shown in some double-blind trials to help men with BPH by improving urinary flow and other symptoms of BPH.  It has also been used successfully in combination with nettle root to treat BPH. Long-term BPH studies (six months or greater) on pygeum are lacking, however.

The accepted form of pygeum used in Europe for treatment of BPH is a lipophilic extract standardized to 13% total sterols (typically calculated as beta-sitosterol).  Men with mild to moderate BPH sometimes take 50–100 mg two times per day. A double-blind trial found that 100 mg once daily was as effective as 50 mg twice per day. Pygeum should be monitored over at least a six-month period to determine efficacy. Men with BPH who are using pygeum should be supervised by a doctor.

Side effects from the lipophilic extract of pygeum are rare. In clinical trials, there were reports of mild gastrointestinal upset in some men.  At the time of writing, there were no well-known drug interactions with pygeum.