Pygeum Clinical Evidence

Breza J, et al. Efficacy and acceptability of tadenan (Pygeum africanum extract) in the treatment of benign prostatic hyperplasia (BPH): a multicentre trial in central Europe. 1998;14(3):127-39. 

Topic: 
Does pygeum aid in the alleviation of urinary symptoms of benign prostatic hyperplasia?

Background:

Benign prostatic hyperplasia (BPH), a nonmalignant enlargement of the prostate, can lead to uncomfortable lower urinary tract symptoms in men.

Study Type:

Human clinical intervention trial

Study Design:

Open-label, multi-center study: men were recruited from three urology clinics in the Czech and Slovak Republics and Poland. Pygeum supplements were provided for 2 months and there was a 1-month follow-up observation period with no treatment.

Subjects:

85 men aged 50-75, with an International Prostate Symptom Score (IPSS) of 12 or above, a quality of life (QoL) score of 3 or above and maximum urinary flow of 15ml/s or less.

Dosage:

50 mg of pygeum twice daily for 2 months

Results:

After 2 months, changes in several parameters of urological health were highly significant:

  • IPSS improved 40%.
  • QoL improved 31%.
  • Nocturnal frequency decreased 32%.
  • Mean maximum urinary flow, average urinary flow and urine volume were also improved to a statistically significant degree.

Interestingly, the improvements were maintained for 1 month even after stopping treatment, indicating a persistence of clinically useful activity.

Conclusion:

“In conclusion, under conditions of daily practice, Pygeum africanum extract induces significant improvement in IPSS and uroflowmetry parameters. These positive effects are accompanied by a very satisfactory safety profile with the overall result of a substantial improvement in QoL.” 

Urology. 
Chatelain C, Autet W, Brackman E. 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. 1999 Sep;54(3):473-8. 

Topic: 
Does pygeum dosage — 50 mg twice daily versus 100 mg once daily — impact the herb’s efficacy in the treatment of benign prostatic hyperplasia (BPH)?

Background:

A previous study found 50 mg of pygeum twice daily significantly improved symptoms of BPH. The goal of this study was to find out if a once-daily supplement provides the same benefits.

Study Type:

Human clinical intervention trial

Study Design:

Randomized, double-blind study with long-term open label extension: For 2 months, 209 study subjects took 1 of 2 different pygeum preparations. Then, 174 of the subjects continued taking the second preparation for 10 months.

Subjects:

209 patients with symptomatic benign prostatic hyperplasia for the first arm; 174 for the extension arm

Dosage:

Either 50 mg of pygeum twice daily or 100 mg once daily for 2 months

Results:

Both treatments had similar efficacy. Specifically:

  • 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 open-label portion of the study.

Conclusion:

“P. africanum extract at 50 mg twice daily and 100 mg once daily proved equally effective and safe at 2 months. Further improvements in efficacy with a satisfactory safety profile were documented after 12 months.” 

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Cochrane Database of Systematic Reviews. 
Wilt T, et al. Pygeum africanum for benign prostatic hyperplasia. 2002(1): CD001044. 

Topic: 
Does the totality of the research support the use of pygeum for benign prostatic hyperplasia (BPH)?

Background:

A number of controlled trials have studied the efficacy of pygeum in the treatment of BPH. This is the first review of all the trials to date.

Study Type:

Review of human clinical trials

Study Design:

A total of 18 controlled trials met the inclusion criteria of: 1.) being randomized, 2.) including men with benign prostatic hyperplasia (BPH), 3. comparing pygeum preparations with placebo or other BPH Medications, and 4.) including clinical outcomes such as urologic symptom scales, symptoms, or urodynamic measures.

Subjects:

A total of 1562 men

Dosage:

Varied by trial

Results:

Compared to men receiving placebo, pygeum provided a moderately large improvement in the combined outcome of urologic symptoms and urinary flow measures. Specifically:

  • Men using pygeum were more than twice as likely to report an improvement in overall symptoms
  • Nocturia (nighttime urination) was reduced by 19%
  • Residual urine volume was reduced by 24%
  • Peak urine flow was increased by 23%

Conclusion:

“A standardized preparation of Pygeum africanum may be a useful treatment option for men with lower urinary symptoms consistent with benign prostatic hyperplasia.” 

Pygeum Mechanism of Action

Androgen (or male hormone) receptor (AR) controls the growth of the prostate gland while NBBS, a compound extracted from the evergreen tree Pygeum africanum, is an androgen antagonist. This means it blocks the action of androgens. That’s important, because androgens such as dihydrotestosterone, a metabolite of testosterone, are considered to play a permissive role in the development of BPH. They don’t necessarily cause the condition, but they do need to be present for it to occur. 

In addition to being an androgen antagonist, pygeum extract can stop the spread and cause the death of benign prostatic cells in the prostate by down-regulating genes and inhibiting cell growth-signaling pathways.