The P. africanum (African plum) tree is a tall evergreen of the family Rosaceae found in central and southern Africa. Its bark has been used medicinally for thousands of years. Traditional African healers have used the bark to treat bladder and micturition (urination) disorders, particularly symptoms associated with benign prostatic hypertrophy (BPH). Historically, the bark was powdered and used to make a tea, which was taken by mouth for these conditions.

The African plum tree has become endangered due to the demand for its bark to process P. africanum extract.

The majority of trials conducted since the 1970s report improvements in BPH symptoms with the administration of P. africanum bark extract, including frequency of nocturia (nighttime urination), urine flow rate, and residual urine volume. This research has led some credibility to the common use of this agent in Europe for BPH. The herb is less commonly used in the United States, where prescription drugs or the herbsaw palmettois more commonly used.

Synonyms

African plum tree, African prune tree, African P. africanum extract, alumty, iluo, kirah, Natal tree, Pigeum africanum, Pigenil®, Pronitol®, Provol®, prunier d'afrique, Pygeum africana , Rosaceae (family), Tadenan®, V1326, vla, wotangue.

Evidence

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Uses based on scientific evidence

Benign prostatic hypertrophy/BPH symptoms

Pygeum ( P. africanum bark extract) has been observed to moderately improve urinary symptoms associated with enlargement of the prostate gland or prostate inflammation. Numerous controlled trials in humans and studies that combine the results of other research (meta-analyses), report pygeum to significantly reduce the number of nighttime urinary episodes (nocturia), urinary hesitancy, urinary frequency, and dysuria (pain with urination) in men who experience mild-to-moderate symptoms. However, pygeum does not appear to reduce the size of the prostate gland or reverse the process of BPH. It is unclear how pygeum compares to the effectiveness or safety of other medical therapies, such as prescription drugs (such as alpha-adrenergic blockers or 5-alpha reductase inhibitors), surgical approaches, or other herbs/supplements such assaw palmetto). Although many of the available studies are not well designed or reported, the weight of scientific evidence supports the benefits of pygeum. Better research would strengthen the scientific support for this therapy, and there is ongoing study in this area. It is recommended that patients with BPH speak with their healthcare professional about the various available treatment options.Most studies have used the European brand Tadenan®. The mechanism of action of pygeum remains unclear. Early research reports reductions in urethral obstruction and improved bladder function. Laboratory studies report inhibition of enzymes including 5-lipoxygenase or 5α-reductase, a mechanism similar to the prescription drug finasteride. Stimulation of secretory activity of the prostate and seminal vesicles is reported in rats and humans, and some estrogen-like properties are noted, as well as anti-inflammatory properties.

Uses based on tradition or theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Aphrodisiac, bladder sphincter disorders, fever, impotence, inflammation, kidney disease, malaria, male baldness, partial bladder outlet obstruction (animal study), prostate cancer, prostatic adenoma, prostatitis, psychosis, sexual performance, stomach upset, urinary tract health.

Dosing

Standardization:

The active component(s) of P. africanum bark extract have not been identified.

Tadenan® (Laboratoires DEBAT, Garches, France), the most popular and commonly studied brand in Europe, is a lipophilic extract of P. africanum standardized to 13% total sterols. Other guidelines specify standardization to 14% triterpenes with 0.5% n-docosanol. One capsule of Tadenan® contains 50mg of standardized extract.

Other studied brands include Pigenil® (Inverni della Beffa, Milan, Italy), Harzol® (Hoyer, Germany), and Prostatonin® (Pharmaton SA, Lugano, Switzerland). Some brands may contain other herbs in addition to pygeum.

Safety of use of pygeum beyond 12 months has not been reliably studied.

Adults (18 years and older):

Capsules: For treating benign prostatic hypertrophy, 75 to 200 milligram capsules of standardized pygeum extract taken daily by mouth either as a single dose or divided into two equal doses have been used and studied. One clinical human trial has shown that Pygeum africanum (25mg) and stinging nettle ( Urtica dioica ) (30 mg), when used in combination, was efficient in treating benign prostatic hypertrophy and its symptoms.

Children (younger than 18 years):

There are not enough scientific data to recommend pygeum for use in children, and pygeum is not recommended because of potential side effects.

Safety

Allergies

People with known allergies to pygeum should avoid this herb.

Side Effects and Warnings

Pygeum has been well tolerated in most studies, with adverse effects similar to placebo (sugar pill). Some people may experience stomach discomfort, including diarrhea, constipation, stomach pain or nausea. Stomach upset is usually mild and does not typically cause people to stop using pygeum.

Safety of use beyond 12 months has not been reliably studied.

Pregnancy and Breastfeeding

Pygeum cannot be recommended during pregnancy or breast-feeding because of a lack of scientific information and possible hormonal effects.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

Use of pygeum with other drugs commonly used to treat symptoms of prostate enlargement, called 5-alpha-reductase inhibitors, such as terazosin (Hytrin®) or finasteride (Propecia®, Proscar®), may increase beneficial effects, although this is not well studied.

In theory, pygeum may interact with estrogen or other hormones.

Interactions with Herbs and Dietary Supplements

Pygeum may result in increased beneficial effects for the prostate if used with saw palmetto ( Serenoa repens ) or stinging nettle ( Urtica dioica ). Combination products are available containing both stinging nettle and pygeum.

Pygeum may interact with herbs/supplements containing chemicals with estrogen-like effects ("phytoestrogens"). Possible examples include alfalfa, black cohosh, bloodroot, burdock, hops, kudzu, licorice, pomegranate, red clover, soy, thyme, white horehound, and yucca.

Tags: Herbal Medicine

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