Pygeum

botanicalbark

What is it

Pygeum is the common name for the bark extract of Prunus africana (formerly Pygeum africanum ), an evergreen tree native to the montane forests of sub-Saharan Africa. The bark contains a characteristic mixture of phytosterols (chiefly beta-sitosterol and its glycosides), pentacyclic triterpenes (ursolic and oleanolic acids), ferulic acid esters of long-chain fatty alcohols (n-docosanol, n-tetracosanol), and other lipophilic constituents. Standardised lipidosterolic extracts are most commonly used in supplements for benign prostatic hyperplasia and lower urinary tract symptoms. The species is CITES-listed owing to overharvesting; sustainably sourced cultivated material is increasingly preferred.

Evidence for 4 uses

AI-assisted evidence assessment — talk to your doctor before relying on any single supplement.

Benign prostatic hyperplasia and lower urinary tract symptoms

Good

A Cochrane systematic review of pygeum for men with symptomatic BPH found moderate-quality evidence that Prunus africana extract modestly improves urinary symptoms (urgency, frequency, nocturia) and urodynamic measures compared with placebo over 6-12 weeks. Effects are smaller than those of 5-alpha-reductase inhibitors and alpha-blockers, but pygeum has been used as a first-line phytotherapy option in several European guidelines.

Nocturia

Good

Several trials of standardised pygeum extract report meaningful reductions in night-time urinary frequency in men with BPH, often by approximately one episode per night, with a favourable tolerability profile.

Chronic prostatitis and chronic pelvic pain syndrome

Limited

Small clinical studies suggest pygeum extract may modestly improve symptoms of category III chronic prostatitis/chronic pelvic pain syndrome, alone or in combination with other agents. Evidence is limited and heterogeneous.

Male sexual function

Mixed

Some BPH trials have reported small concurrent improvements in sexual function scores with pygeum extract, plausibly secondary to symptom relief; pygeum is not established as a primary treatment for erectile dysfunction or low libido.

Dosage

The most studied form is a standardised lipidosterolic extract of Prunus africana bark (often noted as PA), typically dosed at 100-200 mg/day, either as a single dose or divided twice daily, for at least 6-8 weeks before evaluating effect. Some trials have used 50 mg twice daily with broadly similar efficacy. Capsulated whole-bark extracts that are not standardised vary widely; users should choose products specifying lipidosterolic extract content.

Safety

Pygeum extract is generally well tolerated. The most commonly reported side effects in clinical trials are mild gastrointestinal symptoms - nausea, abdominal pain, and constipation - usually occurring in fewer than 10% of users. Allergic reactions are uncommon. No clinically meaningful drug interactions have been firmly established, but as a phytosterol-rich preparation it could theoretically interact with cholesterol absorption-modifying drugs. Pygeum may modestly affect prostate-specific antigen interpretation, so clinicians should be aware of its use during prostate cancer surveillance. Pregnancy and lactation use are not relevant, as the indication is male lower urinary tract symptoms. Sustainability concerns argue for choosing CITES-compliant, cultivated sources.

References

  • Wikidata: Prunus africana (Q959738) — Wikidata link
  • Cochrane: Pygeum africanum for benign prostatic hyperplasia — Cochrane link
  • MSKCC About Herbs: Pygeum — MSKCC link
  • NIH Dietary Supplement Label Database: Pygeum — DSLD link

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Evidence-based·How we grade evidence

Disclaimer: These statements have not been evaluated by the FDA. This page is educational, not a substitute for personalized medical advice. Evidence grades are AI-assisted assessments — talk to your doctor before starting any new supplement, especially if you’re pregnant, breastfeeding, on medications, or managing a chronic condition.