Articles

Pygeum

Plant Part Used

Bark

Active Constituents

Phytosterols (including beta-sitosterol), pentacyclic triterpenes, ferulic acid esters.(1),(2)

[span class=alert]This section is a list of chemical entities identified in this dietary supplement to possess pharmacological activity. This list does not imply that other, yet unidentified, constituents do not influence the pharmacological activity of this dietary supplement nor does it imply that any one constituent possesses greater influence on the overall pharmacological effect of this dietary supplement.[/span]

Introduction

Pygeum grows mainly in Southern Africa, Madagascar and some areas of Central America. Its use as a tribal remedy dates back to ancient times when the powdered herb was added to milk for use in the treatment of bladder pains and micturition problems. Today, a lipophilic extract is used and confirmed as a treatment for benign prostatic hyperplasia (BPH). Pygeum bark is currently indicated for benign prostatic hyperplasia, dysuria, diurnal and nocturnal pollakiuria, prostatitis and prostatosis, and adenomatous fibrosclerosis.(3)

Dosage Info

Dosage Range

100mg (standardized extract), 1-2 times a day.

Most Common Dosage

100mg (standardized extract) daily in divided doses.

Standardization

[span class=doc]Standardization represents the complete body of information and controls that serve to enhance the batch to batch consistency of a botanical product, including but not limited to the presence of a marker compound at a defined level or within a defined range.[/span]

The most current available medical and scientific literature indicates that this dietary supplement should be standardized to 12% phytosterols.

Uses

Frequently Reported Uses

  • Benign Prostatic Hypertrophy (BPH)

Other Reported Uses

  • Prostate Cancer
  • Adenomatous Fibrosclerosis
  • Dysuria
  • Diurnal And Nocturnal Pollakiuria
  • Immunostimulating Effects
  • Cholesterol Lowering

Toxicities & Precautions

General

No toxicity is reported in recommended dosages.

Pregnancy/ Breast Feeding

If pregnant or nursing, consult a physician before use.

Age Limitations

Do not use in children under 2 years of age unless recommended by a physician.

Pharmacology

Pygeum is reported to improve prostate function through a hormonal-like mechanism and reduces the inflammation often connected with BPH. There are several classes of compounds in pygeum that can interfere with the development of BPH, with each compound exhibiting different but complementary pharmacodynamic effects. The classes of bioactive components are the phytosterols, the esters of fatty alcohols with ferulic acid and the pentacyclic terpenes.

The phytosterols, present in free and conjugated form, are reported to be competitive with endogenous and exogenous precursors of androgenic hormones (such as DHT), decreasing exposure of the prostatic cells to hormonal stimulation.(4),(13) Beta-sitosterol and its glucoside posses anti-inflammatory properties on prostatic tissue, medicated by inhibition of prostaglandins PGE2 and PGF2alpha biosynthesis.(5) The prostaglandin content is considerably increased in prostatic tissue in patients with BPH.

The pentacyclic triterpenes are characterized by an antiedemic activity by inhibiting the glucosyl-transferase and the beta-glucoronidase enzymes involved in the first phases of the phlogistic depolymerization of the proteoglycans of the perivascular connective tissue.(6) Also, oleanolic acid has been reported to have immunostimulant activity, useful in the prevention and treatment of malignancy.(7)

The ferulic acid esters found in pygeum bark have a hypocholesterolemic action and may reduce the intraprostatic level of cholesterol, a precursor of the local synthesis of androgens. These esters may increase the number of androgenic receptors, effectively decreasing free hormone levels.(8) The alcoholic moieties of the esters (n-docosanol and tetracosanol) are reported to target specific organs like the adrenal glands and the hypophysis.

In animal experiments, extracts of pygeum have reported improvement in prostate function as confirmed by histological examination of the glandular portion.(9) Over 26 open and double blind clinical trials have been performed using pygeum bark extracts in the management and treatment of BPH, totaling over 721 patients to date.(10),(11) In one of the studies (Breza, et al., 1998) of patients with symptoms of BPH, nocturnal frequency was reduced by 32 percent and the mean reduction was highly statistically significant. Mean maximum urinary flow, average urinary flow and urine volume were also statistically significantly improved, but the modest improvement in post-voiding volume did not reach statistical significance. The improvements, which exceeded those observed with placebo in earlier studies, were maintained after one month without treatment indicating an interesting persistence of clinically useful activity. Prostatic volume and quality of sexual life remained unchanged throughout. No treatment-related adverse effects were observed. Pygeum has been combined with stinging nettle root (Urtica dioica) for patients with BPH with positive clinical results.(12)

Phytosterols in Pygeum bark have been reported to have activity against prostate cancer both in vitro and in vivo.(14)  A laboratory study in rats found that early treatment with P. africanum could effectively suppress the oxidative stress status in diabetic bladder and may slow down the process of diabetic cystopathy.(15)

References

  1. Pierini N, et al. Identification and Determination of N-docosanol in the Bark Extract of Pygeum africanum and In Patent Medicines Containing It. Boll Chim Farm. 1982;121(1):27-34.
  2. Longo R, et al. Steroidal and Other Components of Pygeum africanum Bark. Farmaco. [Prat]. Jul1983;38(7):287-92.
  3. View Abstract: Barlet A, et al. Efficacy of Pygeum africanum Extract in the Medical Therapy of Urination Disorders Due to Benign Prostatic Hyperplasia: Evaluation of Objective and Subjective Parameters. A Placebo-controlled Double-blind multicenter Study. Wien Klin Wochenschr. Nov1990;102(22):667-73.
  4. Mathe G, et al. A Pygeum africanum Extract With So-called Phyto-estrogenic Action Markedly Reduces the Volume of True and Large Prostatic Hypertrophy. Biomed Pharmacother. 1995;49(7-8):341-43.
  5. View Abstract: Paubert-Braquet M, et al. Effect of Pygeum africanum Extract on A23187-stimulated Production of Lipoxygenase Metabolites From Human Polymorphonuclear Cells. J Lipid Mediat Cell Signal. May1994;9(3):285-90.
  6. Kozai K, et al. Inhibition of Glucosyltransferase from Streptococcus mutans by Oleanolic Acid and Ursolic Acid. Caries Res. 1987;21(2):104-08.
  7. View Abstract: Dai Y, et al. Effects of Oleanolic Acid on Immune System and Type I Allergic Reaction. Chung Kuo Yao Li Hsueh Pao. Jul1989;10(4):381-84.
  8. View Abstract: Saito T, et al. Trans-4-hydroxy-3-methoxycinnamic Acid (Ferulic Acid) Inhibits the Effect of Androgens On the Rat Prostate. Experientia. May1979;35(5):696-99.
  9. View Abstract: Clavert A, et al. Effects of An Extract of the Bark of Pygeum africanum (V.1326) On Prostatic Secretions in the Rat and in Man. Ann Urol.(Paris). 1986;20(5):341-43.
  10. View Abstract: 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. Curr Med Res Opin. 1998; 14(3):127-39.
  11. View Abstract: Chatelain C, et al. 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. Urology. Sep1999;54(3):473-78.
  12. View Abstract: Krzeski T, et al. Combined Extracts of Urtica dioica and Pygeum africanum in the Treatment of Benign Prostatic Hyperplasia: Double-blind Comparison of Two Doses. Clin Ther. 1993;15(6):1011-20
  13. Schleich S, Papaioannou M, Baniahmad A, Matusch R. Extracts from Pygeum africanum and other ethnobotanical species with antiandrogenic activity. Planta Med. Jul 2006;72(9):807-813. Epub 2006 Jun 19.
  14. Shenouda NS, Sakla MS, Newton LG, et al. Phytosterol Pygeum africanum regulates prostate cancer in vitro and in vivo. Endocrine. Feb 2007;31(1):72-81.
  15. Wang D, Li Y, Hou G, Wang P, Zhang J, Laudon V, Shi B. Pygeum africanum: effect on oxidative stress in early diabetes-induced bladder. Int Urol Nephrol. 16 Jul 2009. [Epub ahead of print]