The bark of the African plum tree (Pygeum africanum), a traditional African remedy for a variety of conditions, is nowadays widely used for prostate enlargement and other urinary diseases. Read on to learn more about this herbal supplement, its health benefits, and potential side effects.
What Is Pygeum?
Pygeum africanum (or Prunus africana), commonly known as the African plum tree or pygeum, is an evergreen tree native to the mountainous regions of Sub-Saharan Africa, the Madagascar and Comoros islands, and the Gulf of Guinea [1].
In Africa, pygeum bark has traditionally been chewed or crushed into powder and drunk as a tea to help with conditions such as [2, 3]:
- Prostate problems
- Urinary problems
- Bladder discomfort
- Kidney disease
- Chest pain
- Stomach ache
- Malaria
- Fever symptoms
- “Madness”
Pygeum bark is widely sold as an extract in Europe (especially in France) and the US to improve and/or prevent urinary disorders, prostate enlargement, and prostate cancer [4, 5].
The extract is mainly marketed under the brand names [5, 6, 7]:
- Tadenan
- Pygenil
- Prosta-FX
Components of Pygeum
Pygeum bark is rich in phytosterols, fatty acids, pentacyclic triterpenes, and esters of ferulic acid. Phytosterols are compounds found in plants that are structurally similar to cholesterol. The variety of fatty acids found in pygeum include saturated fatty acids and unsaturated omega fatty acids. There are some promising, preliminary data on the pentacyclic triterpenes and ferulic acid found in pygeum bark as anti-cancer compounds and other pygeum compounds (atraric acid and n-butylbenzenesulfonamide) as hormone blockers [8, 9, 10, 11, 12, 13].
Pygeum bark is very rich in phytosterols such as [8, 9, 14]:
- Beta-sitosterol (also found in pygeum leaves)
- Beta-sitosterol glucoside (also found in pygeum leaves)
- Beta-sitostenone
- Campesterol
- Daucosterol
The main fatty acids present in the bark include [8, 10, 11]:
- Palmitic
- Abietic
- Linoleic
- Oleic
- Myristic
- Lauric
The most abundant pentacyclic triterpenes are [12, 14]:
- Ursolic acid
- Oleanolic acid
- Crataegolic acid
- Beta-amyrin (also found in pygeum leaves)
Pygeum bark also contains esters of ferulic acid with the following fatty alcohols [13]:
- n-Docosanol
- n-Tetracosanol
Other active compounds present in pygeum bark include:
How Pygeum Works
1. Blocking of Connective Tissue Cell Growth
Prostate enlargement is caused by the excessive growth of its connective tissue cells, the structural framework of animal tissues. This growth is triggered by the following proteins (growth factors) [17, 18]:
- Basic fibroblast growth factor (bFGF)
- Epidermal growth factor (EGF)
- Transforming growth factor-beta1 (TGF-beta 1)
- Insulin growth factor (IGF)
These proteins activate an enzyme (protein kinase C) that promotes cell division [19].
Pygeum extract reduced prostate connective tissue cell growth in patients with prostate enlargement by decreasing the production of growth factors and blocking their function [20, 21].
Blood extracted from a patient with prostate enlargement that had been given pygeum extract reduced the growth of several types of healthy prostate cells [22].
Pygeum extract also blocked growth in prostate connective tissue cells treated with growth factors [23, 24].
Although the active compound responsible for blocking the growth of connective tissue cells has not been identified yet, another plant containing n-docosanol (Myoschilos oblongum) also blocks prostate cell growth, making n-docosanol a probable candidate [25].
2. Blocking of Cancer Cell Growth
Several compounds present in pygeum extract have been found to kill cancer cells and block their growth. Among them, the most important ones are:
- Ursolic acid: it increases cancer cell death by reducing the production of a protein normally involved in cell death (B-cell leukemia/lymphoma 2 protein) [26, 27].
- Oleanolic acid: it causes cancer cell death and blocks proteins that promote cancer growth [26, 27].
- Ferulic acid: it prevents the growth of new blood vessels, as well as the growth and spread of prostate cancer cells [28].
- Atraric acid: it prevents the growth of prostate cancer cells by blocking the transport and activation of the male sex hormone receptor [29].
- N-butylbenzenesulfonamide: like atraric acid, it prevents the growth of prostate cancer cells by blocking the transport and activation of the male sex hormone receptor but its effect is weaker [30].
- Beta-sitosterol: it alters the function and membrane structure of prostate cancer cells, reduces their spread, and induces their death [31, 32, 33].
- Lauric acid: it prevents the formation of the strong male sex hormone dihydrotestosterone (DHT) and reduces the growth of prostate cancer cells [34, 35].
However, this doesn’t necessarily mean that these compounds have any medical value in cancer therapy. Many substances – including downright toxic chemicals like bleach – have anti-cancer effects in cells and most of them fail to pass further animal studies or clinical trials due to a lack of safety or efficacy.
3. Anti-Inflammatory Activity
Inflammation commonly occurs in patients with enlarged prostates. Their prostate cells have increased levels of the following white blood cell types [36, 37]:
- CD3+ T-cells: cells that recognize and kill infected or cancer cells
- CD11c+ macrophages: cells that capture and “eat” foreign and harmful cells, organisms, and substances
- CD20+ B-cells: cells that produce antibodies
During inflammatory processes, a fatty acid called arachidonic acid is released from cell membranes. In white blood cells, arachidonic acid is broken down into leukotrienes or prostaglandins. Both leukotrienes and prostaglandins trigger several inflammatory responses [38, 39, 40].
In men with prostate enlargement, beta-sitosterol and beta-sitostenone decreased prostaglandin production in this organ [5].
In cells, the addition of pygeum extract blocked the breakdown of arachidonic acid and thus reduced the production of leukotrienes [41].
4. Anti-Sex Hormone Activity
The human prostate contains an enzyme (5 alpha-reductase) that converts the male sex hormone testosterone into its more powerful variant dihydrotestosterone (DHT). Because dihydrotestosterone is increased in patients with prostate enlargement, it is believed to trigger this condition [42].
Alternatively, aromatase is the enzyme that converts male sex hormones into female sex hormones. Excessive female sex hormone build-up also triggers prostate enlargement [43].
A commercial pygeum extract blocked both 5 alpha-reductase and aromatase in prostate tissues. The effect was stronger in combination with stinging nettle extract. Among the compounds present in pygeum extract, lauric acid is known to block 5 alpha-reductase [44, 45].
Testosterone and dihydrotestosterone (DHT) bind to the male sex hormone receptor, which switches on target genes that can trigger prostate enlargement and cancer [46].
Two components capable of blocking the male sex hormone receptor and preventing its activation have been isolated from pygeum bark: atraric acid and n-butylbenzenesulfonamide (NBBS) [16, 15].
Health Benefits
Pygeum extract has been investigated for several health conditions, especially those affecting the prostate, and is commercially available as a supplement.
However, the extract is not approved by the FDA. Supplements generally lack solid clinical research. Regulations set manufacturing standards for supplements but don’t guarantee that they are safe or effective. Talk to your doctor before using pygeum extract for any conditions to avoid unexpected interactions.
Likely Effective for:
Prostate Enlargement
Prostate enlargement is a disease that affects 50% of men in their 60s and 85% of those over 80 years old. Its main symptoms include [47]:
- Increased urinary frequency
- Difficulty in delaying urination
- Certain effort required to start urination
- Weak urinary flow
- Sensation of incomplete emptying of the bladder
Although surgery is often required in severe cases, drugs such as alpha-blockers and 5-alpha reductase inhibitors can be used in the early stages or when the symptoms are mild. Even if it’s not approved by the FDA, some people use herbal therapy for this condition [47].
In two meta-analyses of 43 clinical trials and over 3000 people, pygeum extract showed overall improvement of prostate enlargement symptoms over placebo [48, 49].
In an uncontrolled, open-label, study on 85 patients, pygeum extract resolved symptoms and improved quality of life in patients with prostate enlargement but did not reduce prostate size [50].
The daily intake of a preparation combining the extracts of pygeum, saw palmetto, and hoary willowherb, as well as different plant oils, reduced urination frequency in a trial on 57 people with prostate enlargement) [51].
However, pygeum extract did not relieve prostate enlargement symptoms in a trial on 20 people. Similarly, a combined pygeum and stinging nettle extract did not show any improvements on prostate enlargement symptoms and quality of life in another study on 49 people [52, 53].
Overall, research suggests that pygeum extract may help improve prostate enlargement. However, the evidence is largely based on small, low-quality, or unblinded studies and the results are mixed.
Remember to speak with your doctor before taking pygeum supplements. Pygeum extract should never be used as a replacement for approved medical therapies for prostate enlargement.
Insufficient Evidence for:
1) Long-Term Prostate Inflammation
In a clinical trial on 47 people with long-term prostate inflammation, 42 were healed after taking pygeum extract for 5-7 weeks. Similarly, the extract improved all the urinary parameters measured in another trial on 18 people taking it for 60 days, with or without antibiotics [1, 54].
However, two small clinical trials cannot be considered sufficient evidence that pygeum extract improves prostate inflammation. Additionally, neither of these studies was blinded to the participants or researchers meaning that the results might be due to a placebo effect.
Animal and Cell Studies (Lack of Evidence)
Bladder Function Support
Prostate enlargement is normally accompanied by bladder blockage and bladder muscle damage due to low blood supply [55, 56].
In rabbits with bladder blockage, pygeum extract improved the mobility of the bladder muscles in response to stimulation and protected them from damage. The improved mobility in response to pygeum was possibly due to the restored production of the normal forms of a muscle protein (myosin), while the antioxidant activity of the myristic acid contained in the extract might have protected muscle tissues from damage [57, 58, 59, 60, 10].
Diabetes can lead to a bladder condition (diabetic cystopathy) with similar symptoms to prostate enlargement. In diabetic rats, pygeum extract reduced damage in the bladder and increased the production of two protective growth factors (nerve growth factor and substance P) [61, 62, 63].
Anti-Cancer Effects
Below, we will discuss some preliminary research on pygeum’s anticancer activity. It’s still in the animal and cell stage and further clinical studies have yet to determine if pygeum’s compounds are useful in cancer therapies.
Do not under any circumstances attempt to replace conventional cancer therapies with pygeum extract or any other supplements. If you want to use it as a supportive measure, talk to your doctor to avoid any unexpected interactions.
In a study in mice, pygeum extract reduced the growth of two cancer cell lines and decreased the incidence of prostate cancer [31].
The blood of a man who had taken pygeum extract also reduced the growth of prostate cancer cells [64].
Two compounds isolated from pygeum bark (atraric acid and n-butylbenzenesulfonamide) bound to the male sex hormone receptor of prostate cancer cells and prevented its activation. As a result, the cells could neither grow nor invade other tissues [65, 66].
A dietary supplement (ProstaCaid) containing pygeum bark among many other compounds reduced the growth and spread of prostate cancer cells [67].
Epstein-Barr virus is known to cause several cancers such as lymphatic, throat, and stomach cancer. In a cell-based study, pygeum and other plant extracts decreased the activation of this virus [68, 69].
Hair Loss
Dihydrotestosterone produced by 5 alpha-reductase type 2 reduces hair growth in people with male-pattern baldness [70].
Because pygeum extract decreases dihydrotestosterone production by blocking 5 alpha-reductase, it may prevent hair loss caused by this sex male hormone [44].
However, this benefit is mere speculation based on this mechanism. No human or animal studies have tested if pygeum extract actually helps prevent hair loss.
Acne
During puberty, male sex hormones can stimulate oil glands in the skin. The glands increase their size and oil secretion, which causes acne [71].
By blocking the production of dihydrotestosterone and the interaction of male sex hormones with their receptor, pygeum extract may reduce the incidence of acne [44, 16, 15].
Again, a direct causal link has not been established or studied. The potential effect of pygeum on acne is only speculative.
Limitations and Caveats
Prostate Enlargement Studies
Many of the studies were open-label (both the patients and the researchers knew which treatment was being used) or had a low number of patients [72, 50].
A meta-analysis concluded the prostate enlargement studies were limited by the study duration, variability in the design, dosage, composition of extract preparations, and parameters measured in the studies [49].
Pygeum extract failed to show better performance over placebo in some clinical trials [52, 53].
Prostate Inflammation Studies
The clinical trials were conducted on a few patients and were not placebo-controlled [1, 54].
Bladder Studies
The effects of pygeum extract on bladder function have only been tested in animals. Additionally, a very high pygeum concentration (100 mg/kg body weight) was required compared to the effective dose used against prostate enlargement [57, 58, 59].
Cancer Studies
No clinical trials have been carried out to investigate the role of pygeum extract on prostate cancer prevention. The results are based on studies in cells and mice only [65, 66, 22, 73, 67, 31].
Hair Loss and Acne Claims
The effects of pygeum extract on hair loss and acne prevention have not been clinically tested and are speculations based on its anti-male sex hormone activity [44, 16, 15].
Side Effects & Precautions
Keep in mind that the safety profile of pygeum extract is relatively unknown, given the lack of well-designed clinical studies. The list of side effects below is, therefore, not a definite one. You should consult your doctor about other potential side effects based on your health condition and possible drug or supplement interactions.
Among the side effects observed in clinical studies, the most common ones are those affecting the digestive system, such as [74, 75]:
- Constipation
- Diarrhea
- Stomach pain
- Nausea
Other effects reported include [74, 75]:
- Muscle and joint pain
- Headache
- Dizziness
- Visual disturbances
- Restlessness
- Insomnia/difficulty falling asleep
- Hernia (protrusion of intestines through a canal in the groin: inguinal hernia)
The most serious adverse effects are those related to the urinary system [74]:
- Lack of urination
- Urine retention
Because the effects of pygeum during pregnancy and breastfeeding have not been studied, its use should be avoided in these cases [76].
Drugs Interactions
Because pygeum extract reduces the production of dihydrotestosterone and female sex hormones, it may interfere with hormone drugs such as birth control pills [77, 44].
Pygeum may enhance the action of 5 alpha-reductase blockers (testosterone blockers) such as these medications for prostate enlargement [78]:
- Terazosin (also a high blood pressure medication)
- Finasteride (also treats hair loss)
- Doxazosin (also a high blood pressure medication)
Similarly, it may increase the blocking of aromatase (an enzyme involved in estrogen production) by these breast cancer medications [79]:
- Exemestane
- Anastrozole
- Letrozole
- Testolactone
Pygeum may also increase the effects of these male sex hormone blockers used to treat prostate cancer [80]:
- Flutamide
- Bicalutamide
- Nilutamide
- Abiraterone acetate
- Enzalutamide
Pygeum extract may also enhance the blocking of 5-lipoxygenase by drugs such as zileuton (asthma medication) [81].
Because it reduces the production of the regulator protein B-cell lymphoma 2 (involved in cell death), pygeum extract may decrease the activity of drugs targeting it, such as these cancer medications [82]:
- Oblimersen
- Venetoclax
Pygeum extract may also reduce the activity of protein kinase C activators such as ingenol mebutate (anti-tumor medication) and add to the effect of drugs blocking this protein such as Ruboxistaurin (medication for damage to the retinas from diabetes) [83].
Genes
The protein kinase C PLCγ1-R707Q mutation produces a permanently active protein that increases resistance to death in cancer cells. Pygeum may be less effective in people with this mutation [84].
Male sex hormone receptor variants may have an increased or reduced affinity for atraric acid and n-butylbenzenesulfonamide (NBBS), and thus alter the effect of pygeum extract on prostate cancer [65, 66].
Several 5 alpha-reductase SNPs (rs166050, rs523349, and rs612224) alter the effectiveness of prostate enlargement treatments. Variants in these polymorphisms may also increase or reduce the effect of treatments with pygeum extract [85].
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Dosage & Supplements
Because pygeum extract is not approved for any conditions, there is no official dose. Supplement manufacturers and users have established unofficial guidelines based on trial and error.
Both 50 mg, 2x/day (the most common dosage) and 100 mg, 1x/day for up to 12 months were effective and safe in clinical trials on men with prostate enlargement. In most cases, the effects could be observed after 4-8 weeks [74, 49, 50].
The most widely used pygeum supplement is Tadenan. It is standardized to 14% steroids and 0.5% n-docosanol and sold as 50 mg or 100 mg capsules. Other pygeum supplements are Pygenil and Prosta-FX [1].
Pygeum is also available as a liquid extract or as bark ground into a powder that can be mixed with foods and beverages. Extracts are more effective than the bark powder because they are standardized to a concentration of their main active compounds [86].
In Combination with Other Supplements
Pygeum extract is often sold in preparations with saw palmetto or stinging nettle. These combinations have been reported to have stronger effects than pygeum alone [87, 7].
A commercial supplement for prostate health (ProstaCaid) combines pygeum extract with Curcuma root (turmeric), pumpkin seeds, dandelion herb, stinging nettle extract, saw palmetto fruits, broccoli extract, pomegranate fruit, grapefruit skin extract, tea extract, and a mushroom blend, among others [67].
Because of its effect on the production of male and female sex hormones, pygeum extract may interfere with supplements containing phytoestrogens (e.g., soybean isoflavones) [88].
Although several online anecdotes claim that the combination of pygeum extract with lecithin supplements increases sexual performance and orgasm intensity in men (the combination is popularly known as “the holy grail stack”), they are not backed by any scientific evidence.
User Experiences
The opinions expressed in this section are solely those of pygeum extract users who may or may not have medical or scientific training. Their reviews do not represent the opinions of SelfHacked. SelfHacked does not endorse any specific product, service, or treatment.
Do not consider user experiences as medical advice. Never delay or disregard seeking professional medical advice from your doctor or other qualified healthcare providers because of something you have read on SelfHacked. We understand that reading individual, real-life experiences can be a helpful resource, but it is never a substitute for professional medical advice, diagnosis, or treatment from a qualified healthcare provider.
Pygeum was almost exclusively taken to reduce prostate enlargement symptoms. Users of several commercial brands were generally happy with their effects. Particularly, they reported being able to sleep all night long without having to urinate.
In some cases, users stopped taking the extract after not noticing any effects.
A few users reported dizziness and stomach cramps as the main adverse effects caused by the extract.
Some users took pygeum extract to increase their ejaculate volume. Although there is insufficient scientific evidence to back this claim, they were generally happy with the results.
