Pygeum Africanum for Prostatitis
What Is Pygeum Africanum?
Pygeum africanum for prostatitis is an herbal remedy that is derived from the bark of the Pygeum africanum tree, also known as the African cherry tree. Pygeum has been used to treat bladder problems since ancient times. In fact, some natives of various South African tribes still use the remedy today by boiling the bark of the tree to make a tea. In the 1960s, the Europeans began using a pygeum bark extract to treat mild to moderate benign prostatic hyperplasia (BPH), also commonly known as enlarged prostate. Since then much research has been done on pygeum bark extract, and this supplement has caught the attention of nontraditional healers in other countries.
Pygeum Africanum for Prostatitis—Does It Work?
Pygeum is a Tier 2 supplement for prostatitis. That means there are significant clinical studies and research on using Pygeum africanum for prostatitis and other similar prostate conditions with similar symptoms. Pygeum prevents inflammation and lessens edema, making it useful for treating pain associated with prostatitis as well as sexual dysfunction.
Many of the studies on pygeum involve men with BPH. While BPH and prostatitis are different conditions, sometimes men with prostatitis have similar urinary symptoms to men with BPH, such as frequent urination and nighttime urination. Pygeum has been shown to improve urinary outflow and reduce the amount of residual urine left in the bladder. It helps with urinary urgency and frequency.
The major active components of pygeum bark are fat-soluble sterols (phytosterols) and fatty acids. Phytosterols can inhibit the production of DHT (dihydrotestosterone), a hormone that increase the risk of BPH and prostate cancer. Pygeum also reduces the number of receptor sites where DHT can attach to cells.
The majority of the research on pygeum has featured a pygeum extract standardized to contain 14% triterpenes including beta-sitosterol and 0.5% n-docosanol. This extract has been extensively studied in both experimental animal studies and clinical trials.
Studies involving Pygeum africanum for prostatitis include the following:
- A clinical trial involving 47 patients with chronic prostatitis studied the effect of 100 mg of pygeum daily for five to seven weeks. At the end of the trial, 89% of the men reported a complete remission of symptoms. (Andro 1995)
- A study on sexual dysfunction associated with chronic prostatitis or BPH had men taking 200 mg of pygeum every day for 60 days either alone or with antibiotics. The men who received pygeum experienced improved sexual function. Based on these findings, researchers believe that pygeum may have benefits for patients with sexual or reproductive dysfunction. (Carani 1991)
Exploring the research for of pygeum for urinary symptoms associated with BPH can help us understand how pygeum can work for prostatitis urinary symptoms.
Studies on Pygeum africanum for BPH include the following:
- Investigators isolated atraric acid (AA) from the bark of pygeum and found it to have an impact on prostate health. The ligand-activated human androgen receptor (AR) plays a key role in supporting the growth of the prostate gland. Thus inhibition of the androgen receptor is a main goal in management of patients. Investigators at the Institute of Human Genetics and Anthropology found that AA has anti-androgenic activity and inhibits the “transactivation mediated by the ligand-activated human AR.” Specifically, the scientists found that AA can repress the broth of androgen-dependent LNCaP and androgen-independent C402 prostate cancer cells, but not prostate cancer cells that lack AR. The authors concluded that their study findings “may serve as a basis for AA derivatives as a new chemical lead structure for novel therapeutic compounds as AR antagonists, that can be used for prophylaxis or treatment of prostatic diseases.” (Papaioannou 2009)
- In a subsequent study by many of the same researchers, the scientists identified the compound N-butylbenzene-sulfonamide (NBBS), isolated from Pygeum africanum, as a specific androgen receptor antagonist. They stated that NBBS has antihormonal activity and the ability to inhibit endogenous PSA expression and the growth of prostate cancer cells. The authors concluded, “NBBS and its derivatives may serve as a novel chemical platform for treatment of prostatitis, BPH and PCa [prostate cancer].” (Papaioannou 2010)
- An early animal study evaluated the effect of Pygeum africanum in rat prostatic fibroblast proliferation. The investigators found that “therapeutic effect of Pygeum africanum may be due at least in part to the inhibition of growth factors [bFGF, EGF, IGF-I] responsible for the prostatic overgrowth in man.” (Yablonsky 1997)
- An early human study on the efficacy of Pygeum africanum extract involved 263 men with BPH. The multicenter, double-blind trial was conducted in eight centers in Europe and lasted 60 days. Capsules containing 50 mg of Pygeum africanum extract or placebo were administered twice a day, once in the morning and once in the evening. At the end of the trial, men who had taken pygeum extract showed a “marked clinical improvement” in urinary factors (e.g., residual urine, uroflowmetry, and nighttime urination), with a 66% improvement in urination compared with 31% in the placebo group. (Barlet 1990)
- Urology published a study in which men with symptomatic BPH participated in a two-month randomized, parallel-group, double-blind, comparative phase (group A received 50 mg of Pygeum daily; group B received 100 mg once daily), followed by a ten-month, open phase, during which men were given 100 mg of Pygeum once daily. A total of 209 men completed the comparative phase and 174 finished the open phase. Results and safety were similar between groups A and B: both groups had similar improvements in the International Prostate Symptom Score (38% and 35%, respectively), quality of life (28% in both), and maximum urinary flow rate (increase of 16% and 19%, respectively). The authors concluded that “ africanum extract at 50 mg twice daily and 100 mg once daily proved equally effective and safe at two months.” (Chatelain 1999)
- A multicenter trial that was conducted in central Europe explored the efficacy and safety of Pygeum africanum extract (available as Tadenan) in men aged 50 to 75 years who had mild to moderate BPH. During the two-month study, the men were administered 50 mg of Pygeum africanum extract twice daily. This phase was followed by a one-month period during which none of the men took pygeum. Eighty-five men completed the entire study. After the two-month phase, International Prostate Symptom Score (IPSS) improved 40% and quality of life, 31%. Nighttime frequency was reduced by 32%. These improvements persisted after one month without taking pygeum. No changes were reported in either prostatic volume or quality of sexual life throughout both phases of the study, and no adverse effects related to use of pygeum were noted. The authors concluded, “under conditions of daily practice, Pygeum africanum extract induces significant improvement in IPSS and uroflowmetry parameters.” (Breza 1998)
Uses and Side Effects of Pygeum Africanum
Extract of pygeum does not interact with other drugs. The most common daily dose is 75 to 200 mg capsules of standardized pygeum extract (bark; 13% total sterols) taken daily either as a single dose or divided into two equal doses. Pygeum is usually well tolerated, but it may cause possible side effects such as nausea, loss of appetite, and abdominal pain.
References for Pygeum Africanun for Prostatitis:
Andro MC, Riffaud JP. Pygeum africanum extract for treatment of patients with BPH: a review of 25 years of published experience. Curr Ther Res. 1995;56:796-817.
Barlet A et al. Efficacy of Pygeum africanum extract in the treatment of micturational disorders due to benign prostatic hyperplasia. Evaluation of objective and subjective parameters. A multicenter, randomized, double-blind trial. Wein Klin Wochenschr 1990;102:667–73.
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.
Carani C, Salvioli V, Scuteri A, et al. Urological and sexual evaluation of treatment of benign prostatic disease using Pygeum africanum at high doses. Arch Ital Urol Nefrol Androl. 1991 Sep;63(3):341-5.
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 1999 Sep; 54(3):473-78.
Mantovani F. Serenoa repens in benign prostatic hypertrophy: analysis of 2 Italian studies. Minerva Urol Nefrol 2010 Dec; 62(4): 335-40
Papaioannou M et al. NBBS isolated from Pygeum africanum bark exhibits androgen antagonistic activity, inhibits AR nuclear translocation and prostate cancer cell growth. Invest New Drugs 2010 Dec; 28(6): 729-43
Papaioannou M et al. The natural compound atraric acid is an antagonist of the human androgen receptor inhibiting cellular invasiveness and prostate cancer cell growth. J Cell Mol Med 2009 Aug; 13(8B): 2210-23
University of Maryland Medical Center Pygeum africanum for prostatitis
Wilt T et al. Pygeum africanum for benign prostatic hyperplasia. Cochrane Databases of Systematic Reviews 2002; (1)CD001044
Yablonsky FP et al. Antiproliferative effect of Pygeum africanum extract on rat prostatic fibroblasts. J Urol 1997; 157:2381-87