Pygeum
Pygeum refers to the herbal extract derived from the bark of the Prunus africana tree, which is native to the montane regions of sub-Saharan Africa and the islands of Madagascar, São Tomé, and Grande Comore. The extract is commonly used in traditional medicine and is marketed as a supplement for the treatment of benign prostatic hyperplasia (BPH) and other urinary disorders.
Botanical Description
Prunus africana is an evergreen tree that can grow up to 30 meters in height. It has a straight trunk and a dense, rounded crown. The bark is dark brown to gray, rough, and fissured, which is the part used for medicinal purposes. The leaves are simple, alternate, and elliptic, with a glossy green appearance. The tree produces small, white flowers and a red to black drupe as fruit.
Traditional and Medicinal Uses
The use of Pygeum bark in traditional medicine dates back centuries. Indigenous African communities have used it to treat a variety of ailments, including fever, malaria, kidney disease, and urinary problems. In modern herbal medicine, Pygeum is primarily used for its potential benefits in managing symptoms of benign prostatic hyperplasia (BPH), a common condition in older men characterized by an enlarged prostate gland.
Mechanism of Action
Pygeum is believed to exert its effects through several mechanisms:
- Anti-inflammatory properties: Pygeum contains phytosterols, such as beta-sitosterol, which may reduce inflammation in the prostate.
 - Inhibition of growth factors: It may inhibit fibroblast growth factors, which are involved in the proliferation of prostate cells.
 - Hormonal effects: Pygeum may modulate the levels of hormones such as testosterone and dihydrotestosterone (DHT), which play a role in prostate enlargement.
 
Clinical Evidence
Several clinical studies have investigated the efficacy of Pygeum in treating BPH symptoms. A meta-analysis of these studies suggests that Pygeum may improve urinary symptoms and flow measures, although the quality of evidence is variable. Commonly reported benefits include reduced nocturia, increased peak urine flow, and decreased residual urine volume.
Sustainability and Conservation
The increasing demand for Pygeum bark has led to overharvesting and concerns about the sustainability of Prunus africana populations. The species is listed under Appendix II of the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES), which regulates its trade to prevent exploitation. Conservation efforts are focused on sustainable harvesting practices and cultivation initiatives.
Side Effects and Precautions
Pygeum is generally well-tolerated, but some individuals may experience mild gastrointestinal symptoms such as nausea or diarrhea. It is important for individuals to consult with a healthcare provider before using Pygeum, especially those with underlying health conditions or those taking other medications.
Also see
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Contributors: Prab R. Tumpati, MD