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Pygeum africanum is a large evergreen tree found in central and southern Africa. The extracts from its bark contain several compounds thought to be helpful in reducing prostate enlargement. These include beta-sitosterol, other plant estrogens, triterpenes, and certain compounds known as ferulic acids.
Pygeum extracts have been used for more than 25 years in France for patients suffering from prostate enlargement. One trade-marked name for Pygeum is Tadenan.
In 1990, a double-blind, placebo-controlled study was done in France, Germany, and Austria with 263 patients. Double blind means that neither the researchers, nor the patients, know whether they are taking the real medicine or a dummy pill until the code is broken at the end of the study. This assures that a patient's expectations do not influence the results of the study.
Capsules of 50 mg of Pygeum africanum extract or placebo were given at a dosage of one capsule in the morning and one in the evening for a period of 60 days. Treatment with this extract led to a marked improvement in the ability to urinate easily. The ones who got the Pygeum improved by 66 percent while those on placebo improved by 31 percent. The only side effects were gastrointestinal symptoms that occurred in only 5 out of the 263 patients.
To test the influence of Pygeum on sexual behavior, a clinical study was designed to give twice the normal dose of Pygeum to patients with prostate enlargement. For a period of 60 days, 18 patients were given 200 mg of Pygeum (instead of 100 mg) a day. Symptoms of BPH improved in the patients and no side effects were reported. Interestingly, there was an improvement in sexual behavior in the men.
Which is more effective, SP or Pygeum? A study comparing the two has been done. In a placebo-controlled trial done back in 1983, 60 patients received 320 mg a day of SP and compared to another group that received Pygeum. The study lasted one month. There was significantly greater improvement with SP than with Pygeum. Keep in mind, that each extract could work in a different way and perhaps the combination of both would have a synergistic effect. Many over-the-counter products combine both of these medicines.
The exact mechanism of how Pygeum influences the prostate gland is currently not known. As with many other extracts, a variety of compounds within Pygeum could work together for a synergistic effect. One possible explanation is Pygeum's ability to display anti-inflammatory activity within prostate cells (Marconi, 1986). As discussed in an earlier chapter on the causes of prostate enlargement, infiltration by immune cells is one of the reasons for BPH. In one study done in France, extracts of Pygeum were found to inhibit infiltration of prostate tissue by immune cells.
A most recent study published in 1997 evaluated the role of a Pygeum extract in relation to growth (or proliferation) of prostate cells, specifically the growth of fibroblasts. Fibroblasts are large, oval cells found in connective tissue and in a variety of organs. They help connect many other types of cells together to form an organ.
Pygeum was found to be a potent inhibitor of rat prostatic fibroblast proliferation when these cells were exposed to growth factors that are normally present in prostate glands. The researchers theorize, "Our data suggest that the therapeutic effect of Pygeum africanum may be due at least in part to the inhibition of growth factors responsible for the prostatic overgrowth in man." They add, "We are not yet sure of the mechanism of action of Pygeum on cell proliferation but quite obviously it should not be mediated via the androgen delivery system of the cell, since Pygeum had no effect on 5-alpha-reductase activity or androgen receptor (unpublished results).''
As always with many of these herbal extracts, it will take quite a number of years before the full mechanisms of their actions are discovered.
The recommended dosage of Pygeum is 25 mg or 50 mg twice daily. Most of the pills on the market have between 25 mg and 100 mg or Pygeum extract. The majority will be standardized to contain about 13 percent of sterol extract. Therefore, a Pygeum pill that has 100 mg of the herbal extract will contain 13 mg of the active sterols.