Pygeum, a derivative from the bark of the Prunus africana tree, has a long history of use as a folk cure for bladder problems, but in more recent times pygeum has been used to treat BPH and prostatitis. The bark contains phytosterols, which can inhibit the production of dihydrotestosterone (DHT), a hormone that increases the risk of BPH and prostate cancer.
Of the many studies of pygeum and BPH, a review of 18 randomized controlled trials that involved 1,562 men who had BPH provides a broad look at the research. The reviewers found that compared with placebo, men who took pygeum experienced a “moderately large improvement” in urinary symptoms and urinary flow measures. (Wilt 2002) For the management of prostatitis, two studies have identified compounds in pygeum that may be helpful.
One compound is called atraric acid, which can be isolated from the bark of pygeum (Papaioannou 2009), and another is NBBS (N-bugylbenzene-sulfonamide). In particular, NBBS was found to have antihormonal activity as well as the ability to inhibit the growth of prostate cancer cells. This led the authors to conclude that “NBBS and its derivatives may serve as a novel chemical platform for treatment of prostatitis, BPH and PCa [prostate cancer].” (Papaioannou 2010)
The suggested dosage of pygeum is 75 to 200 mg capsules of standardized pygeum extract (bark; 13% total sterols) taken daily as a single or divided dose. Possible side effects include abdominal pain, loss of appetite, and nausea. (University of Maryland)
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: http://www.umm.edu/altmed/articles/benign-prostatic-000018.htm
Wilt T et al. Pygeum africanum for benign prostatic hyperplasia. Cochrane Databases of Systematic Reviews 2002; (1)CD001044