Pygeum africanum or Prunus africana is a large evergreen tree growing to a height of 35m, and as its name implies native to Africa, principally south of the equator. It is often said that traditionally the local people use the bark for genito-urinary complaints, but this reflects more the western view, where the herb is used almost exclusively for prostate problems. In East Africa, where the tree is known as muiri in Kikuyu, ol-koijuk in Maasai, migambo in Matengo, and mufubia in Vinza, the tree has a variety of uses. The leaves are used as an inhalent against fever; the leaf infusion is used to improve the appetite; and the bark pounded is dissolved in some water, and the red liquid drunk as a remedy for stomach ache. The bark extract is also used as a purgative for cattle. The principal active ingredients of the bark are fat-soluble compounds like the phytosterols known as sitosterols, pentacyclic triterpenoids like ursolic acid, oleanolic acid, crataegolic acid and their derivatives, and the ferulic acid esters of long-chain fatty acids like n-docosanol and n-tetracosanol.

The chief uses of pygeum extract are prostatic hyperplasia, and in particular benign prostatic hypertrophy (BPH) and their effects in males, such as prostatitis, incontinence, urine retention, difficult or painful urination, nocturnal urination, abdominal heaviness, etc. The three major components of pygeum appear to exert different yet complimentary effects on BPH.

The ferulic acid esters act mainly on the endocrine system. N-docosanol reduces the levels of leutinizing hormone and testosterone, while increasing adrenal secretions of androgens and corticosteroids. At the same time, n-docosanol significantly reduces serum prolactin levels. The reduction in prolactin is significant, because this pituitary gland hormone increases the uptake of testosterone and decreases its subsequent conversion into dihydrotestosterone in the prostate, considered to be the major factor in the hyperplasia of prostate cells observed in BPH.

The sterol fraction and especially beta-sitosterol also possess some capacity for lowering testosterone levels in the prostate, but at the same time reduce inflammation by inhibiting the formation of series 1 prostaglandins within the prostate glands.

The pentacyclic triterpenoids also help to restrain inflammation, mainly by blocking enzymatic action. They are also effective anti-edema agents, and help increase the integrity of small veins and capillaries.

Finally, many of the fat-soluble components of pygeum exert a systemic cholesterol-lowering action. Cholesterol breakdown products accumulate in the prostate, initiate a degeneration of prostate cells, which can promote prostate enlargement. The systemic decrease of cholesterol through pygeum’s fat-soluble ingredients is an important part of the herb’s contribution to prostate problems.

Caution. No significant toxicity even at elevated dosage, but side effects may range from nausea to severe stomach aches.