100–200 mg/day of extract.
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Pygeum, or African plum, is Prunus africana (formerly classified as Pygeum africanum), an evergreen tree native to the montane forests of central and eastern Africa whose bark has been used by traditional African medicine for centuries to treat urinary and prostate problems; standardized lipophilic extracts of its bark (Tadenan is the most studied commercial product and was marketed for decades as a medication in France and other European countries) have achieved significant clinical support as a treatment for the urinary symptoms associated with mild to moderate benign prostatic hyperplasia, along with other traditional herbal remedies such as Serenoa repens (saw palmetto), nettle root, and beta-sitosterol.
The active compounds identified are phytosterols (especially beta-sitosterol and derivatives), pentacyclic triterpenic acids (ursolic and oleanolic acids), and long-chain alcohols (n-docosanol), a complex mixture with documented activity on multiple mechanisms related to benign prostatic hyperplasia: anti-inflammatory activity in the prostate, modulation of 5-alpha-reductase (the enzyme that converts testosterone into dihydrotestosterone, the main androgen responsible for prostate growth), modulation of the bladder response to filling, and other effects on urinary function.
The indication with clinical support is symptomatic mild to moderate benign prostatic hyperplasia: a Cochrane review published in 2002 with 18 randomized trials and 1,562 patients concluded that Pygeum extracts produced moderate improvements in urinary symptoms (nocturia, urinary urgency, weak urinary stream) and in objective parameters (urinary flow, postvoid residual volume) at doses of 100-200 mg/day for 6-8 weeks, with a favorable tolerability profile and efficacy comparable to that of Serenoa repens.
Pygeum has been widely used as a medication in France since the 1970s (Tadenan), with clinical data supporting its use; in other European and North American countries its availability as a supplement varies, and commercial products may not be as well standardized as the better-documented European pharmaceutical preparations.
In chronic abacterial prostatitis, a clinical indication that is difficult to manage with conventional drug treatments, several small studies have documented symptomatic improvements with supplementation over weeks to months, especially when there is a significant inflammatory component.
A specific concern with Pygeum is sustainability: the bark is traditionally obtained by stripping it from the living tree, a practice that has led to overexploitation in native African forests and to a "near threatened" status on the IUCN Red List; trade is regulated by the CITES Convention (Appendix II), and it is advisable to choose products from sources certified as sustainable (controlled cultivation, regulated harvesting) to reduce the ecological impact.
The doses studied are 100-200 milligrams daily of standardized lipophilic bark extract, divided into one or two doses with meals; typical commercial products contain 50-100 mg per capsule with a standardized concentration of total phytosterols; the effect on prostate symptoms appears gradually and requires at least 6-12 weeks for clinical evaluation.
Generally very well tolerated at the doses studied; the adverse effects described are rare and mild (mild digestive discomfort, occasionally headache); no significant drug interactions have been described with the usual treatments for benign prostatic hyperplasia; people taking pharmacological alpha-blockers (tamsulosin, doxazosin, terazosin) or 5-alpha-reductase inhibitors (finasteride, dutasteride) may combine them with Pygeum as an adjunct or alternative with a compatible profile, ideally under urological supervision; in pregnancy and breastfeeding, specific data are limited, although the indication is clearly male; it is not recommended in people under 18 because of the effect on prostate development; the clearest indication is symptomatic mild to moderate benign prostatic hyperplasia, where Pygeum is a reasonable option, especially for men who prefer herbal remedies to drugs or who have contraindications to them; in severe benign hyperplasia with obstructive uropathy, prostate cancer, or significant urological complications, specific pharmacological or procedural interventions (including surgery) are superior, and Pygeum is not an alternative.
Information, not medical advice. Scientific evidence reflects the quality of the studies.