Pygeum
Summary
Pygeum is an African cherry bark extract used for urinary symptoms of an enlarged prostate (BPH). A Cochrane review of 18 small, short trials found better symptom and urine-flow measures than placebo (grade C), with mild side effects. The evidence is old, preparations varied, and no trial compared pygeum with standard BPH drugs.
Key facts
- An extract of the bark of the African cherry tree (Prunus africana, also called Pygeum africanum)[1]
- Urinary symptoms and flow in benign prostatic hyperplasia (C)[1]
- 100 mg/day of bark extract, once daily or as 50 mg twice daily[2]
- Mild and similar to placebo across 18 trials[1]
- A 2023 American Family Physician review lists pygeum as possibly effective for BPH symptoms[3]
- 3 graded human outcomes on this page
- October 10, 2026
How it works
ProposedPygeum is one of several plant extracts proposed to act on prostate growth pathways, such as the enzyme 5-alpha-reductase that converts testosterone to DHT. How it affects the prostate in people is not established.[5]
What the human research says
Human trials only, one row per outcome. The form column shows what each trial actually tested. Grades follow our evidence-grading policy.
At a glance: strongest evidence per outcome
| Outcome | Grade | Effect | Strongest evidence | Rows |
|---|---|---|---|---|
| Prostate | Grade C | Improved | Systematic review of 18 trials · n = 1,562 · 2002 | 2 rows |
| Hair | Grade D | Improved | RCT · n = 80 · 2025 | 1 row |
Every graded row
| Outcome | Effect | Grade | Best evidence | PMID |
|---|---|---|---|---|
| Urinary symptoms and flow in benign prostatic hyperplasia | Improved | Grade C | Systematic review · n = 1,562 · 2002 Men with BPH symptoms in 18 RCTs Form: Pygeum africanum extracts, alone or in combination · Dose: Varied doses and preparations · Duration: Mean 64 days (range 30–122) Versus placebo, a moderately large improvement in combined symptom and flow measures (effect size −0.8 SD, 6 trials); men were twice as likely to report overall improvement (RR 2.1). Nighttime urination fell 19% and residual urine 24%, and peak flow rose 23%. Adverse effects were mild and similar to placebo. | 11869585 (opens PubMed)Source [1] |
| Prostate symptom score (IPSS) and urine flow: once- versus twice-daily dosing | Improved | Grade D | RCT · n = 209 · 1999 Men with symptomatic BPH who completed the comparative phase Form: Pygeum africanum extract · Dose: 50 mg twice daily or 100 mg once daily · Duration: 2 months randomized, then 10 months open-label at 100 mg/day Both schedules worked alike: IPSS improved 35–38% and peak flow rose 1.6–2.0 mL/s at 2 months. After 12 months IPSS fell from 16 to 9, and safety was similar across groups and phases. | 10475357 (opens PubMed)Source [2] |
| Hair density in telogen effluvium and pattern hair loss (combination product) | Improved | Grade D | RCT · n = 80 · 2025 Adults aged 18–60 with chronic telogen effluvium or androgenetic alopecia Form: Capsule with L-cystine, saw palmetto, pumpkin seed, Pygeum africanum, vitamins and minerals · Dose: One capsule a day (pygeum amount not stated in the abstract) · Duration: 6 months Hair density rose by 9.9 hairs/cm² at 3 months and 12.3 hairs/cm² at 6 months, significantly more than placebo; no moderate or severe adverse events. | 39911983 (opens PubMed)Source [4] |
Forms
| Form | Elemental % | Absorption (human data) | GI tolerance | Studied for |
|---|---|---|---|---|
| Pygeum africanum bark extract | Varies[1][2] | No human absorption data in our sources.[1] | Adverse effects were mild and comparable to placebo; dropout rates were similar (13% versus 11%).[1] | BPH symptom trials (100 mg/day in the dosing study) |
| Combination products with saw palmetto, pumpkin seed or other ingredients | Varies[1][4] | No human absorption data in our sources.[4] | No moderate or severe adverse events in a 6-month hair trial.[4] | Some BPH trials in the Cochrane review and a hair-loss trial |
Studied doses
Doses studied in human trials ranged from 50 mg twice daily to 100 mg once daily of Pygeum africanum extract (100 mg/day either way), with one study running 12 months. Other trials in the Cochrane review used varied doses for 30 to 122 days.[1][2]
Interactions
Published interactions only: each row cites a source. No row means none was found in our sources, not that a combination is safe.
None found in our sources.
Who should be careful
- Urinary symptoms not yet evaluated
- Lower urinary tract symptoms in men have several causes; the 2023 AFP review describes symptom scoring (IPSS) and evaluation before choosing therapy.[3]
- Using standard BPH medicines
- No trial compared pygeum with alpha blockers or 5-alpha-reductase inhibitors, so its value alongside them is unknown.[1]
Talk to your pharmacist or clinician before starting a supplement, especially if you take prescription medicines.
Safety
Side effects in trials were mild.
How to read the label
- Label dose vs clinical doseThe dosing study used 100 mg/day of Pygeum africanum extract, given once daily or as 50 mg twice daily.[2]
- Preparations differThe Cochrane review notes that trials used varied doses and preparations, which makes products hard to compare.[1]
- CombinationsMany trials and products combine pygeum with other plant extracts; the hair-loss trial tested such a mix.[1][4]
Cost per studied dose, without the sales pitch
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Cost per studied dose
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Frequently asked questions
Does pygeum help an enlarged prostate?
In a Cochrane review of 18 trials, men on pygeum were twice as likely as men on placebo to report symptom improvement, with less nighttime urination and better flow. The trials were small and short.[1]
How much pygeum has been studied?
100 mg/day of bark extract, given once daily or as 50 mg twice daily, which worked equally in a 2-month comparison.[2]
Is pygeum better than saw palmetto?
No head-to-head trials are cited here, but a 2023 AFP review says pygeum may be effective for BPH symptoms while saw palmetto is not.[3]
Does pygeum help hair loss?
Only as part of a multi-ingredient supplement, which increased hair density in an 80-person trial run with the maker; pygeum's own role is unknown.[4]
Sources
- [1]Pygeum africanum for benign prostatic hyperplasia.. Cochrane Database Syst Rev, 2002. systematic-review
- [2]Comparison of once and twice daily dosage forms of Pygeum africanum extract in patients with benign prostatic hyperplasia: a randomized, double-blind study, with long-term open label extension.. Urology, 1999. RCT
- [3]Benign Prostatic Hyperplasia: Rapid Evidence Review.. Am Fam Physician, 2023. review
- [4]Oral Supplementation with l-Cystine, Serenoa repens, Cucurbita pepo, and Pygeum africanum in Chronic Telogen Effluvium and Androgenetic Alopecia: A Double-Blind, Placebo-Controlled, Randomized Clinical Study.. Skin Appendage Disord, 2025. RCT
- [5]Treatment of Benign Prostatic Hyperplasia by Natural Drugs.. Molecules, 2021. review
What changed
- First draft. Every PMID checked against NCBI E-utilities esummary (title and year taken from the record) and abstracts read for the cited rows.
- Adversarial review pass: every evidence row re-read against its PubMed abstract. No NIH ODS or NCCIH fact sheet covers pygeum, so no official monograph is cited. Industry ties: ISDIN employees co-authored the 2025 combination hair trial; funding for the 1999 dosing study is not stated in PubMed; the Cochrane authors declared no conflicts. Retraction, expression-of-concern, erratum and withdrawn checks on all 5 PMIDs: none flagged. Page set indexable. Independent browser review (4 parallel reviewers, every evidence row checked against its abstract and official sources on the Vercel preview) found: no issues.