Pygeum

Prunus africana

RosaceaeAfromontane forests of sub-Saharan Africa: Cameroon, Democratic Republic of Congo, Kenya, Tanzania, Uganda, Malawi, Zimbabwe, Madagascar; often at 1,500–3,000 m elevation

Description

overall appearance

A large evergreen tree reaching 25–40 m in height with a spreading, rounded canopy and a straight trunk up to 1 m or more in diameter. The species is critically threatened by over-harvesting of its bark and is listed on CITES Appendix II.

roots

Deep, woody taproot system; roots not used medicinally; bark of root has similar phytochemical profile to trunk bark

stem

Trunk straight, cylindrical; bark reddish-brown to dark gray, bitter-tasting, roughly furrowed to scaly on mature trees; inner bark reddish

leaves

Alternate, simple, elliptic to obovate, 8–20 cm long and 3–8 cm wide; glossy, dark green above; serrated margins; petiole with 2 glands at junction with blade

flowers

Small, white, 5-petaled, borne in cylindrical racemes 4–10 cm long; fragrant; blooms varies by elevation, typically dry season

fruits/seeds

Fleshy drupes 7–12 mm diameter, dark red to black when ripe, containing a single hard stone; eaten by monkeys and birds

Active Compounds

N-docosanol (n-tetracosanol) — primary phytosterol ester with 5-alpha reductase inhibitory activityBeta-sitosterol and beta-sitosterol glucosideUrsolic acid, oleanolic acid (pentacyclic triterpenes)Ferulic acid esters of long-chain alcoholsAtraric acid (phenolic acid with anti-androgenic activity)N-butylbenzene-sulfonamide (bladder-relaxant compound)Tannins: gallic acid, ellagic acid, and ellagitanninsPhytosterol esters: linoleic and oleic acid esters

Traditional Uses

Zulu and Sotho traditional medicine (South Africa): bark decoction for urinary complaints, kidney disease, and stomach disorders
Cameroonian traditional medicine: treatment of gonorrhea and other STIs
East African traditional medicine: treatment of malaria, fever, and chest pain
Traditional aphrodisiac use in Central and East Africa
Treatment of dysuria and urinary retention in sub-Saharan traditional medicine
Bark preparations used for impotence and infertility in several East African traditions
Treatment of inflammatory chest conditions and pleurisy in traditional African medicine

Modern Applications

Benign prostatic hyperplasia (BPH): meta-analyses of 18 RCTs confirm significant improvements in urinary flow, nocturia, and IPSS scores (Cochrane 2002)
5-alpha reductase inhibition: beta-sitosterol and atraric acid reduce DHT-driven prostatic growth
Anti-androgenic activity: atraric acid blocks androgen receptor binding in prostate cells
Bladder contractility: n-butylbenzene-sulfonamide relaxes detrusor muscle, reducing urgency
Prostate cancer prevention (early research): inhibits cancer cell proliferation via AR pathway suppression
Anti-inflammatory: ursolic and oleanolic acids inhibit PGE2 and COX-2 in prostatic tissue
Complementary therapy alongside alpha-blockers for BPH symptom management
Antioxidant protection of prostatic epithelium from oxidative stress

⚠️ Safety Information

Contraindications

Pregnancy and lactation: anti-androgenic effects contraindicated
Hormone-sensitive cancers (prostate, breast): androgenic modulation requires medical oversight
Gastric ulcers: bark tannins may irritate gastric mucosa
Children: not indicated
Severe hepatic impairment: lipophilic compounds require adequate liver function for processing

Side Effects

Nausea and abdominal pain (most common, 5–10% of users)
Diarrhea and loose stools, especially at higher doses
Headache in initial weeks of use
Rare: constipation with extended use

Drug Interactions

5-alpha reductase inhibitors (finasteride, dutasteride): additive DHT-lowering; monitor for excessive anti-androgenic effects
Anticoagulants (warfarin): phytosterol esters may modestly affect coagulation; monitor INR
Testosterone replacement therapy: anti-androgenic compounds may reduce testosterone efficacy
Alpha-1 blockers (tamsulosin, prazosin): additive hypotensive effect on bladder neck