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Pygeum africanum for BPH


Clinical bottom line

In small, short randomised studies Pygeum africanum provides moderate relief of some of the symptoms of benign prostatic hyperplasia. Mean peak urinary flow rate was increased by 2 mL/second.

Pygeum africanum is an extract of the bark of the African prune tree. It may have some anti-inflammatory properties.


A Ishani et al. Pygeum africanum for the treatment of patients with benign prostatic hyperplasia: a systematic review and quantitative meta-analysis. American Journal of Medicine 2000 109: 654-664.


The review had an excellent comprehensive search strategy for randomised trails of pygeum africanum. There was no common outcome measure.


There were 18 randomised trials of 1,562 men. Many did not report results in a way that allowed analysis. Mean duration was 64 days, and most were shorted than three months. Individual trials had group sizes of seven to 132 men.

There were six comparisons with placebo. Three gave figures for nocturia, in which there was no statistical difference between treatment and placebo. For peak urinary flow rate in four studies there was a significant increase of 2 mL/second over placebo.


This is a good review of disappointing studies. The weight of evidence of any benefit is not great.