Plant Comparison
Midland Hawthorn vs Pygeum
A side-by-side comparison of two medicinal plants — every documented constituent, action, use, safety note and cited source, assembled automatically from the Omnia Sana database.
At a glance
Midland Hawthorn and Pygeum: both belong to the Rosaceae family; they share 3 indicated uses (arthritis / joint pain, inflammation (general), skin irritation); 1 pharmacological action in common.
Evidence face-off — shared uses
| Condition | Midland Hawthorn | Pygeum | Verdict |
|---|---|---|---|
| Arthritis / joint pain | 1/10 | 5/10 | Stronger for Pygeum |
| Inflammation (general) | 1/10 | 2/10 | Comparable evidence |
| Skin irritation | 1/10 | 5/10 | Stronger for Pygeum |
Evidence scores (1–10) are computed from the tier of each cited source. “Comparable” means the two scores are within one point. Follow a score to its detailed sources.
Key Constituents
The principal cardioactive and antioxidant constituents, the basis for extract standardisation.
Additional antioxidant constituents of the flower, leaf and fruit.
Pharmacological Actions
Traditional & Indicated Uses
inferred from anti-inflammatory action
inferred from anti-inflammatory action
inferred from sedative action
inferred from antispasmodic action
inferred from antispasmodic action
inferred from anti-inflammatory action
inferred from anti-inflammatory action
Supports lower urinary tract symptoms of benign prostatic hyperplasia (BPH) - a Cochrane meta-analysis of 18 RCTs (1562 men) found a moderate improvement in urinary symptoms and flow versus placebo, but the trials were small, short and methodologically weak, so the evidence remains uncertain
inferred from anti-inflammatory action
Supports lower urinary tract symptoms of benign prostatic hyperplasia (BPH) - a Cochrane meta-analysis of 18 RCTs (1562 men) found a moderate improvement in urinary symptoms and flow versus placebo, but the trials were small, short and methodologically weak, so the evidence remains uncertain
Supports lower urinary tract symptoms of benign prostatic hyperplasia (BPH) - a Cochrane meta-analysis of 18 RCTs (1562 men) found a moderate improvement in urinary symptoms and flow versus placebo, but the trials were small, short and methodologically weak, so the evidence remains uncertain
Safety, Cautions & Contraindications
Generally safe and well tolerated. High doses may cause low blood pressure and sedation. May interact with cardiac glycosides (digoxin) and antihypertensive drugs. Consult a physician before using with existing heart medications.
Duke (2002) rates hawthorn (Crataegus spp., including C. laevigata) as a triple-plus herb (+++) with Commission E approval (score 2-3) for decreasing cardiac output in functional Stage II heart insufficiency (NYHA). Clinical evidence supports hawthorn standardized extracts (80-500 mg, standardized to flavonoids or procyanidins) for angina, arrhythmia, atherosclerosis, and hypertension. Hawthorn may potentiate digitalis and other cardiac medications and is not considered suitable for self-medication without professional guidance (Duke, 2002).
Lower urinary tract / prostate symptoms must be medically assessed first to exclude prostate cancer. The evidence is mixed and rests on small, short, methodologically weak trials, so men with moderate or severe BPH should not rely on it instead of proven treatment.
Generally well tolerated, with mild gastrointestinal effects the most common report.
External Ids
Botanical Description
Small deciduous tree or large shrub with thorny branches and glossy, shallowly lobed leaves (less deeply cut than common hawthorn). Clusters of small, five-petalled white (occasionally pink) flowers with a strong scent appear in spring, followed by small red berries (haws), each usually containing two seeds (nutlets).[1]
Evergreen tree (Rosaceae), 10-30 m tall, with dark, fissured, red-brown bark (the source of the common name 'red stinkwood', from its unpleasant smell when cut). Leaves are glossy dark green, leathery, oblong with finely toothed margins. Small white, five-petalled flowers are borne in axillary racemes, followed by small reddish-brown, two-lobed fruit.
Habitat
Grows in woodland, woodland edges, hedgerows and scrub, typically on richer, damper soils than common hawthorn; native to western and central Europe.[1]
Native to montane forests of central and southern Africa (and Madagascar), growing at moderate to high altitude (roughly 900-3400 m). The species is CITES-listed and conservation-threatened owing to over-harvesting of bark for the pharmaceutical trade.
Harvesting
Flowers are picked as they open in spring, leaves are picked with the young flowering shoots, and the ripe red berries (haws) are gathered in autumn; all three parts are used, often combined, in hawthorn preparations.[1]
Bark is traditionally stripped from mature trees. Unsustainable stripping - especially removing bark all the way round the trunk - kills the tree and has driven population decline, so sustainable, partial and rotational bark harvesting or cultivated sources are recommended.
Traditional Uses
Hawthorn flower, leaf and berry have a long European tradition, and substantial modern clinical study, as a cardiovascular tonic - supporting heart function, mild circulatory complaints and calming nervous tension - reflected in its traditional use for 'heart strengthening' and its modern standing as a well-studied botanical for mild heart failure symptoms.[1]
Prunus africana bark has a traditional use in East and Central African ethnomedicine for urinary complaints, and its extract (marketed as Pygeum) became one of the most widely used European phytotherapy remedies for benign prostatic hyperplasia (BPH) symptoms in the 20th century. Clinical evidence for symptom benefit is moderate but drawn from small, methodologically weak trials.[11]
Preparations
Leaf-and-flower extract standardised to flavonoid or oligomeric proanthocyanidin content, taken as tablets or capsules; the best-studied clinical form.
The clinically studied commercial form, standardised for phytosterol content.
Dosage
The EU herbal monograph on Crataegus spp., folium cum flore gives dry extracts in divided daily doses of 240-900 mg (single dose 80-450 mg) or, for one quantified extract, 570-1750 mg daily (single dose 190-350 mg), in adults and elderly. If symptoms persist longer than 2 weeks a doctor should be consulted, and hawthorn is never used as a substitute for prescribed heart medication without medical supervision. Educational reference only, not a prescription.
The EU herbal monograph gives 1-2 g of the comminuted leaf and flower in 150 mL of boiling water as an infusion, up to 4 times daily (maximum 6 g daily), in adults and elderly. Educational reference only, not a prescription.
Clinical trials have most often used around 100-200 mg/day of standardised lipophilic bark extract, divided into two doses. Educational reference only, not a prescription; any prostate or urinary symptom should be medically assessed first.
References
Drug Class Interactions
Not documented
Lookalikes Review
References & Sources
- Fong, H.H.S. and Bauman, J.L (2002) 'Hawthorn', Journal of Cardiovascular Nursing, 16(4), pp. 1-8. doi:10.1097/00005082-200207000-00002 Traditional / reference
https://doi.org/10.1097/00005082-200207000-00002 - Orhan, I.E (2018) 'Phytochemical and Pharmacological Activity Profile of Crataegus oxyacantha L. (Hawthorn) - A Cardiotonic Herb', Current Medicinal Chemistry, 25(37), pp. 4854-4865. doi:10.2174/0929867323666160919095519 Traditional / reference
https://doi.org/10.2174/0929867323666160919095519 - Ahmadipour, B., Kalantar, M., Abaszadeh, S. and Hassanpour, H (2024) 'Antioxidant and antihyperlipidemic effects of hawthorn extract (Crataegus oxyacantha) in broiler chickens', Veterinary Medicine and Science, 10(3), pp. e1414. doi:10.1002/vms3.1414 Preclinical
https://doi.org/10.1002/vms3.1414 - Rigelsky, J.M. and Sweet, B.V (2002) 'Hawthorn: pharmacology and therapeutic uses', American Journal of Health-System Pharmacy, 59(5), pp. 417-422. doi:10.1093/ajhp/59.5.417 Meta-analysis / review
https://doi.org/10.1093/ajhp/59.5.417 - Saeedi, G., Jeivad, F., Goharbari, M., Gheshlaghi, G.H. and Sabzevari, O (2018) 'Ethanol Extract of Crataegus Oxyacantha L. Ameliorate Dietary Non-Alcoholic Fatty Liver Disease in Rat', Drug Research, 68(10), pp. 553-559. doi:10.1055/a-0579-7532 Preclinical
https://doi.org/10.1055/a-0579-7532 - Mecheri, A., Benabderrahmane, W., Amrani, A., Boubekri, N., Benayache, F., Benayache, S. and Zama, D (2019) 'Hepatoprotective Effects of Algerian Crataegus oxyacantha Leaves', Recent Patents on Food, Nutrition & Agriculture, 10(1), pp. 70-75. doi:10.2174/2212798410666180730095456 Preclinical
https://doi.org/10.2174/2212798410666180730095456 - Benabderrahmane, W., Lores, M., Benaissa, O., Lamas, J.P., de Miguel, T., Amrani, A., Benayache, F. and Benayache, S (2019) 'Polyphenolic content and bioactivities of Crataegus oxyacantha L. (Rosaceae)', Natural Product Research, 35(4), pp. 627-632. doi:10.1080/14786419.2019.1582044 Preclinical
https://doi.org/10.1080/14786419.2019.1582044 - Ali, M., Muhammad, S., Shah, M.R., Khan, A., Rashid, U., Farooq, U., Ullah, F., Sadiq, A., Ayaz, M., Ali, M., Ahmad, M. and Latif, A (2017) 'Neurologically Potent Molecules from Crataegus oxyacantha; Isolation, Anticholinesterase Inhibition, and Molecular Docking', Frontiers in Pharmacology, 8, pp. 327. doi:10.3389/fphar.2017.00327 Preclinical
https://doi.org/10.3389/fphar.2017.00327 - Cuevas-Duran, R.E., Medrano-Rodriguez, J.C., Sanchez-Aguilar, M., Soria-Castro, E., Rubio-Ruiz, M.E., Del Valle-Mondragon, L., Sanchez-Mendoza, A., Torres-Narvaez, J.C., Pastelin-Hernandez, G. and Ibarra-Lara, L (2017) 'Extracts of Crataegus oxyacantha and Rosmarinus officinalis Attenuate Ischemic Myocardial Damage by Decreasing Oxidative Stress and Regulating the Production of Cardiac Vasoactive Agents', International Journal of Molecular Sciences, 18(11), pp. 2412. doi:10.3390/ijms18112412 Preclinical
https://doi.org/10.3390/ijms18112412 - Alp, H., Soner, B.C., Baysal, T. and Sahin, A.S (2014) 'Protective effects of Hawthorn (Crataegus oxyacantha) extract against digoxin-induced arrhythmias in rats', Anatolian Journal of Cardiology, 15(12), pp. 970-975. doi:10.5152/akd.2014.5869 Preclinical
https://doi.org/10.5152/akd.2014.5869 - Rothfuss, M.A., Pascht, U. and Kissling, G (2001) 'Effect of long-term application of Crataegus oxyacantha on ischemia and reperfusion induced arrhythmias in rats', Arzneimittel-Forschung, 51(1), pp. 24-28. doi:10.1055/s-0031-1299998 Preclinical
https://doi.org/10.1055/s-0031-1299998 - Khan, A., Akram, M., Thiruvengadam, M., Daniyal, M., Zakki, S.A., Munir, N., Zainab, R., Heydari, M., Mosavat, S.H., Rebezov, M. and Shariati, M.A (2022) 'Anti-anxiety Properties of Selected Medicinal Plants', Current Pharmaceutical Biotechnology, 23(8), pp. 1041-1060. doi:10.2174/1389201022666210122125131 Meta-analysis / review
https://doi.org/10.2174/1389201022666210122125131 - Rastogi, S., Pandey, M.M. and Rawat, A.K.S (2015) 'Traditional herbs: a remedy for cardiovascular disorders', Phytomedicine, 23(11), pp. 1082-1089. doi:10.1016/j.phymed.2015.10.012 Meta-analysis / review
https://doi.org/10.1016/j.phymed.2015.10.012 - European Medicines Agency (2016) 'European Union herbal monograph on Crataegus spp., folium cum flore'. Traditional / reference
https://scholar.google.com/scholar?q=European%20Union%20herbal%20monograph%20on%20Crataegus%20spp.%2C%20folium%20cum%20flore - Hendel, N. and Hendel, M (2014) 'Hedgerow Medicine'. Traditional / reference
https://scholar.google.com/scholar?q=Hedgerow%20Medicine - Pittler, M.H., Guo, R. and Ernst, E (2008) 'Hawthorn extract for treating chronic heart failure'. Traditional / reference
https://scholar.google.com/scholar?q=Hawthorn%20extract%20for%20treating%20chronic%20heart%20failure - Duke, J.A (2002) 'Handbook of Medicinal Herbs, Second Edition'. Traditional / reference
https://scholar.google.com/scholar?q=Handbook%20of%20Medicinal%20Herbs%2C%20Second%20Edition - Tankanow, R., Tamer, H.R., Streetman, D.S., Smith, S.G., Welton, J.L., Annesley, T., Aaronson, K.D. and Bleske, B.E (2003) 'Interaction study between digoxin and a preparation of hawthorn (Crataegus oxyacantha)', Journal of Clinical Pharmacology, 43(6), pp. 637-642. doi:10.1177/0091270003253417 Randomized trial
https://doi.org/10.1177/0091270003253417 - Pittler, M.H., Guo, R. and Ernst, E (2008) 'Hawthorn extract for treating chronic heart failure', Cochrane Database of Systematic Reviews, 2008(1), pp. CD005312. doi:10.1002/14651858.CD005312.pub2 Meta-analysis / review
https://doi.org/10.1002/14651858.CD005312.pub2 - Pittler, M.H., Guo, R. and Ernst, E (2008) 'Hawthorn extract for treating chronic heart failure', Cochrane Database of Systematic Reviews, 2008(1), pp. CD005312. doi:10.1002/14651858.CD005312.pub2 Meta-analysis / review
https://doi.org/10.1002/14651858.CD005312.pub2 - Ghasemzadeh Rahbardar, M. and Hosseinzadeh, H (2024) 'Therapeutic potential of hypnotic herbal medicines: A comprehensive review', Phytotherapy Research, 38(6), pp. 3037-3059. doi:10.1002/ptr.8201 Meta-analysis / review
https://doi.org/10.1002/ptr.8201 - Block, K.I., Gyllenhaal, C. and Mead, M.N (2004) 'Safety and efficacy of herbal sedatives in cancer care', Integrative Cancer Therapies, 3(2), pp. 128-148. doi:10.1177/1534735404265003 Meta-analysis / review
https://doi.org/10.1177/1534735404265003
- Thompson, R.Q., Katz, D. and Sheehan, B (2019) 'Chemical comparison of Prunus africana bark and pygeum products marketed for prostate health', Journal of Pharmaceutical and Biomedical Analysis, 163, pp. 162-169. doi:10.1016/j.jpba.2018.10.004 Preclinical
https://doi.org/10.1016/j.jpba.2018.10.004 - Dvorkin, L. and Song, K.Y (2002) 'Herbs for benign prostatic hyperplasia', The Annals of Pharmacotherapy, 36(9), pp. 1443-1452. doi:10.1345/aph.1A228 Meta-analysis / review
https://doi.org/10.1345/aph.1A228 - Keehn, A. and Lowe, F.C (2015) 'Complementary and alternative medications for benign prostatic hyperplasia', The Canadian Journal of Urology, 22(Suppl 1), pp. 18-23. Meta-analysis / review
https://scholar.google.com/scholar?q=Complementary%20and%20alternative%20medications%20for%20benign%20prostatic%20hyperplasia - Kim, T.H., Lim, H.J., Kim, M.S. and Lee, M.S (2012) 'Dietary supplements for benign prostatic hyperplasia: an overview of systematic reviews', Maturitas, 73(3), pp. 180-185. doi:10.1016/j.maturitas.2012.07.007 Meta-analysis / review
https://doi.org/10.1016/j.maturitas.2012.07.007 - Cambronero, J., Osca-Garcia, J.M., Merino-Salas, S., Miguel, J.M. and others (2022) 'Effectiveness of treatment with Pygeum africanum in patients with lower urinary tract symptoms and benign prostatic hyperplasia: a cross-sectional study in the real-world clinical practice in Spain (The PROFIT Study)', Archivos Espanoles de Urologia, 75(3), pp. 219-227. Clinical study
https://scholar.google.com/scholar?q=Effectiveness%20of%20treatment%20with%20Pygeum%20africanum%20in%20patients%20with%20lower%20urinary%20tract%20symptoms%20and%20benign%20prostatic%20hyperplasia%3A%20a%20cross-sectional%20study%20in%20the%20real-world%20clinical%20practice%20in%20Spain%20%28The%20PROFIT%20Study%29 - Quiles, M.T., Arbos, M.A., Fraga, A., de Torres, I.M. and others (2010) 'Antiproliferative and apoptotic effects of the herbal agent Pygeum africanum on cultured prostate stromal cells from patients with benign prostatic hyperplasia (BPH)', The Prostate, 70(10), pp. 1044-1053. doi:10.1002/pros.21138 Preclinical
https://doi.org/10.1002/pros.21138 - Salinas-Casado, J., Esteban-Fuertes, M., Carballido-Rodriguez, J. and Cozar-Olmo, J.M (2020) 'Review of the experience and evidence of Pygeum africanum in urological practice', Actas Urologicas Espanolas, 44(1), pp. 9-13. doi:10.1016/j.acuro.2019.08.002 Meta-analysis / review
https://doi.org/10.1016/j.acuro.2019.08.002 - Villar, A., Silva-Fuentes, F., Mula, A. and Zangara, A (2024) 'Anti-Inflammatory Potential of Prunus africana Bark Extract: An In Vitro Study of Cytokine Release by Lipopolysaccharide-Stimulated Human Peripheral Blood Mononuclear Cells', International Journal of Molecular Sciences, 25(15), pp. 8298. doi:10.3390/ijms25158298 Preclinical
https://doi.org/10.3390/ijms25158298 - Larre, S., Camparo, P., Comperat, E., Boulbes, D. and others (2012) 'Biological effect of human serum collected before and after oral intake of Pygeum africanum on various benign prostate cell cultures', Asian Journal of Andrology, 14(3), pp. 499-504. doi:10.1038/aja.2011.132 Preclinical
https://doi.org/10.1038/aja.2011.132 - Rubegeta, E., Makolo, F., Kamatou, G., Enslin, G. and others (2023) 'The African cherry: A review of the botany, traditional uses, phytochemistry, and biological activities of Prunus africana (Hook.f.) Kalkman', Journal of Ethnopharmacology, 305, pp. 116004. doi:10.1016/j.jep.2022.116004 Meta-analysis / review
https://doi.org/10.1016/j.jep.2022.116004 - Keehn, A. and Lowe, F.C (2015) 'Complementary and alternative medications for benign prostatic hyperplasia', The Canadian Journal of Urology. Randomized trial
https://scholar.google.com/scholar?q=Complementary%20and%20alternative%20medications%20for%20benign%20prostatic%20hyperplasia - Dedhia, R.C. and McVary, K.T (2008) 'Phytotherapy for lower urinary tract symptoms secondary to benign prostatic hyperplasia', The Journal of Urology, 179(6), pp. 2119--2125. doi:10.1016/j.juro.2008.01.094 Meta-analysis / review
https://doi.org/10.1016/j.juro.2008.01.094 - Wilt, T. and Ishani, A. and Mac Donald, R. and Rutks, I. and Stark, G (2002) 'Pygeum africanum for benign prostatic hyperplasia', Cochrane Database of Systematic Reviews. doi:10.1002/14651858.CD001044 Meta-analysis / review
https://doi.org/10.1002/14651858.CD001044
Generated automatically from the Omnia Sana plant database and its cited sources. For educational purposes only — not medical advice. Always consult a qualified practitioner before using medicinal plants.