Plant Comparison
Pygeum vs Saw Palmetto
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
Pygeum and Saw Palmetto: they share 3 indicated uses (prostate support, urinary support, urinary tract infection (uti)).
Evidence face-off — shared uses
| Condition | Pygeum | Saw Palmetto | Verdict |
|---|---|---|---|
| Prostate support | 10/10 | 10/10 | Comparable evidence |
| Urinary support | 10/10 | 10/10 | Comparable evidence |
| Urinary tract infection (UTI) | 9/10 | 8/10 | Comparable evidence |
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
Pharmacological Actions
Traditional & Indicated Uses
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
Lower urinary tract symptoms of benign prostatic hyperplasia (BPH) - widely used, but high-quality Cochrane evidence shows it is NOT better than placebo, even at double and triple doses
General urinary support (traditional); Lower urinary tract symptoms of benign prostatic hyperplasia (BPH) - widely used, but high-quality Cochrane evidence shows it is NOT better than placebo, even at double and triple doses
Safety, Cautions & Contraindications
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.
Generally well tolerated; mild gastrointestinal upset is the most common effect. BPH must be medically diagnosed (to exclude prostate cancer), and because the best evidence does not show benefit, saw palmetto should not replace proven treatment.
Has mild anti-androgen and antiplatelet effects, so use caution with anticoagulant medicines and before surgery; avoid in pregnancy (hormonal activity).
External Ids
Botanical Description
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.
Low, clump-forming fan-palm shrub (Arecaceae), usually with a creeping or short, often prostrate trunk. Leaves are fan-shaped (palmate) on long, spiny-edged stalks. Small, creamy-white flowers are borne in branched clusters among the leaves, followed by large, dark blue-black, olive-sized berries - the part used.[12]
Habitat
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.
Native to the south-eastern United States (particularly Florida and the Gulf Coast), a dominant understorey palm of coastal pine flatwoods, scrub and sandy coastal habitats.[12]
Harvesting
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.
Ripe berries are hand-harvested in late summer/autumn once they turn dark blue-black, then dried. Wild harvest is regulated in parts of the plant's native range given conservation concerns about overharvesting.[12]
Traditional Uses
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]
Saw palmetto berries have a long Native American food and medicinal tradition, and were adopted into 19th- and 20th-century American and European phytotherapy as a tonic for the urinary and reproductive systems. The modern, most-studied use is for lower urinary tract symptoms of benign prostatic hyperplasia (BPH), though high-quality Cochrane evidence for pooled mixed extracts shows no benefit over placebo, while some meta-analyses of a specific standardised hexanic extract report symptom benefit.[12, 13]
Preparations
Dosage
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.
Clinical trials have most often used around 160 mg of standardised extract twice daily (320 mg/day total). Educational reference only, not a prescription; any prostate or urinary symptom should be medically assessed first, and saw palmetto should not replace proven treatment given uncertain efficacy evidence.
References
Lookalikes Review
Drug Class Interactions
Not documented
References & Sources
- 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
- Vela-Navarrete, R., Alcaraz, A., Rodriguez-Antolin, A., Minana Lopez, B., Fernandez-Gomez, J.M. and others (2018) 'Efficacy and safety of a hexanic extract of Serenoa repens (Permixon) for the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH): systematic review and meta-analysis of randomised controlled trials and observational studies', BJU International, 122(6), pp. 1049--1065. doi:10.1111/bju.14362 Meta-analysis / review
https://doi.org/10.1111/bju.14362 - Novara, G., Giannarini, G., Alcaraz, A., Cozar-Olmo, J.M., Descazeaud, A., Montorsi, F. and Ficarra, V (2016) 'Efficacy and Safety of Hexanic Lipidosterolic Extract of Serenoa repens (Permixon) in the Treatment of Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: Systematic Review and Meta-analysis of Randomized Controlled Trials', European Urology Focus, 2(5), pp. 553--561. doi:10.1016/j.euf.2016.04.002 Meta-analysis / review
https://doi.org/10.1016/j.euf.2016.04.002 - Franco, J.V., Trivisonno, L., Sgarbossa, N.J., Alvez, G.A., Fieiras, C., Escobar Liquitay, C.M. and Jung, J.H (2023) 'Serenoa repens for the treatment of lower urinary tract symptoms due to benign prostatic enlargement', Cochrane Database of Systematic Reviews, 6(6), pp. CD001423. doi:10.1002/14651858.CD001423.pub4 Meta-analysis / review
https://doi.org/10.1002/14651858.CD001423.pub4 - Ooi, S.L. and Pak, S.C (2017) 'Serenoa repens for Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia: Current Evidence and Its Clinical Implications in Naturopathic Medicine', Journal of Alternative and Complementary Medicine, 23(8), pp. 599-606. doi:10.1089/acm.2016.0302 Meta-analysis / review
https://doi.org/10.1089/acm.2016.0302 - Cai, T., Cui, Y., Yu, S., Li, Q., Zhou, Z. and Gao, Z (2020) 'Comparison of Serenoa repens With Tamsulosin in the Treatment of Benign Prostatic Hyperplasia: A Systematic Review and Meta-Analysis', American Journal of Men's Health, 14(2), pp. 1557988320905407. doi:10.1177/1557988320905407 Meta-analysis / review
https://doi.org/10.1177/1557988320905407 - Trivisonno, L.F., Sgarbossa, N., Alvez, G.A., Fieiras, C., Escobar Liquitay, C.M., Jung, J.H. and Franco, J.V.A (2021) 'Serenoa repens for the treatment of lower urinary tract symptoms due to benign prostatic enlargement: A systematic review and meta-analysis', Investigative and Clinical Urology, 62(5), pp. 520-534. doi:10.4111/icu.20210254 Meta-analysis / review
https://doi.org/10.4111/icu.20210254 - Kwon, Y (2019) 'Use of saw palmetto (Serenoa repens) extract for benign prostatic hyperplasia', Food Science and Biotechnology, 28(6), pp. 1599-1606. doi:10.1007/s10068-019-00605-9 Meta-analysis / review
https://doi.org/10.1007/s10068-019-00605-9 - MacDonald, R., Tacklind, J.W., Rutks, I. and Wilt, T.J (2012) 'Serenoa repens monotherapy for benign prostatic hyperplasia (BPH): an updated Cochrane systematic review', BJU International, 109(12), pp. 1756-1761. doi:10.1111/j.1464-410X.2012.11172.x Meta-analysis / review
https://doi.org/10.1111/j.1464-410X.2012.11172.x - Minutoli, L., Bitto, A., Squadrito, F., Marini, H., Irrera, N., Morgia, G., Passantino, A. and Altavilla, D (2013) 'Serenoa Repens, lycopene and selenium: a triple therapeutic approach to manage benign prostatic hyperplasia', Current Medicinal Chemistry, 20(10), pp. 1306-1312. doi:10.2174/0929867311320100007 Meta-analysis / review
https://doi.org/10.2174/0929867311320100007 - Boyle, P., Robertson, C., Lowe, F. and Roehrborn, C (2004) 'Updated meta-analysis of clinical trials of Serenoa repens extract in the treatment of symptomatic benign prostatic hyperplasia', BJU International, 93(6), pp. 751-756. doi:10.1111/j.1464-410X.2003.04735.x Meta-analysis / review
https://doi.org/10.1111/j.1464-410X.2003.04735.x - Willetts, K.E., Clements, M.S., Champion, S., Ehsman, S. and Eden, J.A (2003) 'Serenoa repens extract for benign prostate hyperplasia: a randomized controlled trial', BJU International, 92(3), pp. 267-270. doi:10.1046/j.1464-410x.2003.04316.x Randomized trial
https://doi.org/10.1046/j.1464-410x.2003.04316.x - 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 - Tacklind, J., Macdonald, R., Rutks, I., Stanke, J.U. and Wilt, T.J (2012) 'Serenoa repens for benign prostatic hyperplasia', Cochrane Database of Systematic Reviews. doi:10.1002/14651858.CD001423.pub3 Meta-analysis / review
https://doi.org/10.1002/14651858.CD001423.pub3 - Cheema, P., El-Mefty, O. and Jazieh, A.R (2001) 'Intraoperative haemorrhage associated with the use of extract of Saw Palmetto herb: a case report and review of literature', Journal of Internal Medicine, 250(2), pp. 167-169. doi:10.1046/j.1365-2796.2001.00851.x Clinical study
https://doi.org/10.1046/j.1365-2796.2001.00851.x
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.