Pygeum / Pygeum africanum for Urinary Symptoms (LUTS)
Pygeum africanum shows a modest signal for the urinary symptoms of benign prostatic hyperplasia (BPH), but the evidence is old and methodologically weak. It is not a proven treatment, and modern urology guidelines do not recommend it.
Why this grade7-layer evidence engine
The grade rests almost entirely on two systematic reviews that pool the same set of 18 small, short trials (mean ~64 days) in about 1,562 men with BPH (PMID 11099686; PMID 11869585). Pooled, men taking pygeum were roughly twice as likely to report symptom improvement (RR 2.1), with nocturia down about 19%, peak urinary flow up about 23%, and residual urine reduced. The signal is real but low-quality: doses varied widely and the trials did not use validated symptom scales such as the IPSS.
Newer work has not strengthened the case. The 2022 PROFIT cohort (PMID 35435166, n=115) reported an IPSS drop of about 4.5 points, but it had no control group and was industry-funded, so its bias risk is high. A 2023 review of phytotherapy for BPH (PMID 36902686) judged the overall evidence inconclusive and noted that no such agents are recommended in EAU or AUA guidelines. There has been no updated high-quality synthesis.
Regulators and clinicians are split rather than convinced. The WHO monograph supports pygeum for BPH urinary complaints at 100-200 mg/day, but the U.S. FDA grants no approved health claim and European authorities classify it only as 'traditional use,' not established efficacy. Decisively, urology specialty guidance does not recommend phytotherapy for LUTS/BPH, which anchors the weak (Grade C) rating. The data also apply only to BPH-related symptoms, not to urinary symptoms from other causes.
Scoring transparency
All scores computed by a 7-layer evidence engine — fully auditable▸View the full decision path (audit trail)
- compute_raw_score — 加權公式: L2×0.30 + L3×0.25 + L5×0.25 + L11×0.10 + L1×0.10 = 0.53
- tier_from_score — 依分數區間映射至 tier letter
- apply_hec_rules — 高品質 SR/MA 顯示 positive (2 篇 > 0 negative)
- tier_strict_requirement_check — Tier 條件達標，未降階
- detect_disputes — 偵測到 0 個 hard + 0 個 soft dispute
- decide_status — 依 tier + dispute 結果決定 status