A scientific basis for the therapeutic effects of Pygeum africanum and Serenoa repens

In Europe, phytotherapeutic preparations have been prescribed for the treat ment of symptomatic benign prostatic hyperplasia (BPH) for over 20 years [1 -14]. In these countries, phytotherapeutic preparations represent approxima tely 1/3 of total sales of all therapeutic agents sold for the treatment of BPH. In France, acid other countries, phytotherapeutic preparations are th e most widely used drugs for the treatment of BPH. In Asia, Africa, and Ind ia, phytotherapy is considered a first-line treatment for BPH and has been utilized effectively for centuries. In the United States, the multimillion dollar sales of phytotherapeutic preparations for "the health of the prosta te and bladder" attests to the widespread utilization of these agents [3, 4 ]. Two of the most popular phytotherapeutic agents that have undergone both cl inical studies to determine their efficacy, and have been the subject of ba sic science studies to identify the mechanism(s) of action are Pygeum afric anum (Tadenan), an extract from the bark of the African plum tree, and Sere noa repens (Permixon), a lipido-sterol extract of dwarf palm. Tadenan and P ermixon are registered therapeutic agents of Debat Pharmaceuticals, and Pie rre Fabre Medicament, respectively. Manufacture of both preparations are ti ghtly controlled and subjected to strict quality control for stability of c omponent composition. In regard to phytotherapeutic agents, each individual preparation (even from the same plant source) must be considered individua lly because of differences in the extraction techniques, preparation of pro ducts, composition, and biological activities. Thus, the clinical and biolo gical activities of one preparation cannot be extrapolated to other prepara tions of the same plant source. Thus, studies described in this review whic h utilize the preparations that are manufactured by DEBAT (Pygeum africanum ) or Pierre Fabre Medicament (Serenoa repens) are referred to by their trad e names, Tadenan and Permixon, to differentiate them from other nonstandard ized preparations of the same plants.