Across 3 review studies, only 1 reported a moderate beneficial effect of Pygeum bark on lower urinary tract symptoms (BPH), while 2 found no significant benefit (small effect, neutral). The evidence base is small and mixed, with no consistent dose, duration, or population data available.
Caveats: Evidence base is small (only 3 studies) — conclusions should be considered preliminary. Many of the included studies did not reach statistical significance — effect may be smaller than the predominant direction suggests. All three studies are narrative reviews, not original clinical trials, which limits causal inference.
Generally, though, all treatments were tolerated well with minimal side effects.
from: Role of Phytotherapy in the Management of BPH: A Summary of the Literature.For most of the reviewed substances, only modest effectiveness was reported.
more recent, larger and more soundly constructed studies found no significant benefit for the use of phytotherapy in the treatment of BPH
This articles review the mode of action, the efficacy, and the safety, including herb-drug interactions of the most common botanicals (Serenoa repens, Pygeum africanum, Urtica dioica, and Cucurbita pepo) and nutraceuticals (isoflavones, lycopene, selenium, and β-Sitosterol) in controlling the lower urinary tract symptoms associated to BPH.