One of the most popular active substance sources of recent times

This is an evergreen tree that grows in mountainous areas of Africa and can reach heights of up to 30 metres. Its popularity in relation to prostate problems almost led to the disappearance of the species, as the bark is used as an ingredient.

Its trunk is cylindrical, straight and its crown is thick. The tree has leathery leaves, usually 8 to 12 cm long, with pointed ends. Its small, white flowers, which hang on red pedicels, are arranged in groups of five. The fruit is cherry-shaped, 8 to 12 mm in diameter and red in colour.

It contains triterpenes (ursolic acid, epimaslinic acid, oleanolic acid), sterols (beta-sitosterol) and long-chain (C12-24) fatty acids such as palmitic acid. It also contains atraric acid. Typical compounds are n-docosyl trans-ferulate and n-tetracosyl trans-ferulate.

The mechanism of action of African prune bark in treating obstructive prostate symptoms has not yet been fully proven. It is probably a complex mechanism. It has a proven 5-alpha-reductase enzyme inhibitory mechanism. ¹ In light of this, the European Food Safety Authority (EFSA) has included in its list the following health claim, which currently has on-hold status: Pygeum Africanus – ‘support of normal urinary function in men’. ^{EFSA ONHOLD 3874}

The most common and widely researched ingredient in drugs and food supplements for benign prostate enlargement.

This palm species is endemic in the south-east of the United States and Central America. The dried fruit and its extract are used in medicine. Its main use is to treat micturition disorders in benign prostate hyperplasia (BPH) stage I and II. ^[EFSA]

The lipophilic extract of saw palmetto inhibits the activity of the 5-alpha-reductase enzyme. This effect is probably caused by the fatty acid content. As it inhibits both isoenzymes (I-II) of the 5-alpha-reductase enzyme, it reduces the conversion of testosterone to biologically active dihydrotestosterone (DHT). The latter is responsible for the increased volume of prostate cells and cell proliferation. ¹

Saw palmetto aids the maintenance of normal urination in men over 45 years of age and ensures maximum urine flow. ^[EFSA]

PSA (prostate specific antigen) levels are not affected. ²

Hull-less Styrian oil pumpkin and the pumpkin seed oil pressed from it (Cucurbitae peponis semen et oleum)

Traces of its medicinal use have been found in all ancient cultures, including European Graeco-Roman medicine and pharmacy. Encapsulated oil was introduced to the domestic medicinal product market in 1985 and has maintained its position as the leading BPH preparation through pharmacy sales until recently. ⁴

It is an important fact that pumpkin seeds and pumpkin seed oil have a high sterol content with a remarkably high quantity of unsaturated sterols in the ∆7 position and a high proportion compared to other sterols. The active substances of pumpkin seeds are mainly considered in the literature to be sterols having a specific structure (∆7). These are rare in nature. The European Food Safety Authority (EFSA) has included in its list the following health claim, which currently has on-hold status: Cucurbita pepo – ‘supports normal function of prostate and urinary tract.’ ^{EFSA ONHOLD 4551}

The mechanism of action and human efficacy have been satisfactorily demonstrated. 5 In experiments, pumpkin seed oil inhibited testosterone-induced prostate hyperplasia. Pumpkin seed extract also contains selenium, which, like its vitamin E content, protects against oxidative damage. ^EFSA

The steroid derivative that is considered in the literature to be most responsible for the effects of natural preparations for benign prostate enlargement

Besides and in addition to plant extracts with good evidence of use in the treatment of benign prostate hyperplasia (BPH), Fluxus Prostatae™ contains beta-sitosterol, considered to be the main active ingredient of these extracts, in an enriched, standardised form from soya.

Research has shown that beta-sitosterol has an experimentally proven inhibitory effect on 5-alpha-reductase; this enzyme is critical in steroid biosynthesis. Its effects have been studied in benign prostate hyperplasia (BPH) in both human and animal testing. ^{[Berges et al., 1995; Awad et al., 1998; Souchet and Laplante, 2007]}

In a clinical trial, phytosterol extracts containing beta-sitosterol as well as beta-sitosterol and glycosylated beta-sitosterol improved BPH symptoms, excretion symptoms and quality of life considerably. ^{[Kobayashi és mtsai, 1998; Wilt és mtsai, 1999]}

Traditionally, it has frequently been used to relieve rheumatic pain and as a diuretic.

Preparations made from its leaves and the liquid pressed from them have a diuretic effect. Potassium salts and flavonoids are probably responsible for this effect. Both hydrophilic and lipophilic extracts from the roots have been successfully tested. Effects which can curb the development of BPH or alleviate existing symptoms are attributed to the extracts. Examples include inhibition of the 5-alpha-reductase enzyme and the aromatase enzyme. ³

Similarly to the saw palmetto extract, nettle (Urtica dioica) contributes to the symptomatic treatment of urinary disorders in benign prostate hyperplasia (BPH) stage I and II. ^EFSA

In one experiment, it was combined with saw palmetto and the effect of this combination was tested against finasteride. It was found that the effect was the same, while the tolerance of the plant extract was even better. A similar study tested the same combination against a placebo. Here, too, a similar, good result was reported as in the aforementioned study. ³

Like most trace elements, zinc plays a major role in regulating enzymatic processes.

It is necessary for the formation of active centres for the functioning of many enzymes and for the stabilisation of the spatial structure of protein enzymes. Zinc also plays a part in the correct alignment of the spatial structure of nucleic acids (DNA, RNA).

Zinc is found in abundance in protein-rich foods such as pulses, eggs, dairy products, meat and seafood. Taking zinc supplements is not necessary with a balanced diet but, for unbalanced diets or for certain diseases, zinc supplementation can be beneficial.

Prostate tissue has a high concentration of zinc because it plays a major role in hormonal metabolism processes. Zinc contributes to normal fertility and reproduction.^EFSA

Boron is a rare element in both the solar system and the crust of the Earth.

Boron is a semi-metal, and occurs naturally in the form of sodium borate and boron chelate. Boron consumed in food is absorbed rapidly and then most of it is excreted in urine. It is present in most soils and is an essential nutrient for many plants, being present in relatively high proportions in soy, plums, red wine, raisins, avocados and nuts. Its levels are quite low in meat and dairy products.

Daily dietary intake is assumed to be about 2 mg/day. It is mainly converted into boric acid in the gastrointestinal tract by forming complex bonds with sugar, vitamins B2 and B6 or vitamin C, and is fully absorbed. Given that it is excreted via the kidneys very quickly, there is little chance of it accumulating in the tissues.

Sufficient boron intake can be achieved primarily by having a good diet but, if difficulties occur, a dietary supplement may be necessary.