The King of Sex-Enhancing Fruits - But Drinking Just the Juice Doesn't Cut It
No other fruit or vegetable can affect human sexual performance like pomegranate. It may not be the absolute champ when it comes to raising your testosterone level, increasing erectile strength, or improving the health of your blood vessels (which is a big factor in achieving and maintaining erections), but no other fruit or vegetable does ALL three things so effectively.
I'm sure you're at least peripherally aware of some of the healthy attributes of pomegranate fruit or juice, and maybe you even eat some of it or drink some of its tangy juice on a regular basis.
That's great, and you're probably reaping some of the benefits. However, I can tell you with complete confidence that eating the fruit or drinking the juice of pomegranates isn't getting you close to tapping into its full pro-sexual potential.
The problem is that the plant chemical that does most of the heavy lifting for pomegranates is something called "punicaligans" (a polyphenol – an ellagitannin to be specific) and the heaviest concentration of them is in the RIND or skin of the pomegranate, a part of the fruit that generally gets discarded both by consumers and manufacturers of pomegranate juice.
So I'll say it right up front: To really get all the pro-sexual benefits of punicaligans, you either have to eat a lot of the dried peel – as they do in many places in the Middle East where the powder's used for a variety of medicinal purposes – or you have to buy a punicaligans supplement (like P-Well™) that contains standardized quantities of the polyphenol.
Obviously, the latter alternative is the far more effective and practical choice, but you can decide if you want to go that route later after we do a quick run-through of the specific pro-sexual properties of punicaligans:
1. Punicaligans Elevates Testosterone
When you ingest punicaligans, they're partially metabolized by gut microflora into a compound called "urolithin," which is a powerful inhibitor of aromatase activity. Aromatases are enzymes that turn testosterone into estrogen, and if you can inhibit the activity of these aromatases, in this case by urolithin, you automatically increase testosterone levels.
And I'm not talking about a little duck-snort of testosterone elevation, either. A study of men and women found that punicaligans raised levels of the hormone by an average of 24%.
Punicaligans might also raise testosterone through another mechanism, one that's relatively minor but still worth noting: People who ingest punicaligans daily have a reduced appetite and felt more satiated after eating than a placebo group.
Since being fat or overweight in itself can cause lower levels of testosterone and raise levels of estrogen, anything that helps you lose weight could also have the downstream effect of raising testosterone.
2. Punicaligans Might Work When Erection Drugs Don't
Nitric oxide (NO) is a chemical that relaxes the smooth muscle fibers of the penile arteries so they allow more blood to flow into the penis; typically 8 to 10 times what it would normally hold.
Unfortunately, NO levels start to decline with age, starting at about 40. Men in their 50s or 60s often produce half the NO they did when they were in their 20s. Luckily, it's something we can easily manipulate. It's exactly this phenomenon that's the basis of erectile dysfunction (ED) drugs like Viagra and Cialis.
The drugs inhibit an enzyme called PDE5, which prevents your body from chemically dismantling the NO that's released by your nerves and penile blood vessels. More NO means a better erection. Unfortunately, approximately one-third of men don't respond to these drugs.
This is where punicaligans present an attractive alternative. They too elevate levels of NO, but they elevate neuronal nitric oxide synthase, whereas Viagra and similar drugs elevate endothelial nitric oxide synthase. Of course, elevating either type of NO usually results in a prize-winning erection.
Here's the thing, though: The neuronal nitric oxide synthase, unlike the other type that's increased by Viagra and co., seems to bypass PDE5. That means that punicaligans might work for those men for whom PDE5 inhibitors don't do squat.
But the effectiveness of punicaligans aren't just restricted to men for whom Viagra and its cousins don't work – they appear to improve erectile function in just about everybody. A double-blind crossover study with 61 male subjects found that 47% reported improved erections with pomegranate while only 32% of placebo did... and that was with plain pomegranate and not purified and standardized punicaligans.
3. Punicaligans Can Improve the Health of Blood Vessels
Erections are all about hydraulics: if the "hoses" (blood vessels) are strong and clear of gunk, they can provide a lot of the pressure needed to hoist your penis skywards.
We've already discussed how punicaligans raise levels of NO, which in itself opens up blood vessels, but punicaligans also appear to improve circulatory function in general through their powerful anti-oxidant capability. Multiple studies have shown them to enhance blood flow in general and even reverse arterial plaque growth (roto-rooter out the plaque and you automatically improve blood flow).
Other Stuff Peripherally Associated with Sexing It Up
Punicaligans also have other beneficial effects on the male reproductive system in general. For one thing, people who ingest pomegranate produce more sperm and the sperm in general has better motility and better structure. Again, that's just with plain juice, so imagine what ingesting concentrated punicaligans might accomplish. (Super sperm!)
Pomegranate in general also reduces prostate inflammation, along with interfering with androgen pathways that can cause dreaded prostate hypertrophy (5-alpha reductase type one and 3-beta-hydroxysteroid dehydrogenase type two).
References:
Pooja Sharma, et al. Pomegranate for Prevention and Treatment of Cancer: An Update, Molecules, 24 January 2017. – This review summarizes preclinical and clinical studies highlighting the role of pomegranate in prevention and treatment of skin, breast, prostate, lung, and colon cancers.
Roberto Vicinanza, Yanjun Zhang, Susanne M. Henning, and David Heber, Pomegranate Juice Metabolites, Ellagic Acid and Urolithin A, Synergistically Inhibit Androgen-Independent Prostate Cancer Cell Growth via Distinct Effects on Cell Cycle Control and Apoptosis, Evidence Based Complementary and Alternative Medicine,19 February 2013 – This study describes how ellagitannins (ETs) from pomegranate juice (PJ) are bioactive polyphenols with chemopreventive potential against prostate cancer (PCa).
Lei Wang, et al. Cellular and molecular mechanisms of pomegranate juice-induced anti-metastatic effect on prostate cancer cells, Integr Biol, 2011 May 19 – This study demonstrates how, in addition to causing cell death of hormone-refractory prostate cancer cells, pomegranate also increases cell adhesion and decreases cell migration of the cells that do not die.
Fernando Machado Chaves, et al. Pomegranate Juice and Peel Extracts are Able to Inhibit Proliferation, Migration and Colony Formation of Prostate Cancer Cell Lines and Modulate the Akt/mTOR/S6K Signaling Pathway, Plant Foods Hum Nutr., 2020 March;75(1):54-62. – This study presents evidence that both juice and isolated peel extracts from pomegranate fruit have important anti-cancer effects against prostate cancer cells, modulating the mTOR/S6K signaling pathway.
Cp Forest, et al. Efficacy and safety of pomegranate juice on improvement of erectile dysfunction in male patients with mild to moderate erectile dysfunction: a randomized, placebo-controlled, double-blind, crossover study, Int J Impot Res. Nov-Dec 2007;19(6):564-7 – This randomized-controlled trial examined the efficacy of wonderful variety pomegranate juice versus placebo in improving erections in 53 completed subjects with mild to moderate erectile dysfunction. The crossover design consisted of two 4-week treatment periods separated by a 2-week washout. Of the 42 subjects who demonstrated improvement in GAQ scores after beverage consumption, 25 reported improvement after drinking pomegranate juice. Further, 17 subjects showed preference of one beverage to the other. Subjects were more likely to have improved scores when pomegranate juice was consumed (P=0.058).
Channing J. Paller, et al. A Review of Pomegranate in Prostate Cancer, Prostate Cancer Prostatic Dis. 2017 Sep; 20(3):265-270 – A randomized clinical trial of a polyphenol-rich multi-component food supplement tablet, including 31.25% pomegranate extract, found significant slowing of PSA increase in the food supplement arm vs. placebo in men on active surveillance and those experiencing biochemical recurrence.
David Heber, Chapter 10: Pomegranate Ellagitanins, Herbal Medicine: Biomolecular and Clinical Aspects, 2nd edition. Boca Raton, CRC Press/Taylor & Francis, 2011 – "Since ancient times, pomegranate has been used for medicinal purposes. Extensive research on bioactive substances in the pomegranate extract has shown potential applications in the chemoprevention of common forms of cancer. This work has progressed in cell culture, human studies, and in some clinical research demonstrating the preventive potential of pomegranate. Pomegranates have been shown to contain 124 different phytochemicals, and some of them act in concert to exert antioxidant and anti-inflammatory effects on cancer cells. Ellagitannins are bioactive polyphenols present in pomegranate."
Matthew Resnick, Complementary and Alternative Medicine (CAM) in Prostate and Bladder Cancer, Primary Care, November 26, 2013 – This article is a summary of the evidence of CAM therapies for prostate and bladder cancer. The author reviewed the evidence and listed the benefits of pomegranate, along with those of green tea, and resveratrol (through grapes and dark-colored berries).
Maryam R Sartippour, Ellagitannin-rich pomegranate extract inhibits angiogenesis in prostate cancer in vitro and in vivo, Int J Oncol. 2008 Feb;32(2): 475-80 – These results demonstrate that an ellagitannin-rich pomegranate extract can inhibit tumor-associated angiogenesis as one of several potential mechanisms for slowing the growth of prostate cancer in chemopreventive applications.
Arrigo F G Cicero, et al. Nutraceutical treatment and prevention of benign prostatic hyperplasia and prostate cancer, Arch Ital Urol Androl. 2019 Oct 2;91(3) – This study explains how medicinal plants, in the form of plant parts or extracts of them, are commonly used for the treatment of prostate diseases such as benign hypertrophy, prostatitis and chronic pelvic pain syndrome. The pharmacological properties searched for the treatment of prostatic diseases are anti-androgenic, anti-estrogenic, antiproliferative, antioxidant and anti-inflammatory.
Navindra P Seeram, et al. Pomegranate ellagitannin-derived metabolites inhibit prostate cancer growth and localize to the mouse prostate gland, J Agric Food Chem. 2007 Sep 19;55(19):7732-7 – The scientists explain how pomegranate juice (PJ) increases prostate specific antigen (PSA) doubling time in prostate cancer (CaP) patients with a rising PSA. Ellagitannins (ETs) are the most abundant polyphenols present in PJ and contribute greatly towards its reported biological properties. On consumption, ETs hydrolyze to release ellagic acid (EA), which is then converted by gut microflora to 3,8-dihydroxy-6H-dibenzo[b, d]pyran-6-one (urolithin A, UA) derivatives. The chemopreventive potential of pomegranate ETs and localization of their bioactive metabolites in mouse prostate tissue suggest that pomegranate may play a role in CaP treatment and chemoprevention.
Nils Kroeger, et al. Pomegranate Extracts in the Management of Men's Urologic Health: Scientific Rationale and Preclinical and Clinical Data, Evid Based Complement Alternat Med. 2013 Mar 26 – Numerous micronutrients and polyphenols found in soy, green tea, and many fruits and vegetables have been described to impact diseases including erectile dysfunction, benign prostatic hyperplasia, and prostate cancer. However, oftentimes these reports lack both a scientific rationale and supportive evidence base. The efficacy of pomegranate, on the other hand, in the modulation of central biological processes like inflammation, hypoxia, and oxidative stress that are important in the pathogenesis of urological maladies has been robustly demonstrated in preclinical in vitro and in vivo studies. Moreover, clinical trials have further supported its use in the treatment of several diseases, in particular in the management of prostate cancer.
CP Forest, et al. Efficacy and safety of pomegranate juice on improvement of erectile dysfunction in male patients with mild to moderate erectile dysfunction: a randomized, placebo-controlled, double-blind, crossover study, Int J Impot Res. Nov-Dec 2007;19(6):564-7 – This randomized-controlled trial examined the efficacy of wonderful variety pomegranate juice versus placebo in improving erections in 53 completed subjects with mild to moderate erectile dysfunction. The crossover design consisted of two 4-week treatment periods separated by a 2-week washout. Efficacy was assessed using International Index of Erectile Function (IIEF) and Global Assessment Questionnaires (GAQ). Of the 42 subjects who demonstrated improvement in GAQ scores after beverage consumption, 25 reported improvement after drinking pomegranate juice. Further, 17 subjects showed preference of one beverage to the other. Subjects were more likely to have improved scores when pomegranate juice was consumed (P=0.058).
Julie Jeranka,Therapeutic Applications of Pomegranate (Punica granatum L.): A Review, Alternative Medicine Review: A Journal of Clinical Therapeutic, July 2008,13(2):128-44 – In addition to its ancient historical uses, pomegranate is used in several systems of medicine for a variety of ailments. In the past decade, numerous studies on the antioxidant, anticarcinogenic, and anti-inflammatory properties of pomegranate constituents have been published, focusing on treatment and prevention of cancer, cardiovascular disease, diabetes, dental conditions, erectile dysfunction, bacterial infections and antibiotic resistance, and ultraviolet radiation-induced skin damage. Other potential applications include infant brain ischemia, male infertility, Alzheimer's disease, arthritis, and obesity.
S. Gur, et al. Characterisation of pomegranate juice effects on human corpus cavernosum, Andrologia 2017 Oct;49(8) – This study evaluates the molecular characterisation and confirmation of POM's action on human corpus cavernosum (HCC) obtained from patients (n = 16) undergoing penile prosthesis implantation. We conclude that POM induced marked relaxation of HCC via: (i) nNOS stimulation, and (ii) downstream relaxation stimulated by nNOS and cGMP and bypassing the NO and PDE5. This action provides a rationale for the therapeutic or preventative use of POM in men with erectile dysfunction who do not respond well to PDE5 inhibitors.
Kazem Azadzoi, et al, Oxidative stress in arteriogenic erectile dysfunction: prophylactic role of antioxidants, J Urol. 2005 Jul;174(1):368-93 – Antioxidant activity of known antioxidant beverages, such as pomegranate juice (PJ), red wine, blueberry juice, cranberry juice, orange juice and green tea, was examined spectrophotometrically. PJ demonstrated the highest free radical scavenging capacity. Antioxidant therapy may be a useful prophylactic tool for preventing smooth muscle dysfunction and fibrosis in ED.
Yuanie Deng, et al. The extract from Punica granatum (pomegranate) peel induces apoptosis and impairs metastasis in prostate cancer cells, Biomed Pharmacother, 2017 Se9;93:976-984 – This study aimed to investigate the effects of pomegranate peel extract (PoPx) on the apoptosis and metastasis of prostate cancer cells and the related mechanism. They found that PoPx showed growth inhibition on prostate cancer cells. Nuclei morphological and flow cytometer (FCM) analysis indicated that PoPx could induce prostate cancer apoptosis. Wound healing assay and transwell migration and invasion assay implied that PoPx has the potential to inhibit migration and invasion, two critical steps in prostate cancer metastasis. Downregulation of MMP2/MMP9 and upregulation of TIMP2 showed accordance with the inhibition of migration and invasion. In summary, the present data showed that PoPx could be a promising drug candidate to treat prostate cancer, showing us a better way to develop novel drugs from natural compounds.
Shahindokht Bassiri-Jahromi, Punica granatum (Pomegranate) activity in health promotion and cancer prevention, Oncol Res. 2018 Jan 30;12(1):345 – The available data suggest that Punica granatum (pomegranate) might be used in the control and potential therapeutic for some disease conditions and benefits human health status. This review summarizes in vitro, in vivo and clinical trial studies highlighting the pomegranate role in prevent and treatment of breast, prostate, lung, colon, skin and hepatocellular cell cancers.
Sigrun Chrubasik-Hausman, et al. Pomegranate juice and prostate cancer: importance of the characterisation of the active principle, Phytoter Res. 2014 Nov;28(11):1676-8 – Two exploratory clinical studies investigating proprietary pomegranate products showed a trend of effectiveness in increasing prostate-specific antigen doubling time in patients with prostate cancer. A recent clinical study did not support these results. We therefore analysed a lot of the marketed pomegranate blend for co-active pomegranate compounds. The results show that the co-active compounds in the daily dose of the pomegranate blend were far below those previously tested and that the photometric assessment is not reliable for the standardisation of study medications. Not pomegranate but the low amount of co-active compounds in the proprietary pomegranate blend was responsible for its clinical ineffectiveness.
Lei Wang, et al. Pomegranate and Its Components as Alternative Treatment for Prostate Cancer, Int J Mol Sci. 2014 Sep; 15 (9):14949-14966 – Recent research has shown that pomegranate juice (PJ) and/or pomegranate extracts (PE) significantly inhibit the growth of prostate cancer cells in culture. In preclinical murine models, PJ and/or PE inhibit growth and angiogenesis of prostate tumors. More recently, it has been shown that three components of PJ, luteolin, ellagic acid and punicic acid together, have similar inhibitory effects on prostate cancer growth, angiogenesis and metastasis. Results from clinical trials are also promising. PJ and/or PE significantly prolonged the prostate specific antigen (PSA) doubling time in patients with prostate cancer.
Zahra Amri, et al. Growth Inhibitory and Pro-Apoptotic Effects of Ornamental Pomegranate Extracts in Du145 Human Prostate Cancer Cells, Nutrition and Cancer, Volume 72, 2020, issue 6 – This study was aimed to investigate the influence of dwarf pomegranate extracts (peel, juice, and seeds oil) on the proliferation and apoptosis of human prostate androgen-independent cell line DU145. The three tested extracts exhibited a dose-response cytotoxic effect and antiproliferative action on DU145 cell line and induce morphological changes. The three extracts could also induce prostate cancer cell apoptosis by an increase of DNA fragmentation, PARP cleavage, and inhibition of the COX-2 expression. The strongest pro-apoptotic effect was shown after peel treatment.
No other fruit or vegetable can affect human sexual performance like pomegranate. It may not be the absolute champ when it comes to raising your testosterone level, increasing erectile strength, or improving the health of your blood vessels (which is a big factor in achieving and maintaining erections), but no other fruit or vegetable does ALL three things so effectively.
I'm sure you're at least peripherally aware of some of the healthy attributes of pomegranate fruit or juice, and maybe you even eat some of it or drink some of its tangy juice on a regular basis.
That's great, and you're probably reaping some of the benefits. However, I can tell you with complete confidence that eating the fruit or drinking the juice of pomegranates isn't getting you close to tapping into its full pro-sexual potential.
The problem is that the plant chemical that does most of the heavy lifting for pomegranates is something called "punicaligans" (a polyphenol – an ellagitannin to be specific) and the heaviest concentration of them is in the RIND or skin of the pomegranate, a part of the fruit that generally gets discarded both by consumers and manufacturers of pomegranate juice.
So I'll say it right up front: To really get all the pro-sexual benefits of punicaligans, you either have to eat a lot of the dried peel – as they do in many places in the Middle East where the powder's used for a variety of medicinal purposes – or you have to buy a punicaligans supplement (like P-Well™) that contains standardized quantities of the polyphenol.
Obviously, the latter alternative is the far more effective and practical choice, but you can decide if you want to go that route later after we do a quick run-through of the specific pro-sexual properties of punicaligans:
1. Punicaligans Elevates Testosterone
When you ingest punicaligans, they're partially metabolized by gut microflora into a compound called "urolithin," which is a powerful inhibitor of aromatase activity. Aromatases are enzymes that turn testosterone into estrogen, and if you can inhibit the activity of these aromatases, in this case by urolithin, you automatically increase testosterone levels.
And I'm not talking about a little duck-snort of testosterone elevation, either. A study of men and women found that punicaligans raised levels of the hormone by an average of 24%.
Punicaligans might also raise testosterone through another mechanism, one that's relatively minor but still worth noting: People who ingest punicaligans daily have a reduced appetite and felt more satiated after eating than a placebo group.
Since being fat or overweight in itself can cause lower levels of testosterone and raise levels of estrogen, anything that helps you lose weight could also have the downstream effect of raising testosterone.
2. Punicaligans Might Work When Erection Drugs Don't
Nitric oxide (NO) is a chemical that relaxes the smooth muscle fibers of the penile arteries so they allow more blood to flow into the penis; typically 8 to 10 times what it would normally hold.
Unfortunately, NO levels start to decline with age, starting at about 40. Men in their 50s or 60s often produce half the NO they did when they were in their 20s. Luckily, it's something we can easily manipulate. It's exactly this phenomenon that's the basis of erectile dysfunction (ED) drugs like Viagra and Cialis.
The drugs inhibit an enzyme called PDE5, which prevents your body from chemically dismantling the NO that's released by your nerves and penile blood vessels. More NO means a better erection. Unfortunately, approximately one-third of men don't respond to these drugs.
This is where punicaligans present an attractive alternative. They too elevate levels of NO, but they elevate neuronal nitric oxide synthase, whereas Viagra and similar drugs elevate endothelial nitric oxide synthase. Of course, elevating either type of NO usually results in a prize-winning erection.
Here's the thing, though: The neuronal nitric oxide synthase, unlike the other type that's increased by Viagra and co., seems to bypass PDE5. That means that punicaligans might work for those men for whom PDE5 inhibitors don't do squat.
But the effectiveness of punicaligans aren't just restricted to men for whom Viagra and its cousins don't work – they appear to improve erectile function in just about everybody. A double-blind crossover study with 61 male subjects found that 47% reported improved erections with pomegranate while only 32% of placebo did... and that was with plain pomegranate and not purified and standardized punicaligans.
3. Punicaligans Can Improve the Health of Blood Vessels
Erections are all about hydraulics: if the "hoses" (blood vessels) are strong and clear of gunk, they can provide a lot of the pressure needed to hoist your penis skywards.
We've already discussed how punicaligans raise levels of NO, which in itself opens up blood vessels, but punicaligans also appear to improve circulatory function in general through their powerful anti-oxidant capability. Multiple studies have shown them to enhance blood flow in general and even reverse arterial plaque growth (roto-rooter out the plaque and you automatically improve blood flow).
Other Stuff Peripherally Associated with Sexing It Up
Punicaligans also have other beneficial effects on the male reproductive system in general. For one thing, people who ingest pomegranate produce more sperm and the sperm in general has better motility and better structure. Again, that's just with plain juice, so imagine what ingesting concentrated punicaligans might accomplish. (Super sperm!)
Pomegranate in general also reduces prostate inflammation, along with interfering with androgen pathways that can cause dreaded prostate hypertrophy (5-alpha reductase type one and 3-beta-hydroxysteroid dehydrogenase type two).
References:
Pooja Sharma, et al. Pomegranate for Prevention and Treatment of Cancer: An Update, Molecules, 24 January 2017. – This review summarizes preclinical and clinical studies highlighting the role of pomegranate in prevention and treatment of skin, breast, prostate, lung, and colon cancers.
Roberto Vicinanza, Yanjun Zhang, Susanne M. Henning, and David Heber, Pomegranate Juice Metabolites, Ellagic Acid and Urolithin A, Synergistically Inhibit Androgen-Independent Prostate Cancer Cell Growth via Distinct Effects on Cell Cycle Control and Apoptosis, Evidence Based Complementary and Alternative Medicine,19 February 2013 – This study describes how ellagitannins (ETs) from pomegranate juice (PJ) are bioactive polyphenols with chemopreventive potential against prostate cancer (PCa).
Lei Wang, et al. Cellular and molecular mechanisms of pomegranate juice-induced anti-metastatic effect on prostate cancer cells, Integr Biol, 2011 May 19 – This study demonstrates how, in addition to causing cell death of hormone-refractory prostate cancer cells, pomegranate also increases cell adhesion and decreases cell migration of the cells that do not die.
Fernando Machado Chaves, et al. Pomegranate Juice and Peel Extracts are Able to Inhibit Proliferation, Migration and Colony Formation of Prostate Cancer Cell Lines and Modulate the Akt/mTOR/S6K Signaling Pathway, Plant Foods Hum Nutr., 2020 March;75(1):54-62. – This study presents evidence that both juice and isolated peel extracts from pomegranate fruit have important anti-cancer effects against prostate cancer cells, modulating the mTOR/S6K signaling pathway.
Cp Forest, et al. Efficacy and safety of pomegranate juice on improvement of erectile dysfunction in male patients with mild to moderate erectile dysfunction: a randomized, placebo-controlled, double-blind, crossover study, Int J Impot Res. Nov-Dec 2007;19(6):564-7 – This randomized-controlled trial examined the efficacy of wonderful variety pomegranate juice versus placebo in improving erections in 53 completed subjects with mild to moderate erectile dysfunction. The crossover design consisted of two 4-week treatment periods separated by a 2-week washout. Of the 42 subjects who demonstrated improvement in GAQ scores after beverage consumption, 25 reported improvement after drinking pomegranate juice. Further, 17 subjects showed preference of one beverage to the other. Subjects were more likely to have improved scores when pomegranate juice was consumed (P=0.058).
Channing J. Paller, et al. A Review of Pomegranate in Prostate Cancer, Prostate Cancer Prostatic Dis. 2017 Sep; 20(3):265-270 – A randomized clinical trial of a polyphenol-rich multi-component food supplement tablet, including 31.25% pomegranate extract, found significant slowing of PSA increase in the food supplement arm vs. placebo in men on active surveillance and those experiencing biochemical recurrence.
David Heber, Chapter 10: Pomegranate Ellagitanins, Herbal Medicine: Biomolecular and Clinical Aspects, 2nd edition. Boca Raton, CRC Press/Taylor & Francis, 2011 – "Since ancient times, pomegranate has been used for medicinal purposes. Extensive research on bioactive substances in the pomegranate extract has shown potential applications in the chemoprevention of common forms of cancer. This work has progressed in cell culture, human studies, and in some clinical research demonstrating the preventive potential of pomegranate. Pomegranates have been shown to contain 124 different phytochemicals, and some of them act in concert to exert antioxidant and anti-inflammatory effects on cancer cells. Ellagitannins are bioactive polyphenols present in pomegranate."
Matthew Resnick, Complementary and Alternative Medicine (CAM) in Prostate and Bladder Cancer, Primary Care, November 26, 2013 – This article is a summary of the evidence of CAM therapies for prostate and bladder cancer. The author reviewed the evidence and listed the benefits of pomegranate, along with those of green tea, and resveratrol (through grapes and dark-colored berries).
Maryam R Sartippour, Ellagitannin-rich pomegranate extract inhibits angiogenesis in prostate cancer in vitro and in vivo, Int J Oncol. 2008 Feb;32(2): 475-80 – These results demonstrate that an ellagitannin-rich pomegranate extract can inhibit tumor-associated angiogenesis as one of several potential mechanisms for slowing the growth of prostate cancer in chemopreventive applications.
Arrigo F G Cicero, et al. Nutraceutical treatment and prevention of benign prostatic hyperplasia and prostate cancer, Arch Ital Urol Androl. 2019 Oct 2;91(3) – This study explains how medicinal plants, in the form of plant parts or extracts of them, are commonly used for the treatment of prostate diseases such as benign hypertrophy, prostatitis and chronic pelvic pain syndrome. The pharmacological properties searched for the treatment of prostatic diseases are anti-androgenic, anti-estrogenic, antiproliferative, antioxidant and anti-inflammatory.
Navindra P Seeram, et al. Pomegranate ellagitannin-derived metabolites inhibit prostate cancer growth and localize to the mouse prostate gland, J Agric Food Chem. 2007 Sep 19;55(19):7732-7 – The scientists explain how pomegranate juice (PJ) increases prostate specific antigen (PSA) doubling time in prostate cancer (CaP) patients with a rising PSA. Ellagitannins (ETs) are the most abundant polyphenols present in PJ and contribute greatly towards its reported biological properties. On consumption, ETs hydrolyze to release ellagic acid (EA), which is then converted by gut microflora to 3,8-dihydroxy-6H-dibenzo[b, d]pyran-6-one (urolithin A, UA) derivatives. The chemopreventive potential of pomegranate ETs and localization of their bioactive metabolites in mouse prostate tissue suggest that pomegranate may play a role in CaP treatment and chemoprevention.
Nils Kroeger, et al. Pomegranate Extracts in the Management of Men's Urologic Health: Scientific Rationale and Preclinical and Clinical Data, Evid Based Complement Alternat Med. 2013 Mar 26 – Numerous micronutrients and polyphenols found in soy, green tea, and many fruits and vegetables have been described to impact diseases including erectile dysfunction, benign prostatic hyperplasia, and prostate cancer. However, oftentimes these reports lack both a scientific rationale and supportive evidence base. The efficacy of pomegranate, on the other hand, in the modulation of central biological processes like inflammation, hypoxia, and oxidative stress that are important in the pathogenesis of urological maladies has been robustly demonstrated in preclinical in vitro and in vivo studies. Moreover, clinical trials have further supported its use in the treatment of several diseases, in particular in the management of prostate cancer.
CP Forest, et al. Efficacy and safety of pomegranate juice on improvement of erectile dysfunction in male patients with mild to moderate erectile dysfunction: a randomized, placebo-controlled, double-blind, crossover study, Int J Impot Res. Nov-Dec 2007;19(6):564-7 – This randomized-controlled trial examined the efficacy of wonderful variety pomegranate juice versus placebo in improving erections in 53 completed subjects with mild to moderate erectile dysfunction. The crossover design consisted of two 4-week treatment periods separated by a 2-week washout. Efficacy was assessed using International Index of Erectile Function (IIEF) and Global Assessment Questionnaires (GAQ). Of the 42 subjects who demonstrated improvement in GAQ scores after beverage consumption, 25 reported improvement after drinking pomegranate juice. Further, 17 subjects showed preference of one beverage to the other. Subjects were more likely to have improved scores when pomegranate juice was consumed (P=0.058).
Julie Jeranka,Therapeutic Applications of Pomegranate (Punica granatum L.): A Review, Alternative Medicine Review: A Journal of Clinical Therapeutic, July 2008,13(2):128-44 – In addition to its ancient historical uses, pomegranate is used in several systems of medicine for a variety of ailments. In the past decade, numerous studies on the antioxidant, anticarcinogenic, and anti-inflammatory properties of pomegranate constituents have been published, focusing on treatment and prevention of cancer, cardiovascular disease, diabetes, dental conditions, erectile dysfunction, bacterial infections and antibiotic resistance, and ultraviolet radiation-induced skin damage. Other potential applications include infant brain ischemia, male infertility, Alzheimer's disease, arthritis, and obesity.
S. Gur, et al. Characterisation of pomegranate juice effects on human corpus cavernosum, Andrologia 2017 Oct;49(8) – This study evaluates the molecular characterisation and confirmation of POM's action on human corpus cavernosum (HCC) obtained from patients (n = 16) undergoing penile prosthesis implantation. We conclude that POM induced marked relaxation of HCC via: (i) nNOS stimulation, and (ii) downstream relaxation stimulated by nNOS and cGMP and bypassing the NO and PDE5. This action provides a rationale for the therapeutic or preventative use of POM in men with erectile dysfunction who do not respond well to PDE5 inhibitors.
Kazem Azadzoi, et al, Oxidative stress in arteriogenic erectile dysfunction: prophylactic role of antioxidants, J Urol. 2005 Jul;174(1):368-93 – Antioxidant activity of known antioxidant beverages, such as pomegranate juice (PJ), red wine, blueberry juice, cranberry juice, orange juice and green tea, was examined spectrophotometrically. PJ demonstrated the highest free radical scavenging capacity. Antioxidant therapy may be a useful prophylactic tool for preventing smooth muscle dysfunction and fibrosis in ED.
Yuanie Deng, et al. The extract from Punica granatum (pomegranate) peel induces apoptosis and impairs metastasis in prostate cancer cells, Biomed Pharmacother, 2017 Se9;93:976-984 – This study aimed to investigate the effects of pomegranate peel extract (PoPx) on the apoptosis and metastasis of prostate cancer cells and the related mechanism. They found that PoPx showed growth inhibition on prostate cancer cells. Nuclei morphological and flow cytometer (FCM) analysis indicated that PoPx could induce prostate cancer apoptosis. Wound healing assay and transwell migration and invasion assay implied that PoPx has the potential to inhibit migration and invasion, two critical steps in prostate cancer metastasis. Downregulation of MMP2/MMP9 and upregulation of TIMP2 showed accordance with the inhibition of migration and invasion. In summary, the present data showed that PoPx could be a promising drug candidate to treat prostate cancer, showing us a better way to develop novel drugs from natural compounds.
Shahindokht Bassiri-Jahromi, Punica granatum (Pomegranate) activity in health promotion and cancer prevention, Oncol Res. 2018 Jan 30;12(1):345 – The available data suggest that Punica granatum (pomegranate) might be used in the control and potential therapeutic for some disease conditions and benefits human health status. This review summarizes in vitro, in vivo and clinical trial studies highlighting the pomegranate role in prevent and treatment of breast, prostate, lung, colon, skin and hepatocellular cell cancers.
Sigrun Chrubasik-Hausman, et al. Pomegranate juice and prostate cancer: importance of the characterisation of the active principle, Phytoter Res. 2014 Nov;28(11):1676-8 – Two exploratory clinical studies investigating proprietary pomegranate products showed a trend of effectiveness in increasing prostate-specific antigen doubling time in patients with prostate cancer. A recent clinical study did not support these results. We therefore analysed a lot of the marketed pomegranate blend for co-active pomegranate compounds. The results show that the co-active compounds in the daily dose of the pomegranate blend were far below those previously tested and that the photometric assessment is not reliable for the standardisation of study medications. Not pomegranate but the low amount of co-active compounds in the proprietary pomegranate blend was responsible for its clinical ineffectiveness.
Lei Wang, et al. Pomegranate and Its Components as Alternative Treatment for Prostate Cancer, Int J Mol Sci. 2014 Sep; 15 (9):14949-14966 – Recent research has shown that pomegranate juice (PJ) and/or pomegranate extracts (PE) significantly inhibit the growth of prostate cancer cells in culture. In preclinical murine models, PJ and/or PE inhibit growth and angiogenesis of prostate tumors. More recently, it has been shown that three components of PJ, luteolin, ellagic acid and punicic acid together, have similar inhibitory effects on prostate cancer growth, angiogenesis and metastasis. Results from clinical trials are also promising. PJ and/or PE significantly prolonged the prostate specific antigen (PSA) doubling time in patients with prostate cancer.
Zahra Amri, et al. Growth Inhibitory and Pro-Apoptotic Effects of Ornamental Pomegranate Extracts in Du145 Human Prostate Cancer Cells, Nutrition and Cancer, Volume 72, 2020, issue 6 – This study was aimed to investigate the influence of dwarf pomegranate extracts (peel, juice, and seeds oil) on the proliferation and apoptosis of human prostate androgen-independent cell line DU145. The three tested extracts exhibited a dose-response cytotoxic effect and antiproliferative action on DU145 cell line and induce morphological changes. The three extracts could also induce prostate cancer cell apoptosis by an increase of DNA fragmentation, PARP cleavage, and inhibition of the COX-2 expression. The strongest pro-apoptotic effect was shown after peel treatment.