It's not often you see multiple cultures and multiple religions throughout history devote so much devotion, so much text, to a fruit, but that's exactly what you see with the pomegranate.
Zoroastrians regarded it as a symbol of eternal life and fertility. Ancient Egyptians associated it with prosperity and ambition, and the Buddhists considered it a sacred plant. It was designated a food of God in the Vedas, while The Old Testament believed it conferred powers of fertility, abundance, and good luck.
Much of this spiritual reverence for the fruit stemmed from its medicinal properties. Ayurvedic tradition even regarded it as a "pharmacy unto itself" and used it to treat sexual inadequacies, cardiac conditions, anemia, and cough, stomach, and urine-related issues.
It even inspired those that had intentions that contrasted mightily with religion and/or healing, as French forces under King Francis I used the fruit as a model for a new weapon of war named the grenade, which is French for pomegranate. The devices were made of glass globes, jars, kegs, or firepots, and they were filled with tiny pieces of shrapnel that were allegedly inspired by the many seeds contained within the fruit.
And while it's easy to dismiss the medical knowledge of ancient societies, it's telling when so many cultures across so many centuries noticed that pomegranate, either in its unadulterated form or through teas and tinctures, fixed things that ailed the human body.
Maybe they thought it had divine powers or that it was magic, but today we know the pomegranate's "magic" is the result of the complex array of phytochemicals it contains. Aside from its taste and versatility, the fruit is known mainly for its antioxidant powers, 90% of which it owes to the polyphenols it contains.
Tease apart that percentage a little further, though, and we find that 50% of that high-horsepower antioxidative power is contributed by one polyphenol alone, and that polyphenol is an ellagitannin (a class of polyphenols) called punicalagin.
So What's This Punicalagin Stuff, or Its Metabolites, Do?
Here's the thing: By themselves, punicalagins don't do very much at all. In fact, they're not even absorbed very well by your body. However, once they make the trek through your gastrointestinal tract, they're converted into a substance called ellagic acid, some of which is further metabolized into other compounds, chief among them urolithin, which enters your circulation quite efficiently through the colon.
Both ellagic acid and urolithin are among the most powerful antioxidants known to man. Being a powerful antioxidant is just one of their superpowers, though. They have plenty of other capabilities, too, among them the following:
They block the conversion of testosterone to estrogen
Punicalagin/urolithin is a powerful inhibitor of aromatase activity, which means it thwarts the conversion of testosterone into estrogen, thereby elevating testosterone levels naturally.
This elevation appears to be substantial, too, as one study of men and women found that punicalagins raised levels of the hormone by an average of 24%.
They block conversion of testosterone to DHT
Punicalagin/ellagic acid inhibits the 5-alpha reductase enzyme. This results in less testosterone being converted to DHT, thereby increasing testosterone levels while preventing growth of the prostate.
They act like Viagra
Punicalagin/urolithin elevates levels of nitric oxide (NO), which relaxes the smooth muscle fibers of the penile arteries so they allow more blood to flow into the penis.
That's exactly how drugs like Viagra work, too, but punicalagins/urolithins 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.
What's important about that fact is punicalagins/urolithins might work for those men for whom Viagra and its cousins are an epic failure.
But the effectiveness of punicalagins/urolithins isn't restricted to men for whom Viagra and its cousins don't work – they appear to improve erectile function in just about every healthy man.
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 punicalagins.
They improve the health of blood vessels
We've already discussed how punicalagins/urolithins raise levels of NO, which in itself opens up blood vessels, but punicalagins also appear to improve circulatory function in general through their powerful antioxidant 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).
As an added bonus, erections are all about hydraulics, and 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.
They appear to inhibit different types of cancers
The higher the amount of urolithin in the blood, the greater the inhibition of two types of prostate cancer cells. The same inhibition seems to be true for colon cancer cells and melanoma cells too.
They prevent absorption of carbs
Punicalagins/urolithin inhibit alpha-glucoside, which leads to a decrease in glucose absorption, thus ameliorating diabetes and helping ward off obesity.
- They reduce cholesterol
- They have an antimicrobial effect against urinary tract infections
- They appear to improve anaerobic exercise performance
- They reduce inflammation in coronary arteriosclerosis
- They reduce prostate-specific antigen (PSA)
How Much Do I Need and Where Do I Get It?
The evidence is clear. Punicalagins possess a remarkable array of benefits. The trouble is, punicalagins appear to be found in only two members of the pomegranate family and some weird bush that grows in Africa.
Okay, so you can just eat pomegranates or drink the juice. That's a step in the right direction, but unfortunately, punicalagins are mainly present in the root, bark, and leaves of the pomegranate, none of which is used to make commercial pomegranate juice.
That's not to say that commercial pomegranate juice doesn't contain punicalagins; it does, just not much. That means the best way to augment your intake of punicalagins/ellagic acid/urolithin is to take a supplement.
Biotest was so high on punicalagins that they made them the backbone of P-Well™, their new multi-functional supplement for vascular sexual health, urinary tract health, and prostate support. Each serving contains 180 mg. of punicalagins (from pomegranate), along with 30 mg. of lycopene from natural tomato extract and 500 mg. of cranberry whole fruit concentrate.
Together, they should make you, well, pee well, or at least pee better. The product also helps protect your all-too-vulnerable prostate and possibly allows you to enjoy a better sex life by improving testosterone levels and allowing more blood to flow into the penis when aroused.
It might also convey some or all of the health benefits described in this article.
Try taking three capsules a day for a month and pay special attention to your erectile strength and erectile frequency, along with any other tell-tail signs of good health, to determine if it's working for you.
- Kumara Isha, Kaurav Hemlata, Chaudary Gitika, Punica granatum L. (Dadim), Therapeutic Importance of World's Most Ancient Fruit Plant, Journal of Drug Delivery and Therapeutics, 2021: 11(3): 113-121. – The review provides information related to the phytochemistry and traditional uses in Ayurveda and folk medicine concerning the therapeutic properties of Punica granatum.
- 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.