The best replacement for pygeum is saw palmetto.

The best alternatives to pygeum are rated as following:
★★★★★  saw palmetto
★  beta sitosterol
★  beta-sitosterol
★  nettle root

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Speaking about pygeum, one probably shouldn't forget about saw palmetto.

Other search terms related to pygeum and their ratings are:
★★★★★ saw palmetto
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pygeum
saw palmetto
beta sitosterol