Tribulus Terrestris for Decreased Sex Drive

Tribulus has modest randomized support for improving desire and sexual satisfaction — notably in women and in men with mild erectile dysfunction — even though it does not change testosterone.

Overview

Tribulus has modest randomized support for improving desire and sexual satisfaction — notably in women and in men with mild erectile dysfunction — even though it does not change testosterone.

Verdict

Mixed evidence

Small trials show real score improvements, but effect sizes are moderate, extracts differ widely, and hormone-mediated explanations do not hold up.

How It Works

Protodioscin appears to enhance nitric oxide release in cavernosal and clitoral tissue and may act centrally on dopaminergic desire pathways, independent of any hormone change.

Dosing & Protocol

Typical dose

Recommended dose: 750 mg/day standardized extract in three divided doses
Expected timeframe: 8-12 weeks

Protocol

form: Extract standardised to saponin content (commonly 40-60% furostanol saponins)
duration: 12 weeks with a validated sexual function questionnaire
co factor: Take with food. Evidence is mixed and split by sex: several randomised trials in women with hypoactive sexual desire disorder report improved desire and arousal scores at 750 mg/day, and some trials in men report improved erectile function, while other trials show nothing - and notably, benefit occurs without any measurable rise in testosterone.
titration: Trials in women used 750 mg/day; men's trials have used up to 1500 mg/day
starting dose: 250 mg Tribulus terrestris extract three times daily (750 mg/day) with meals

Evidence

What the studies say

A double-blind trial in women with hypoactive sexual desire disorder (n=60, 7.5 mg/day of a concentrated extract for four weeks) reported significant FSFI improvements in desire, arousal and satisfaction. A separate trial in postmenopausal women found similar gains. In men, a 12-week randomized study (n=180) using 750 mg/day of protodioscin-standardized extract found improved IIEF scores in mild-to-moderate erectile dysfunction, while a smaller trial in severe ED found no benefit. Testosterone was unchanged in every study that measured it, so the effect, if real, is vascular or central. Extract standardization varies enormously between products, which is the main reason results are inconsistent across the literature.

Evaluation of the efficacy and safety of Tribulus terrestris in male sexual dysfunction-A prospective, randomized, double-blind, placebo-controlled clinical trial

Score: 7/10

2017

rct

n=180

Kamenov Z, Fileva S, Kalinov K +1 more

Tribulus terrestris improved IIEF erectile function and desire scores versus placebo without changing testosterone

View source

Safety

Caveats

Low libido usually has a cause worth finding: depression, relationship difficulty, medication (SSRIs, beta-blockers, hormonal contraception), thyroid disease, menopause, chronic pain and alcohol are common contributors. Erectile dysfunction can be the first sign of cardiovascular disease and warrants medical review. Safety ceiling: above 1500 mg/day is unstudied. Tribulus has caused hepatotoxicity and nephrotoxicity in case reports, and a livestock syndrome of neurological damage is documented with heavy consumption. It may lower blood glucose and blood pressure. Contraindicated in pregnancy and breastfeeding, and in hormone-sensitive cancers.

Less likely to help if

People whose low desire is driven by depression, medication side effects or relationship factors.

Medical Disclaimer

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Individual results may vary. The statements on this website have not been evaluated by the Food and Drug Administration. Products and information are not intended to diagnose, treat, cure, or prevent any disease.