Effect of Tribulus terrestris
treatment on impotence and libido disorders
Andalas University, School of Medicine, Padang, Indonesia (1993)
To test the effectiveness of Tribulus terrestris in treating impotence
and male libido disorders, we enrolled 11 subjects, composed of
4 men diagnosed with lowered or nonexistent libido and 7 impotent
men. To these two groups, 3 x 1 Libilov tablets were administered
per day for 2 weeks, without any additional vitamin supplements
or pharmaceutical therapeutics. 50% of the subjects with reduced
libido reported increased sex drive after Libilov treatment. Close
to 60% of impotent subjects experienced improved erection, including
prolonged duration of erection after treatment. This trial suggested
that even a short period of treatment with Libilov was effective
in treating these two conditions. Furthermore, as with previous
trials, no adverse side-effects were observed.
Diagnoses of sexual disorders are often hampered by the tendencies
of male patients to conceal their symptoms, due to fear or embarrassment.
The lack of early diagnoses, not the unavailability of effective
treatment, is often the primary reason for these disorders not being
medically treated. It is not uncommon that when left untreated,
such disorders can lead to marriage or relationship problems (Paat
1985). The most common forms of male sexual disorders are libido
disorder and impotence, which can occur simultaneously or individually
in a male patient (Adimoelja 1986, Mansur 1985). A man experiencing
libido disorder, defined as decreased or nonexistent sex drive,
will simultaneously have impotence. The reverse, however, is not
always true. An impotent male often has a normal sex drive.
In this clinical trial, we seek to determine the effect and possible
side-effects of Libilov treatment on the male sexual drive as well
as its effect on impotence. In addition, as Libilov treatment involves
administration of a non-hormonal herbal extract, this trial will
determine whether such treatment can supplement or replace hormone
therapies in treatment of sexual disorders. If so, depending on
the possible side-effects, Libilov treatment may be preferable to
hormone replacement therapies. This is because hormone treatments
are often associated with much unwanted or even harmful side-effects,
which often include internal organ toxicity.
Libido disorder is defined by andrologists as decreased, nonexistent
or even excessive sexual drives. Masters and Johnson (1969), Steno
et al. (1977), Picollo and Picollo (1978) defined impotence as the
inability to achieve or maintain penile erection that is sufficient
for normal sexual activities, including sexual intercourse. This
becomes a medical condition if this inability to achieve erection
occurs in 50% or more of sexual activities. It is possible that
a man experience both libido disorder, especially decreased or non-existent
sex drive, and impotence at the same time.
Libilov is a non-hormonal herbal preparation of the plant Tribulus
terrestris L. It has been used to treat infertility, as it has been
shown to increase spermatozoa concentration by increasing the number
of spermatogonia, spermatocytes and spermatids, as well as to treat
libido disorders and impotence.
Tests performed on laboratory animal models have shown that the
administration of Tribulus extract was effective in eliciting an
increase in libido as measured by the increase in the number of
sexual intercourse or attempt at intercourse. A dose of 70 mg /
kg of body weight for 10 days typically achieves improvement in
libido or sexual reflects in 71% of test cases.
Clinical trials of Tribulus extracts on subjects that suffered
from decreased libido as well as from impotence due to primary and
secondary hypogonadisms resulted in increased libido and improvement
in the quality and duration of erection. Two trials involving otherwise
normal subjects suffering from decreased libido and impotence showed
that Libilov treatment regiment of 3 x 2 tablets / day for as little
as 30 to 60 days resulted in dramatic improvement in libido and
duration of erection. Furthermore, this effect was not limited to
those experiencing decreased libido: a clinical trial involving
more than 200 normal men between the ages of 40 to 60 years showed
that administration of this extract resulted in a remarkable increase
in sex drive as well as improved erection.
FACTORS THAT LEAD TO LIBIDO DISORDERS AND IMPOTENCE
Libido disorders and impotence can be caused by a variety of factors,
such as physical or hormonal and psychological factors (Basjuriddin
and Nasution 1993, Pangkahila 1984).
Psychological factors are responsible for the majority of sexual
disorders. It has been estimated that between 60% to more than 90%
of sexual disorder cases can be traced to these factors (Simpson
1950, Stafford and Clark 1954, Baheri 1966 and Cooper 1972). Psychological
factors include interpersonal and sexual development problems, emotive
and cognitive factors, as well as sexual history problems.
Physical and hormonal factors are often grouped together to form
organic factors. These factors include diseases, iatrogenic and
medicinal side-effects (Pangkahila 1986). The most prevalent disease
that causes sexual disorders is diabetes mellitus (Nasution 1989).
Iatrogenic factors include perineal abdominal surgeries, such as
hemorrhoid or hernia surgeries, colon, vascular and urological,
as well as sympathectomy surgeries. In cases of sympathectomy surgeries,
more than 60% of subjects suffered from post-operative impotence.
Medical side-effects that result in impotence include treatments
with anti-hypertension, anti-androgen or estrogen, antihistamine,
anti-anxiety and depression medications amongst others.
There are several available treatments for libido disorders and
impotence, including supportive treatment, sex therapy, vacuum or
mechanical therapy, and prosthetic implants. Supportive treatment
includes administration of neurotrophic vitamins, hormonal preparations,
as well as a non-hormonal preparation marketed under the name Libilov™.
Selection of treatment should take into account effectiveness of
treatment, the ease of administration, cost, as well as possible
side-effects. As even organic impotence often includes, or results
in psychological effects such as embarrassment or depression, the
involvement of the female sexual partner in the treatment of impotence
or libido disorders is generally very important. It is not uncommon
that the role of the female partner or the degree of her involvement
can determine the success of medical treatment of the male's impotence
or sexual dysfunctions.
This clinical trial involved 11 male subjects medically diagnosed
with either decreased or nonexistent libido (4 subjects) or impotence
(7 subjects). To these two groups Libilov (3 x 1 tablets / day)
were administered for 2 weeks. No additional vitamin supplements
or pharmaceutical therapeutics were given. After two weeks of Libilov
treatment, effects and progress in these subjects were evaluated.
Out of the four subjects diagnosed with libido disorders, two (50%)
reported increased sexual drive after treatment with Libilov. One
(25%) did not report any increase in libido, whereas unfortunately
one did not return for post-treatment evaluation. In the second
group of seven subjects that were diagnosed with impotence, four
subjects (57.1%) experienced improved erection and prolonged duration
of erection after treatment. One patient did not experience any
change. Unfortunately, two subjects from this group failed to return
This clinical trial suggests that even a short period of treatment
with Tribulus extract is effective in treating libido disorders
and impotence: 50% of subjects diagnosed with decreased libido experienced
significant improvement in sex drive and more than 57% of subjects
diagnosed with erectile dysfunction or impotence experience improvement
in the quality and duration of penile erection.
Previous clinical trials of Libilov involved administration of
the preparation for 30 to 60 days, with dosage as much as 3 x 2
tablets / day. This trial suggests that a much shorter period of
treatment, involving a lower dose of 3 x 1 tablet / day can be as
effective in treating libido disorders and impotence. As with previous
trials, no adverse side-effects were reported. Furthermore, administration
of only Libilov was sufficient to achieve the benefits, as no additional
vitamin supplements or pharmacotherapeutics were administered.
Libilov treatment of cases of libido disorders and impotence has
been proven to be beneficial, due to its high effectiveness, absence
of side-effects, and the absence of requirement of supplemental
medications or vitamins.
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