Tribulus Research

Tribulus terrestris for Sexual Dysfunction and Infertility: A Systematic Review and Meta-Analysis

Qin D et al. • Phytomedicine (2023)

Tribulus terrestris significantly improved sexual function scores without affecting testosterone levels in healthy men.

• Significant improvements in sexual desire and satisfaction across pooled RCTs
• No significant effect on serum testosterone in healthy males
• Benefits in women with hypoactive sexual desire disorder confirmed

Beneficial effects of natural products on female sexual dysfunction: A systematic review and meta-analysis

Sha'ari N et al. • Phytomedicine : international journal of phytotherapy and phytopharmacology (2021)

Preliminary evidence suggests that Tribulus terrestris and Panax ginseng may be effective as alternative treatments for FSD in a clinical setting.

• Panax ginseng was found to be effective in treating sexual arousal (SMD = 0.54, 95% CI = 0.11 - 0.97, p = 0.014) and sexual desire (SMD = 0.59, 95% CI = 0.27 - 0.90, p < 0.001) compared to placebo.
• Preliminary evidence suggests that Tribulus terrestris and Panax ginseng may be effective as alternative treatments for FSD in a clinical setting.
• Further research warranted to confirm findings

Effects of Tribulus (Tribulus terrestris L.) Supplementation on Erectile Dysfunction and Testosterone Levels in Men-A Systematic Review of Clinical Trials

Vilar Neto JO et al. • Nutrients (2025)

Conclusions: TT supplementation has a low level of evidence regarding its effectiveness in improving erectile function in men with erectile dysfunction, and no robust evidence was found for increasing testosterone levels.

• The Jadad score revealed low methodological quality for 50% of the studies.
• TT supplementation at doses of 400 to 750 mg/d for 1 to 3 months improved erectile dysfunction in 3 of the 5 studies that assessed this parameter.
• Eight out of ten studies did not report significant changes in androgen profile following TT supplementation, but the subjects in the neutral studies did not have low androgen levels at baseline.

Tribulus terrestris for management of patients with erectile dysfunction: a systematic review and meta-analysis of randomized trials

Suharyani S et al. • International journal of impotence research (2026)

• The outcomes of continuous variables were aggregated into the mean difference (MD) with corresponding 95% confidence intervals (95% CI) utilizing random-effects models.
• Additionally, on both the IIEF-5 [MD 3.23 (95%CI 1.89, 4.58), p < 0.00001] and IIEF-15 [MD 14.44 (95%CI 5.75, 23.14), p = 0.001], Tribulus terrestris outperformed placebo.
• However, the two groups were not significantly different in terms of total testosterone levels.

Do "testosterone boosters" really increase serum total testosterone? A systematic review

Morgado A et al. • International journal of impotence research (2024)

The Author(s), under exclusive licence to Springer Nature Limited.

• Testosterone boosters are heavily marketed on social media and marketplaces to men with claims to significantly increase testosterone.
• Our findings indicate that most fail to increase total testosterone.
• The exceptions were β-hydroxy β-methylbutyrate and betaine, which can be considered effective for male athletes.

Effects of Tribulus terrestris on Athletic Performance and Body Composition: A Systematic Review

Ma Y et al. • Journal of Dietary Supplements (2021)

Tribulus terrestris did not significantly improve body composition or athletic performance in healthy athletes.

• No significant effects on muscle mass, strength, or body composition
• No increase in testosterone or anabolic hormones in athletes
• Any performance benefits may be related to improved recovery rather than hormonal effects

Dietary Supplements for Erectile Dysfunction: Analysis of Marketed Products, Systematic Review, Meta-Analysis and Rational Use

Petre GC et al. • Nutrients (2023)

DSs marketed in Italy are usually blends of many substances that are frequently employed at a negligible dose or without any evidence.

• Based on the scoring system, 2 (8%) supplements matched with the cluster of higher expected efficacy, 3 (12%) with the lower efficacy cluster and 20 (80%) matched with the criterion of no expected efficacy.
• A systematic review of the literature was performed to evaluate the effect of DS and to detect the active ingredients able to improve erectile function-called effective ingredients (EIs)-and their minimal effective daily dose (mED).
• A metanalysis identified some nutraceuticals, such as Panax ginseng, Tribulus terrestris and L-arginine, that are able to improve male sexual function.

Effects of Tribulus terrestris L. on Sport and Health Biomarkers in Physically Active Adult Males: A Systematic Review

Fernández-Lázaro D et al. • International journal of environmental research and public health (2022)

More studies are needed to confirm the benefits of TT due to the limited number of studies available in the current literature.

• Overall, participants supplemented with TT displayed significant improvements in lipid profile.
• No positive effects were observed on the immune system response.
• Additionally, no TT-induced toxicity was reported.

A systematic review and evidence-based analysis of ingredients in popular male testosterone and erectile dysfunction supplements

Kuchakulla M et al. • International journal of impotence research (2021)

Many male supplements claim to improve testosterone or ED parameters; however, there is limited evidence, which should be considered when counseling patients.

• No whole supplement products have published RCT evidence. 19% of ingredients received an A grade for strong positive evidence with net positive evidence in two or more RCTs.
• In total, 68% received C or D grades for contradicting, negative, or lacking evidence.
• Overall, 69% of ingredients in testosterone supplements and 52% of ingredients in ED supplements have published RCT evidence.

Effect of Tribulus terrestris L. on sperm parameters in men with idiopathic infertility: A systematic review

Sanagoo S et al. • Complementary therapies in medicine (2019)

The results of the present systematic review showed that the consumption of T terrestris L., in general, resulted in the improvement of sperm parameters.

• The results of the present systematic review showed that the consumption of T terrestris L., in general, resulted in the improvement of sperm parameters.
• This result was obtained from 6 out of the 7 articles.
• Further research warranted to confirm findings

The aetiology, prevalence and morbidity of outbreaks of photosensitisation in livestock: A review

Chen Y et al. • PloS one (2019)

Hepatogenous photosensitisation in livestock represents a significant risk to livestock production, particularly in Australia, Brazil, and the United States.

• Hepatogenous (Type III) photosensitisation was the most frequently reported diagnosis (68.5%) and resulted in higher morbidity.
• Hepatogenous photosensitisation in livestock represents a significant risk to livestock production, particularly in Australia, Brazil, and the United States.
• Management of toxic pastures and common pasture weeds may reduce the economic impact of photosensitisation both at a national and global level.

Therapeutic potential of medicinal plants for the management of urinary tract infection: A systematic review

Shaheen G et al. • Clinical and experimental pharmacology & physiology (2019)

Although herbal medicines have more potential over conventional medicine but more discoveries are required to explore the phytoconstituents and their mechanism of action responsible for the management and cure of UTI.© 2019 John Wiley & Sons Australia, Ltd.

• Herbal medicines are effective to combat bacterial resistance with high efficacy, and easy availability with minimal or no side effects.
• For these reasons it has attained the attention of researchers wanting to explore the herbal treatment of UTI.
• Vaccinium macrocarpon, Tribulus terrestris, Trachyspermum copticum, Cinnamomum verum and Hybanthusenn easpermus are some common medicinal plants reported to have therapeutic potential for the management and cure of the UTI.

A systematic review on the herbal extract Tribulus terrestris and the roots of its putative aphrodisiac and performance enhancing effect

Qureshi A et al. • Journal of dietary supplements (2014)

The nitric oxide release effect of TT may offer a plausible explanation for the observed physiological responses to TT supplementation, independent of the testosterone level.

• A limited number of animal studies displayed a significant increase in serum testosterone levels after TT administration, but this effect was only noted in humans when TT was part of a combined supplement administration.
• Literature available for the effectiveness of TT on enhancing testosterone concentrations is limited.
• Evidence to date suggests that TT is ineffective for increasing testosterone levels in humans, thus marketing claims are unsubstantiated.

[Results of a comparative multi-center randomized clinical study of efficacy and safety of EFFEX Tribulus and Tribestan in patients with erectile dysfunction]

Spivak LG et al. • Urologiia (Moscow, Russia : 1999) (2018)

The herbal preparations EFFEX Tribulus and Tribestan have a similar efficacy and safety profiles.

• In both groups, all other IIEF domain scores demonstrated a statistically significant increase.
• Besides, the use of the herbal preparations was associated with a decrease in the serum cholesterol level, more pronounced with increasing patient age (correlation coefficient -0.06, p=0.41).
• The herbal preparations EFFEX Tribulus and Tribestan have a similar efficacy and safety profiles.

Effect of vaginal suppository on bacterial vaginitis based on Persian medicine (Iranian traditional medicine): a randomised double blind clinical study

Baery N et al. • Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology (2018)

A clinical study with a longer follow-up time is suggested for assessing the recurrence of BV after treatment with Forzejeh metronidazole.

• The amount and odour of discharge, Amsel criteria, pelvic pain and cervical inflammation significantly decreased in Forzejeh and metronidazole groups (p = <.001).
• There was no statistically significant difference between the metronidazole and Fozejeh groups with respect to any of the clinical symptoms or the laboratory assessments.
• What do the results of this study add?

Tribulus terrestris versus placebo in the treatment of erectile dysfunction: A prospective, randomized, double blind study

Santos CA Jr et al. • Actas urologicas espanolas (2014)

At the dose and interval studied, Tribulus terrestris was not more effective than placebo on improving symptoms of erectile dysfunction or serum total testosterone.

• The time factor caused statistically significant changes in both groups for IIEF-5 only (P = .0004), however, there was no difference between the two groups (P = .7914).
• At the dose and interval studied, Tribulus terrestris was not more effective than placebo on improving symptoms of erectile dysfunction or serum total testosterone.
• Further research warranted to confirm findings

Effect of Tribulus Terrestris in the Treatment of Female Sexual Dysfunction and Clitoral Vascularization. Results of a Randomized Study Comparing Two Different Dosage Regimes

Vale FBC et al. • Journal of sex & marital therapy (2021)

Moreover, its use, increased total, free and bioavailable testosterone.

• QS-F results showed a significant improvement in the mean total score in women of both reproductive phases, for both groups.
• Postmenopausal patients improved in all sexual domains, except for "orgasm" in the TT1 group.
• PI of the clitoral artery showed no difference in both reproductive phases, in both groups.

Effects of Aphrodite (an Herbal Compound) on SSRI-Induced Sexual Dysfunctions and Depression in Females with Major Depressive Disorder: Findings from a Randomized Clinical Trial

Shahmoradi N et al. • Medicina (Kaunas, Lithuania) (2023)

Further and similar studies should investigate the underlying psychophysiological mechanisms.

• Results: Symptoms of sexual dysfunction, depression, and anxiety decreased over time, but more so in the Aphrodite condition, compared to the placebo condition (significant p-values and large effect sizes).
• Over time, sleep disturbances decreased irrespective of the study condition.
• Further and similar studies should investigate the underlying psychophysiological mechanisms.

Efficacy of Khār-i-khasak (Tribulus terrestris Linn.) in prehypertension: a randomized, double-blind, placebo-controlled trial

Siddiqui MA et al. • Journal of complementary & integrative medicine (2021)

The test drug Khār-i-khasak (T. terrestris Linn.) was found to be effective and safe in lowering blood pressure compared to placebo in prehypertensive individuals.

• The test drug Khār-i-khasak (T. terrestris Linn.) was found to be effective and safe in lowering blood pressure compared to placebo in prehypertensive individuals.
• Published in Journal of complementary & integrative medicine (2021)
• Further research warranted to confirm findings

Clinical efficacy of herbal extracts in treatment of mild to moderate acne vulgaris: an 8-week, double-blinded, randomized, controlled trial

Yang JH et al. • The Journal of dermatological treatment (2021)

This herbal extracts can be a new therapeutic option for patients with mild to moderate acne vulgaris who are reluctant to use drugs.

• By the end of the study period, both inflammatory and non-inflammatory acne lesion counts were significantly decreased in herbal extracts group (p< .05).
• In immunohistochemistry staining, expressions of IL-1α, IL-8, and keratin 16 were significantly decreased in herbal extracts group compared to vehicle group from baseline to week 8.
• This herbal extracts can be a new therapeutic option for patients with mild to moderate acne vulgaris who are reluctant to use drugs.