Tribulus Terrestris
Specifically for Erectile Dysfunction
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Why it works for Erectile Dysfunction:
Possible nitric-oxide (NO) pathway effects. Laboratory work suggests TT (especially its saponin protodioscin) can relax corpus cavernosum tissue via the NO/NO-synthase pathway—i.e., a blood-flow mechanism independent of testosterone. Memorial Sloan Kettering Cancer Center
“Aphrodisiac”/neuroendocrine hypothesis. Some reviews describe protodioscin converting to DHEA or otherwise modulating sex hormones, though human testosterone changes are inconsistent. Mainstream urology sources describe this as theoretical and not firmly proven. Memorial Sloan Kettering Cancer Center
How to use for Erectile Dysfunction:
- Standardized extract (Tribestan®) regimen used in an RCT: 500 mg three times daily for 12 weeks (adult men with mild–moderate ED). This is the best-described single-herb protocol that showed improvement in sexual function scores versus placebo in that study. Clinician
- Another RCT dose that showed no benefit: 800 mg/day (divided bid) for 30 days of TT (non-brand, Brazil) did not outperform placebo on IIEF-5. www.elsevier.com
- Combination products (confounded): Some trials combine TT with agents like Panax ginseng and L-arginine (both have independent pro-erectile data). These combos improved erectile function, but you can’t attribute the effect to TT alone. Examine
General practicalities if you and your clinician decide to try TT
- Prefer standardized, single-herb products with declared saponin/protodioscin content and batch testing; avoid “male performance blends” with undisclosed formulas. (See safety notes re: adulteration below.) Therapeutic Goods Administration (TGA)
- Consider a time-limited trial of 8–12 weeks, monitoring erectile function (e.g., IIEF-5), blood pressure, and any adverse effects; stop if no benefit. (12-week horizon mirrors the positive Tribestan trial.) Clinician
- If you’re in Australia, ensure any product is listed on the ARTG (AUST L/AUST R); check the public database before buying. Therapeutic Goods Administration (TGA)
Scientific Evidence for Erectile Dysfunction:
Positive RCT: In 180 men with mild–moderate ED, Tribestan® for 12 weeks significantly improved the International Index of Erectile Function (IIEF) domains vs placebo; no serious drug-related AEs reported. (Note: industry involvement; results should be interpreted with that in mind.) Caldic Magistral
Negative RCT: In 30 men, 800 mg/day for 30 days did not outperform placebo for IIEF-5 or testosterone. www.elsevier.com
Latest meta-analysis (2025, Int. J. Impotence Research): Pooled randomized trials (n=8 studies) reported TT improved IIEF-5 and IIEF-15 vs placebo, with no difference in total testosterone and no increase in adverse events compared with placebo. Heterogeneity and trial quality vary, so conclusions are cautious. Nature
Broader review of herbal ED supplements (Drugs, 2018): Found better evidence for Panax ginseng and pycnogenol + L-arginine than for TT; overall evidence base for most herbs is limited. SIF 2022
Specific Warnings for Erectile Dysfunction:
Liver & kidney toxicity (rare case reports). Acute hepatitis, renal injury, and even liver failure have been reported after TT use. Anyone with liver or kidney disease should avoid TT unless a specialist approves; stop immediately and seek care if you develop jaundice, dark urine, severe fatigue, abdominal pain, or itching. ResearchGate
Adulteration risk in “herbal ED” products. Some “natural” ED supplements (not necessarily TT-only) have contained undeclared sildenafil/tadalafil. Buy only ARTG-listed Australian products and avoid unknown overseas sites. The Guardian
Drug interactions & precautions.
- Lithium: TT may act like a mild diuretic and increase lithium levels—risk of toxicity. Avoid combination without prescriber oversight. WebMD
- Surgery / BP / glucose: TT may affect blood sugar and blood pressure; stop ≥2 weeks before surgery and use caution if you have diabetes or BP issues. WebMD
- General herb–drug interactions: See NCCIH overview; supplements can interact like any active drug. NCCIH
Pregnancy/breastfeeding: Avoid—insufficient safety data. (General consensus across consumer-health monographs.) WebMD
Duration: Consumer monographs consider ≤90 days of use “possibly safe” in healthy adults; long-term safety is unknown. WebMD
General Information (All Ailments)
What It Is
Tribulus terrestris is a small flowering plant used in traditional Ayurvedic and Chinese medicine. Supplements are typically made from its fruit or aerial parts and come in capsules, extracts or powders. In modern alternative health, it is marketed for physical performance, libido enhancement, testosterone modulation, and cardiovascular/metabolic benefits.
How It Works (Proposed Mechanisms)
The exact mechanisms in humans are not fully confirmed, but several plausible pathways are cited:
- Sex hormone support (indirect): Tribulus does not reliably raise testosterone in healthy adult men in high-quality trials, but it may increase androgen receptor density or affect the hypothalamus–pituitary–gonadal axis in ways that modulate libido and sexual function.
- Steroidal saponins (e.g. protodioscin): These phytochemicals may influence nitric oxide availability and smooth-muscle relaxation in vasculature, which can help erectile function and blood flow — independently of testosterone.
- Stress and mood modulation: There is preliminary evidence for adaptogenic-like effects, potentially by influencing monoamine neurotransmitters involved in sexual motivation, stress response and energy regulation.
- Cardiometabolic effects: Some small trials suggest improved lipid profile, lower fasting glucose, or lower blood pressure in certain populations, possibly through antioxidant, endothelial, and insulin-signaling effects.
Mechanisms are partly hypothesized from animals/in vitro; translation to humans is incomplete.
Why It’s Considerimportant in Some Contexts
People consider Tribulus because it occupies a “middle lane” between lifestyle alone and pharmaceuticals for issues such as:
- Low libido or sexual dissatisfaction when there is no clear endocrine pathology, or when someone prefers to try non-drug options first.
- Erectile function support via vascular and nitric-oxide pathways without PDE5 inhibitors.
- Performance and motivation among athletes who seek legal botanical adjuncts (even though strength/testosterone data are inconsistent).
- Metabolic and cardiovascular adjunct for people exploring plant-based co-interventions beyond diet and exercise.
It is “important” not because it is strong, but because it is a low-barrier, lower-risk experiment in scenarios where pharmaceuticals are not yet warranted or desired — provided expectations are realistic.
Considerations (Benefits, Caveats, Safety, When to Avoid)
- Evidence quality: Effects on libido are the most consistently positive domain, especially in women with low desire and in men with mild ED not caused by structural disease. Testosterone increases are not reliable in healthy men.
- Individual variability: Response is heterogeneous — some notice libido changes within 2–4 weeks; others feel nothing.
- Dosing & product variability: Extract standardization (e.g., % protodioscin) matters. Non-standardized products produce inconsistent outcomes.
- Safety & interactions: Generally well-tolerated; possible GI upset. There are case reports of nephrotoxicity and liver enzyme elevations (rare). Avoid or use under supervision in pregnancy, lactation, hormone-sensitive cancers, kidney disease, or with antihypertensives, antidiabetics, or PDE5 inhibitors due to potential additive effects.
- Not a substitute for diagnosis: Using Tribulus to “cover” for uninvestigated ED, infertility, low libido, low mood or fatigue risks missing underlying endocrine, vascular, sleep, psychological, or medication-induced causes.
Helps with these conditions
Tribulus Terrestris is most effective for general wellness support with emerging research . The effectiveness varies by condition based on clinical evidence and user experiences.
Detailed Information by Condition
Erectile Dysfunction
Possible nitric-oxide (NO) pathway effects. Laboratory work suggests TT (especially its saponin protodioscin) can relax corpus cavernosum tissue via t...
Kidney Stones
Antiurolithic actions seen in animals/in-vitro. An aqueous extract reduced calcium-oxalate stone burden, improved renal histology, and showed antioxid...
Fertility Support (Female)
Proposed mechanisms. Tribulus fruits/leaves contain steroidal saponins (notably protodioscin) that may influence pituitary–ovarian signaling. In precl...
Low Testosterone
Proposed mechanisms. Tribulus contains steroidal saponins (especially protodioscin) that have been hypothesized to influence androgen pathways and nit...
Low Sperm Count
Possible mechanisms (theoretical/indirect):Improved sperm motility and acrosome reaction have been reported in small human studies and in vitro work;...
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Helps With These Conditions
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