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Effect of
Tribulus terrestris treatment on impotence and libido disorders
A.W. Nasution
Andalas University,
School of Medicine, Padang, Indonesia (1993)
SUMMARY
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.
INTRODUCTION
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.
DEFINITIONS
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.
TREATMENT
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.
METHODS
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.
RESULTS
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 for
evaluation.
DISCUSSION
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.
SUMMARY
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.
REFERENCES
A. Adimoelja (1986). Male
impotence in young and old men. Impotence Seminar in Denpasar, Indonesia.
A.J. Cooper (1972). The
causes and management of impotence. Postgraduate Medical Journal 48(563)
548-54.
E.H. Masters and V.E.
Johnson (1969). Undue distinction of sex. New England Journal of Medicine
281(25) 1422-3.
A.W. Nasution (1989).
Libido disorder and impotence in males diagnosed with diabetes mellitus.
NKKBS Seminar in Palembang, Indonesia.
W. Pangkahila (1984).
Methods to distinguish psychological and non-psychological factors in
impotence. PANDI Scientific Symposium in Bandung, Indonesia.
W. Pangkahila (1986).
Pathophysiology of impotence. Impotence Seminar in Denpasar, Indonesia.
H. Basjuriddin and A.W.
Nasution (1993). The disturbance of sexual drive of post-stroke male
subjects. The 4th Biennial Asian Pacific Meeting on Impotence in Denpasar,
Indonesia.
G. Paat (1985).
Impotence's effect on family life. Male Reproductive Process and Fertility.
FKUI Jakarta.
I.G. Mansur (1985).
Erection problem and male impotence. Male Reproductive Process and
Fertility. FKUI Jakarta.
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