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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
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E.H.
Masters and V.E. Johnson (1969). Undue distinction of sex. New England
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A.W.
Nasution (1989). Libido disorder and impotence in males diagnosed with
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