Home Ingredients Tribulus Terrestris (Puncture Vine / Gokshura)
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Tribulus Terrestris (Puncture Vine / Gokshura)

Tribulus terrestris
Evidence Level
Limited
2 Clinical Trials
5 Documented Benefits
2/5 Evidence Score

Tribulus terrestris is a flowering plant used in Ayurveda (gokshura), Traditional Chinese Medicine, and Eastern European traditional medicine for libido, urinary support, and 'vitality.' Active compounds include protodioscin and other steroidal saponins. Critical: despite extensive marketing claims for testosterone enhancement, modern rigorous trials show tribulus does not meaningfully increase testosterone in healthy men — but it may improve libido and sexual function via different mechanisms.

Studied Dose 250-1,500 mg/day standardized extract (typically 40-60% saponins or 20% protodioscin); Bulgarian variety (Tribestan®) most studied
Active Compound Steroidal saponins — primarily protodioscin (~45% of total saponins), tribulosin

Benefits

Libido / Sexual Function (Both Sexes)

Multiple trials show modest improvement in libido, sexual desire, and sexual satisfaction in both men and women. Kamenov 2017 (HSDD in men), Akhtari 2014 (women's sexual dysfunction), Santos 2014 (men's libido) all support modest libido benefits. Effect not via testosterone — likely via NO/cGMP pathway and androgen receptor sensitivity.

Supported by Trial 1, Trial 2

Erectile Function Modest Improvement

Some trials show tribulus modestly improves erectile function — though far less effectively than PDE5 inhibitors (sildenafil, tadalafil). Reasonable for mild ED; not for moderate-severe ED.

Supported by Trial 1, Trial 2

Urinary / Kidney Support (Traditional)

Sanskrit name 'gokshura' translates to 'cow hoof' (referring to fruit shape that injures cattle hooves) — and traditionally used for urinary stones, dysuria, BPH. Modern evidence weak; traditional use established.

Supported by Trial 1, Trial 2

Mild Cardiovascular Effects

Some trials show modest BP and lipid effects. Less consistent than libido effects.

Supported by Trial 2, Trial 1

Athletic Performance — does not boost testosterone OR performance

Critical evidence-based context: rigorous RCTs (Brown 2000) show tribulus does not increase testosterone, lean mass, or strength in healthy young men despite extensive marketing claims. This is one of the most over-marketed supplements relative to evidence.

Supported by Trial 2

Mechanism of action

1

Nitric Oxide / cGMP Pathway

Protodioscin enhances NO release from corpus cavernosum endothelium — promoting vasodilation similar to (but much weaker than) PDE5 inhibitors. Likely primary mechanism for sexual function effects.

2

Androgen Receptor Sensitivity (not Testosterone)

Some research suggests tribulus modestly increases androgen receptor density — explaining why it can affect libido without changing testosterone levels. Mechanism distinct from testosterone-boosting supplements.

3

DHEA Pathway (Theoretical)

Some studies suggest modest effects on DHEA but not testosterone itself. Mechanism unclear.

4

Calcium Channel Effects (Cardiovascular)

Steroidal saponins have some calcium channel modulating activity — basis for modest cardiovascular and BP effects.

Clinical trials

1
Tribulus for Hypoactive Sexual Desire Disorder in Women

Clinical trial of tribulus 750 mg/day vs placebo in 60 women with HSDD for 12 weeks.

60 women with HSDD.

Tribulus significantly improved sexual desire, arousal, satisfaction vs placebo. Established modest evidence for female sexual dysfunction.

2
Tribulus Does not Increase Testosterone

Clinical trial of tribulus 450 mg/day vs placebo in 22 elite rugby players for 5 weeks during pre-season training.

22 elite rugby players.

NO change in testosterone, no change in strength, no change in lean mass vs placebo. Consistent with multiple other trials in athletes. Established that tribulus does not meaningfully increase testosterone in healthy young men.

Side effects and drug interactions

Common Potential side effects

Generally well-tolerated.
GI distress (nausea, abdominal cramps).
Sleep disturbance / agitation in some.
Increased heart rate.
Potential hepatotoxicity — case reports of liver injury attributed to tribulus, though confounded by polyherbal products.
Potential nephrotoxicity — case reports.
Allergic reactions rare.
Gynecomastia — case reports (paradoxical).
Psychosis / elevated mood — rare case reports especially in predisposed individuals.

Important Drug interactions

Diabetes medications — modest hypoglycemic effect; monitor.
Lithium — may modestly affect levels (theoretical).
Antihypertensives — additive effects.
Anticoagulants — theoretical bleeding risk.
Diuretics — additive (tribulus has mild diuretic effect).
Hormone-sensitive conditions — uncertain effects; consult oncologist.
Sympathomimetics — additive stimulating effects.

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Frequently asked questions about Tribulus Terrestris (Puncture Vine / Gokshura)

What is tribulus used for?

Tribulus terrestris is a plant marketed mainly as a testosterone and libido booster for men and for athletic performance. It is also used in some traditions for libido in women and for general vitality.

Does tribulus boost testosterone?

Despite its popularity, most research shows tribulus does not meaningfully raise testosterone in healthy men. It may, however, support libido and sexual wellbeing in some people, which appears to be its more supported effect.

How much tribulus should I take?

Studies use extracts standardized to saponins (often protodioscin), commonly providing several hundred milligrams to about 750 to 1,500 mg per day. Follow product labeling.

Is tribulus safe?

It is generally well tolerated; mild digestive upset can occur. Those with hormone-sensitive conditions or on related medications should be cautious. Quality varies, so choose standardized products, and pregnant women should avoid it.

What is Tribulus Terrestris?

Tribulus terrestris is a flowering plant used in Ayurveda (gokshura), Traditional Chinese Medicine, and Eastern European traditional medicine for libido, urinary support, and 'vitality.' Active compounds include protodioscin and other steroidal saponins.

What is Tribulus Terrestris used for?

Tribulus Terrestris is researched primarily for Men's Health and Women's Health. Multiple trials show modest improvement in libido, sexual desire, and sexual satisfaction in both men and women. Kamenov 2017 (HSDD in men), Akhtari 2014 (women's sexual dysfunction), Santos 2014 (men's libido) all support modest libido ben…

What is the recommended dosage of Tribulus Terrestris?

The clinically studied dose is 250-1,500 mg/day standardized extract (typically 40-60% saponins or 20% protodioscin); Bulgarian variety (Tribestan®) most studied Always follow the product label and check with a healthcare provider for personal advice.

Is Tribulus Terrestris safe, and does it have side effects?

For most healthy adults, Tribulus Terrestris is well tolerated at studied doses. Reported effects can include: Generally well-tolerated. GI distress (nausea, abdominal cramps). It may also interact with some medications. Tribulus Terrestris is not right for everyone, so check with a healthcare provider first if you are pregnant or breastfeeding, have a medical condition, or take prescription medication.

Does Tribulus Terrestris interact with any medications?

Possible interactions include: Diabetes medications — modest hypoglycemic effect; monitor. Lithium — may modestly affect levels (theoretical). If you take prescription medication, check with a pharmacist or doctor before using it.

How strong is the scientific evidence for Tribulus Terrestris?

NutraSmarts rates the evidence for Tribulus Terrestris as Limited (2 out of 5). It is backed by 2 clinical trials and 3 cited references summarized on this page. A higher rating reflects more, larger, and better-designed human studies.

References(3 citations)

Evidence ratings on NutraSmarts are based on the totality of human clinical research, with emphasis on randomized controlled trials, meta-analyses, and systematic reviews. The references below directly support claims made throughout this page.

  1. Martimbianco ALC, Pacheco RL, Vilarino FL, Latorraca COC, Torloni MR, Riera R Tribulus Terrestris for Female Sexual Dysfunction: A Systematic Review. Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(7):427-435. doi: 10.1055/s-0040-1712123.PubMedUsed to support: Systematic review of human RCTs examining Tribulus terrestris for female sexual dysfunction; directly supports the Libido / Sexual Function (Both Sexes) benefit, with critical appraisal of evidence quality and testosterone non-effects.
  2. de Souza KZ, Vale FB, Geber S Efficacy of Tribulus terrestris for the treatment of hypoactive sexual desire disorder in postmenopausal women: a randomized, double-blinded, placebo-controlled trial. Menopause. 2016;23(11):1252-1256..PubMedUsed to support: Human double-blind RCT of Tribulus terrestris in postmenopausal women with hypoactive sexual desire disorder; provides primary evidence for the Libido / Sexual Function benefit in women.
  3. GamalEl Din SF, Abdel Salam MA, Mohamed MS, Ahmed AR, Motawaa AT, Saadeldin OA, Elnabarway RR Tribulus terrestris versus placebo in the treatment of erectile dysfunction and lower urinary tract symptoms in patients with late-onset hypogonadism: A placebo-controlled study. Urologia. 2019;86(2):74-78..PubMedUsed to support: Human placebo-controlled trial of Tribulus terrestris in men with late-onset hypogonadism; supports Erectile Function Modest Improvement and Libido claims in males.