Tribulus for Women: Are There Any Specifics

Tribulus is usually sold as a «male» testosterone supplement, but more and more women are seeing it in complexes for energy, libido, or training. The editorial team examined which studies were conducted specifically on women, what they showed, where the data end and marketing begins, and who is better off avoiding tribulus.

Why the question of women stands apart

Most sports studies of tribulus were conducted on men, and their main question was testosterone. For women the logic is different: a higher level of androgens is not a desirable goal, and an excess can cause acne, increased hair growth, and cycle disturbances. So «male» conclusions cannot be transferred directly to women in either direction.

At the same time, women have their own evidence niche for tribulus - sexual function. Several randomized studies have evaluated it for reduced sex drive, in particular in women of reproductive age and during menopause. It is precisely here that the most «female» data have accumulated, and it is these that are worth considering when it comes to this supplement.

A third aspect is the hormonal sensitivity of the female body. The menstrual cycle, the use of hormonal contraception, pregnancy, breastfeeding, polycystic ovary syndrome - all of this changes the context in which a person takes any plant supplement with potential hormonal activity. In men these factors are simply absent.

Finally, marketing. Women's products with tribulus are often positioned as remedies for «tone», «fat burning», or «hormonal balance». None of these formulations has any direct clinical studies behind it, and the editorial team considers them separately from what has actually been tested.

Studies on female libido

One of the best-known studies is the work of Akhtari and colleagues (2014), published in the journal DARU. It was a randomized, double-blind, placebo-controlled trial involving women with hypoactive sexual desire disorder. After several weeks of taking tribulus leaf extract, participants in the main group reported greater improvement on the Female Sexual Function Index (FSFI) than in the placebo group.

Another randomized study - Vale and colleagues (2018) - studied premenopausal women with hypoactive sexual desire disorder. The authors also noted an improvement in measures of sexual function and an increase in the level of free and bioavailable testosterone compared with placebo. This hormonal signal is interesting but was obtained in a small sample and requires confirmation.

There are also studies in postmenopausal women, in particular by Brazilian authors, who reported improvement in certain domains of sexual function. Overall the picture is as follows: several small RCTs show a moderate positive effect on subjective measures of libido, but the studies are short, differ in the extracts (leaf, fruit, aerial part), and in the populations.

An important caveat is that the placebo effect in studies of sexual function is traditionally high, and self-assessment scales are sensitive to expectations. So these data do not mean that tribulus «cures» reduced libido. Rather, it may be one of the options discussed with a gynecologist after medical causes have been ruled out: anemia, thyroid disorders, drug side effects, depression.

Hormones, training, and body composition

Will tribulus help a woman who trains to gain muscle faster or burn fat? There are practically no direct studies specifically on trained women. And in men, for whom «testosterone boosters» were created, randomized works (Antonio et al., 2000; Rogerson et al., 2007) showed no advantage over placebo in strength and body composition.

It is logical to expect that in women the picture will not be better. Even if individual studies record changes in free testosterone, these changes are small and do not approach the levels that could substantially affect muscle mass. For a woman this is rather a good thing: a noticeable increase in androgens would be a warning signal, not a goal.

As for «fat burning», tribulus has no mechanism that would directly increase energy expenditure or fat oxidation in humans, and there are no clinical data confirming such an effect. If a tribulus product «for weight loss» really produces a noticeable effect, it is worth carefully checking the composition for the presence of stimulants.

Women who want to improve their body composition will gain far more from well-studied approaches: adequate protein intake, strength training with progressive overload, a moderate calorie deficit, and quality sleep. Among supplements with a proven effect for training is creatine monohydrate, which is effective in women too.

Safety, pregnancy, and contraindications

In short-term studies on adult women, tribulus was generally well tolerated; gastrointestinal discomfort was most often described. However, there are no long-term safety data, and the medical literature describes isolated cases of serious adverse reactions, in particular kidney injury (Talasaz et al., 2010), although in such cases large amounts or nonstandard forms were often involved.

Pregnancy and breastfeeding are clear contraindications. In animal studies, tribulus was associated with a possible effect on fetal development, and there are no data in pregnant women. In such a situation the precautionary principle is unambiguous: tribulus and similar plant remedies with potential hormonal activity are not taken during this period.

Caution is also required for women with hormone-dependent conditions: polycystic ovary syndrome (where there is already an excess of androgens), a history of hormone-dependent tumors, endometriosis. Interactions are possible with drugs for lowering blood sugar and blood pressure, since in experimental work tribulus was credited with hypoglycemic and hypotensive effects.

A separate risk is quality. Supplements that promise «hormonal balance» or «female energy» sometimes turn out to be contaminated or to contain undeclared substances. For female athletes who undergo doping control, this threatens disqualification.

• Do not take:during pregnancy, when planning a pregnancy, during breastfeeding.
• Discuss with a doctor:PCOS, hormone-dependent diseases, kidney and liver diseases.
• Possible interactions:glucose-lowering and antihypertensive drugs, diuretics.
• Signals to stop:acne, cycle changes, male-pattern hair growth, lower back pain, swelling.

How to approach choosing and taking it

If, after consulting a doctor, a woman decides to try tribulus to support libido, it is worth focusing on products with a clearly stated part of the plant and standardization by saponins. Studies used different extracts - from the leaf, the fruit, the aerial part - so «tribulus» on the label does not yet mean that it is the same remedy that was studied.

As for the amount - studies of female sexual function used daily doses of extract on the order of several hundred milligrams, divided into several intakes, over 1-3 months. It is not worth exceeding the dose recommended by the manufacturer, and it is better to limit the duration of intake to a period over which the effect can be assessed.

The result is worth assessing honestly: if after a few weeks there are no noticeable changes, there is no point in continuing. It is useful to keep brief notes about how you feel, your cycle, and the condition of your skin - this will help notice unwanted effects in time and discuss them with a doctor.

And finally, reduced libido is a symptom, not a diagnosis. Its causes can be chronic fatigue, iron deficiency, thyroid dysfunction, stress, the side effects of antidepressants or contraceptives. A supplement should not delay the search for and elimination of the real cause.

Editorial conclusions

For women, tribulus is neither a «female anabolic» nor a weight-loss remedy: there is no corresponding evidence. Its only relatively studied niche is supporting sexual function with reduced desire, where several small RCTs have shown a moderate effect.

The safety of tribulus in the short term is assessed as acceptable for adult non-pregnant women, but during pregnancy and breastfeeding, as well as with hormone-dependent conditions, it is worth avoiding.

Any changes in libido, cycle, or how you feel are a reason to see a doctor, rather than choosing a supplement at random.

We also recommend reading our articles «Tribulus and sleep», «The history of Tribulus: how the supplement became popular», and «Tribulus after age 40».

References

1. Akhtari E, Raisi F, Keshavarz M, et al. Tribulus terrestris for treatment of sexual dysfunction in women: randomized double-blind placebo-controlled study. Daru. 2014;22:40.
2. Vale FBC, Zanolla Dias de Souza K, et al. Efficacy of Tribulus terrestris for the treatment of premenopausal women with hypoactive sexual desire disorder: a randomized double-blinded, placebo-controlled trial. Gynecol Endocrinol. 2018;34(5):442–445.
3. Qureshi A, Naughton DP, Petroczi A. A systematic review on the herbal extract Tribulus terrestris and the roots of its putative aphrodisiac and performance enhancing effect. J Diet Suppl. 2014;11(1):64–79.
4. Antonio J, Uelmen J, Rodriguez R, Earnest C. The effects of Tribulus terrestris on body composition and exercise performance in resistance-trained males. Int J Sport Nutr Exerc Metab. 2000;10(2):208–215.
5. Talasaz AH, Abbasi MR, Abkhiz S, et al. Tribulus terrestris-induced severe nephrotoxicity in a young healthy male. Nephrol Dial Transplant. 2010;25(11):3792–3793.
6. Chhatre S, Nesari T, Somani G, Kanchan D, Sathaye S. Phytopharmacological overview of Tribulus terrestris. Pharmacogn Rev. 2014;8(15):45–51.