Tribulus

Tribulus terrestris · Puncture vine · Gokshura

Snapshot

Indications	Contraindications
Erectile dysfunction¹ Female sexual desire² Postmenopausal sexual function³ Sperm parameters⁴	Pregnancy or breastfeeding⁵ Clopidogrel co-use⁶ Under age 18⁷

Tribulus (Tribulus terrestris) is used in Ayurveda and traditional Chinese medicine and is marketed for sexual function and body building on the belief that it acts like testosterone⁶. Reviews instead point to nitric oxide-dependent pathways, not androgen enhancement, behind its pro-erectile effects⁸. Users include men with erectile dysfunction, women with low sexual desire, men with idiopathic infertility, and recreational athletes.

A 2026 meta-analysis of randomized trials found erectile function scores higher than with placebo and no difference in total testosterone, yet a systematic review judged the evidence for erectile dysfunction low. Systematic reviews find no robust evidence that it raises testosterone in men. In women, a meta-analysis found better sexual function than placebo, though a systematic review rated certainty very low. In a 2025 laboratory study, extracts from Iranian plant populations inhibited growth of human prostate cancer cells; no human trial has tested this. Products listing tribulus are sold most often as capsules; see Form comparison.

Case reports describe kidney injury, and LiverTox rates tribulus an unproven but possible rare cause of liver injury at high doses or with pre-existing liver disease⁹. Memorial Sloan Kettering advises against clopidogrel co-use after reported stent thrombosis with an herbal formula, while diuretic, antihypertensive, and antidiabetic combinations carry unknown clinical relevance⁶.

Last updated October 16, 2026. Read how we make monographs.

In the full monograph

53 sources, 39 studies

When to useThe situations practitioners use it for, each with the reason and the study behind it.
SafetyWho should avoid it, who needs extra care, and the side effects reported in studies.
InteractionsThe medicines and supplements it interacts with, the effect of each, and what labeling says to watch.
Protocol notesThe doses used in studies, how and when they were taken, and how the forms on the market compare.
How it worksWhat it is and how it works in the body, in plain terms.
Published studiesThe studies behind each use, popular claims checked against them, and trials still under way.
Word of mouthWhat patients and practitioners report online, kept separate from the clinical evidence.
Clinical perspectiveA closing read of where the evidence is solid, where it is thin, and what has not been studied.

Snapshot

In the full monograph

Sources