At the end of the 20th century, herbal medicines became more popular. Especially since scientific and pharmacological research has been able to identify active components, they have introduced standardization in this area. This has contributed to the understanding of the role of natural bioactive phytochemicals in traditional herbal medicines and the benefit of human health.
A large number of plants and their extracts are used in traditional medicine in different countries. Today, about 80% of the world's population prefers to use herbal treatments to maintain health in the event of a variety of illnesses. Even the World Health Organization recommends the use of herbal medicines in national health programs as they are easily accessible and safe (Chaudhury, 1999).
Biologically active substances of herbs positively affect the health status, general condition and sexual health.
Tribulus Terrestris is a herbal medicine that has been scientifically tested, purified, standardized and clinically tested for its benefit and for the treatment of impotence due to decreased sperm production (Protich et al., 1984). Tribulus Terrestris is a plant that originated in Bulgaria (the Balkan Peninsula in Eastern Europe) and parts of Asia. In Bulgaria, the plant has a long history of being a powerful aphrodisiac and a traditional medicine for the treatment of male infertility Tribulus Terrestris (Zygophyllaceae family) contains many biologically active compounds such as: furostanol saponins (protodioscin and protogratsilin), flavonoids, alkaloids, vitamins, polyunsaturated fatty acids, tannins (Kostova et al., 2002).
Tribulus has long been used as a herbal remedy in Eastern and Asian countries to treat sexual disorders such as impotence or for the treatment of infertility.
The Tribulus Terrestris plant is used to treat infertility as it has been shown to increase sperm concentration by increasing the number of newly formed sperm, as well as treating libido disorders and impotence.
The mechanism of DHEA
It is well known that sufficient dehydroepiandrosterone is necessary for the sperm maturation process. Dehydroepiandrosterone (DHEA) is a hormone synthesized by the adrenal glands, which is the precursor of many hormones in the body, including testosterone and estrogen. Depending on the needs of the body, DHEA can be transformed into testosterone (the main male sex hormone), estrogen (an important female sex hormone) or steroids. In addition, DHEA is responsible for the production of hormones that regulate the metabolism of fats and minerals.
It is believed that some idiopathic oligospermics (decreased sperm count or concentration ejaculated) are due to the low concentration of DHEA in the epididymis (vital organ in the male reproductive system). The distemper is the most susceptible to infection in the scrotum - the infection is called epididymitis.
Consequently, infections lead to the development of scarring that can block the movement of the sperm by holding them in the testis (or in the part of the epididymis before the blockage). Spermatozoids continue to be produced but cannot pass through it. If this happens on both sides, these men will have no sperm to ejaculate.
The study concludes that protocioscin in Tribulus Terrestris L may be a precursor to DHEA in patients with a low serum level of this hormone. On the other hand, DHEA can enhance the cell membrane's integrity and function, resulting in better sexual performance and overall sense of well-being.
The mechanism of DHEA to improve the sexual function of erectile dysfunction (ED) patients is believed to include improvement in cell integrity and cellular function, improvement in blood circulation, health, well-being, and indirect improvement of the sexual drive.
Treatment with Tribulus extract
Clinical trials of Tribulus extracts on individuals who suffer from decreased libido and impotence due to primary and secondary hypogonadism (hypogonadism is a condition in which a person does not produce enough testosterone and this leads to a reduction in male growth and development, as well as hindering their sexual life) lead to increased libido and improvement in quality and duration of erection.
Detailed sperm analysis of the treated group indicate that there are significant improvements in sperm morphology, especially in the acrosome reaction (the sperm acrosyme is a specialized secretory vacuole located in the front of the sperm head. It contains hydrolytic enzymes that allow the sperm to passes through the outer shell of the egg), but there are no significant differences in sperm concentration or motility. Improved interaction between sperm and cervical mucus suggests that increased acrosomal response leads to improved sperm functions leading to successful conception.
Tribulus Terrestris helps in triggering the body to produce more testosterone. This happens by stimulating the luteinizing hormone, which is responsible for producing testosterone. The active substance in Tribulus Terrestris, called steroid saponins, are responsible for the change in testosterone levels which also influence libido.
By triggering the luteinizing hormone, the testosterone level increases the energy level of a person, muscles and sexual effects, making them stronger and also prolongs stamina during physical activity.
Treatment with Bulgarian Tribulus Terrestris extract is effective in treating libido disorders and impotence: most patients diagnosed with decreased libido have a significant improvement in sexual drive, and more patients diagnosed with erectile dysfunction or impotence have an improvement in quality and duration of erection.
Some animal studies
Animal studies have shown that the use of Bulgarian Tribulus Terrestris extract induces an increase in libido, measured by increasing the number of sexual intercourse or intercourse attempts.
The Tribulus Terrestris extract has a wide range of activities: hypoglycemic, anti-inflammatory, anti-microbial and anticancer (Gandhi et al., 2013; Hammoda et al., 2013; Sisto et al., 2012).
Based on experiments with laboratory animals, Tomova et. Al. (1981) concludes that the effect of Bulgarian Tribulus Terrestris on the male reproductive system is achieved by activating the luteinizing hormone (LH) that stimulates the secretion of male hormone, testosterone.
Studies in rats demonstrated that sustained Tribulus Terrestris intake improves erection due to increased blood pressure in the genital area; In healthy rats, the effect was negligible, but in castrated rats and those with sequelae problems, a significant increase of 25 to 55% was noted.
As mentioned earlier, Tribulus Terrestris herb has long history of use in Bulgaria and has proven its beneficial effect over the reproductive system since ancient times. No wonder why this plant attracts the attention of the scientific society. Many biochemical experts are showing great interest in conducting experiments with various animals by supplementing animals’ diet with extract from the plant Bulgarian Tribulus Terrestris, produced by VEMO 99 Ltd, and measuring the reproductive performance indices. It is amazing that all the animals supplemented with Bulgarian Tribulus Terrestris extract showed better sexual function and fertility. The tested species are of different kind: poultry, pigs, rabbits, rams, bulls, guinea flows, bees, etc. Application of Bulgarian Tribulus extract, produced by VEMO 99 Ltd improved sperm motility and live sperm counts.
The addition of an extract of VEMO 99’s Bulgarian Tribulus Extract to the compound feed for broiler parents under the conditions of the experiment held in Bulgaria by Prof. Dn. S. Shardjiyska, Dr. B. Kashamov, increased fertility of breeding eggs, reduced unfertilized eggs, increased hatchability and testosterone content in cocktail's blood serum.
The positive effect of Bulgarian Tribulus Terrestris extract, produced by VEMO 99 Ltd, on the libido of cocks in the experiment of Dr. V. Serdakova, Dr. B. Kashamov, was noticed. The volume of ejaculate obtained was higher than the control group. The addition of the extract showed a positive effect on sperm motility.
Another experiment (V. Mateva, L. Angelova, I. Makedonski), testing the addition of dry extract of Bulgarian Tribulus terrestris herb (proprietary VEMO 99’s production) showed a positive impact on the quantitative and qualitative semen indicators in boars.
Bulgarian Tribulus Terrestris (proprietary VEMO 99’s extract, containing polyphenols, flavonoids, coumarins, tannic compounds) is also tested in rams. The authors found a very positive effect on spermatogenesis in rams during the breeding season. The number of sperm cells, the duration of their vitality and mobility have improved. The number of newborn lambs after use of the product has increased. Male breeds showed good libido and improved sexual activity.
The study from D. Abadjieva showed that supplementation of diet with Bulgarian Tribulus Terrestris, manufactured by VEMO 99 Ltd, affects the folliculogenesis (maturation of the ovarian follicle) in two generation of female rabbits. The detection of growth factors at all stages of folliculogenesis in rabbit ova demonstrates the great importance of these growth factors for the fertility of rabbits.
The results show strong evidence that the addition of the biological active substances from Bulgarian Tribulus Terrestris extract in rabbit feed during the sexual maturation or around the mating can affect the reproductive performances not only in I-st generation but in II-nd generation, too.
The obtained results from the study named “Blood biochemical changes and sperm quality in bulls fed with diet supplemented with dry extract from Bulgarian Tribulus Terrestris” by Mariana Petkova, Svetlana Grigorova, Desislava Abadjieva are indicative for the biological effects of dry extract of Bulgarian Tribulus Terrestris.
The main effect is on the testosterone in the blood, which was increased by 45% (P <0.01) under the influence of the tested product.
The blood lipid profile was positive reversed:
- LDL cholesterol was decreased by 27% (P < 0.05)
- Triglycerides were decreased by 23% (P <0.05)
- HDL cholesterol was increased by 8% (P> 0.05)
- Total lipids were decreased by 6.9%
It was found the significant decrease (P < 0.001) of blood glucose.
The Bulgarian Tribulus Terrestris plant containing furostanol saponins shows that it increases libido and erection, spermatogenesis, sperm motility, ejaculation volume, muscle mass and testosterone in animal and human models. It is found that the effect is more pronounced in the reduced functioning of the testicles. Additional studies on cellular changes shed light on the mechanisms leading to increases in androgen levels after administration of Bulgarian Tribulus Terrestris.
In conclusion, studies have shown that the addition of Bulgarian Tribulus Terrestris leads to the following effects: elevated luteinizing hormone levels and stimulated testosterone production; a positive impact on the sexual function of men and women; positive impact on libido (natural aphrodisiac); improved sexual activity and erectile function; increased volume of the ejaculate; improving sperm motility; increased sperm count; reduced percentage of pathological forms of sperm; as a whole, improved semen analysis and has a stimulating effect on spermatogenesis.
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16. “Blood biochemical changes and sperm quality in bulls fed diet supplemented with dry extract from Tribulus terrestris”, “VEMO-99” Ltd., Sofia, Mariana Petkova, Svetlana Grigorova, Desislava Abadjieva
17. Effect of plant Tribulus Terrestris extract of reproductive performance of rams, “VEMO-99” Ltd., Sofia, Elena Kristanova, Hristo Zlatev, V Karcheva, A. Kolev
18. Dose-dependent effect of Tribulus terrestris on reproductive organs of growing male rabbits, D. Abadjieva, S. Grigorova2, E. Kistanova1, “VEMO-99” Ltd., Sofia
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20. Tribulus terrestris Alters the Expression of Growth Differentiation Factor 9 and Bone Morphogenetic Protein 15 in Rabbit Ovaries of Mothers and F1 Female Offspring“VEMO-99” Ltd., Sofia, Desislava Abadjieva and Elena Kistanova