(627) Effects of Tribulus Terrestris on Sexual Function and Androgenic Parameters in Climacteric Women with Hypoactive Sexual Desire Disorder

Introduction During the climacteric transition, the decline in estrogen and androgen levels significantly contributes to the reduction of sexual desire. Tribulus terrestris (TT), a natural source of protodioscin, has been investigated as a potential androgenic modulator. Psychosocial strategies, such as brief sexual counseling based on the PLISSIT model, may further enhance clinical outcomes. This study evaluated the effects of TT, administered alone or in combination with PLISSIT-based counseling, on sexual function and serum levels of total, free, and bioavailable testosterone in climacteric women with Hypoactive Sexual Desire Disorder (HSDD). Objective To evaluate the effects of Tribulus terrestris on sexual function (FSFI) and androgenic parameters in climacteric women with HSDD, comparing the isolated pharmacologic intervention and the combined approach with PLISSIT-based brief sexual counseling. Methods This retrospective observational study (2016–2024), interrupted between 2020 and 2022 due to the COVID-19 pandemic, included 192 women aged 45–59 years clinically diagnosed with HSDD. Participants were divided into three groups: (1) TT (equivalent to 112 mg of protodioscin) combined with brief sexual counseling following the PLISSIT model (6 biweekly sessions); (2) TT alone; (3) brief sexual counseling only (PLISSIT model). The Female Sexual Function Index (FSFI) and serum total, free, and bioavailable testosterone levels were assessed before and after 90 days of treatment. Data were analyzed using paired t-tests and one-way ANOVA (p < 0.05), with effect size calculated as Cohen’s d and η2. Results Both TT groups showed significant improvements in overall FSFI scores (Group 1: 14.5 → 24.0; d = 1.59 / Group 2: 13.9 → 22.6; d = 2.29; p < 0.001) and in all domains, particularly Desire (d = 1.54), Lubrication (d = 1.08), and Satisfaction (d= 1.10). TT also produced significant increases in total testosterone (12.2 → 17.8 ng/dL; p < 0.001; d = 1.02), free testosterone (0.24 → 0.36 ng/dL; p < 0.001; d = 0.97), and bioavailable testosterone (1.46 → 1.96 ng/dL; p < 0.001; d = 0.94). The greatest effects were observed in TT-treated groups, while counseling alone produced modest functional improvement without hormonal changes. No relevant adverse events were reported. These findings are summarized in Table 1, which presents the Female Sexual Function Index (FSFI) baseline and post-treatment scores in climacteric women with HSDD (n = 192), and in Table 2, which shows the Serum Testosterone Levels (Mean ± SD) before and after 90 days of treatment in the same population. Conclusions Tribulus terrestris (equivalent to 112 mg of protodioscin) demonstrated consistent efficacy in improving sexual function and increasing total, free, and bioavailable testosterone levels in climacteric women with HSDD. The combination with PLISSIT-based counseling further optimized functional response, reinforcing the complementary role of psychosocial interventions. These results strengthen the evidence supporting TT as a safe and effective therapeutic option for managing HSDD during the climacteric transition. Disclosure No