Effect of Gokshura (Tribulus terrestris L.) on gynecomastia and levels of sex hormone in chronic liver disease: A case report

Abstract

Gynecomastia, a benign hypertrophy of male breast tissue is an issue with considerable discomfort ranging from social embarrassment to the possibility of malignant transformation. The basic pathophysiology being the decreased testosterone activity following an imbalance in estrogen androgen ratio. Among the various causes for such manifestations, the commonest are Chronic Liver Diseases (CLDs) and at times may be drug-induced. Ayurveda considers such manifestations under the dysfunctions of Shukra dhatu (~altered hormonal balance). Gynaecomastia with loss of libido can be reported by patients with a history of CLDs owing to altered testosterone levels. Here, a case of gynecomastia with underlying CLD and extra hepatic portal vein obstruction is presented, who was managed with 1000 mg aqueous extract of Gokshura (Tribulus terrestris L.) for three months. Good response in serum testosterone level and in reversing gynecomastia was observed showing beneficial effect of the herb in managing the condition.