Antiglycation and antioxidant activities of the crude extract and saponin fraction of Tribulus terrestris before and after microcapsule release / 中西医结合学报

OBJECTIVE@#The present study investigated antiglycation and antioxidant activities of crude dry extract and saponin fraction of Tribulus terrestris. It also developed a method of microencapsulation and evaluated antiglycation and antioxidant activities of crude dry extract and saponin fraction before and after microcapsule release.@*METHODS@#Antiglycation activity was determined by relative electrophoretic mobility (REM), free amino groups and inhibition of advanced glycation end-product (AGE) formation. Antioxidant activity was determined by 2,2-diphenyl-1-picrylhydrazyl (DPPH), ferric ion-reducing antioxidant power (FRAP), nitric oxide (NO) and thiobarbituric acid reactive species (TBARS) tests. Microcapsules were prepared using maltodextrin as wall material and freeze-drying as encapsulation technique. Morphological characterization of microcapsules was evaluated by scanning electron microscopy, and encapsulation efficiency and microcapsule release were determined by total saponins released. Antiglycation and antioxidant assays were performed using crude dry extract and saponin fraction of T. terrestris before and after release.@*RESULTS@#Saponin fraction showed an increase of 32.8% total saponins. High-performance liquid chromatography-mass spectrometry analysis showed the presence of saponins in the obtained fraction. Antiglycation evaluation by REM demonstrated that samples before and after release presented antiglycation activity similar to bovine serum albumin treated with aminoguanidine. Additionally, samples inhibited AGE formation, highlighting treatment with saponin fraction after release (89.89%). Antioxidant tests demonstrated antioxidant activity of the samples. Crude dry extract before encapsulation presented the highest activities in DPPH (92.00%) and TBARS (32.49%) assays. Saponin fraction before encapsulation in FRAP test (499 μmol Trolox equivalent per gram of dry sample) and NO test (15.13 μmol nitrite formed per gram of extract) presented the highest activities.@*CONCLUSION@#This study presented antiglycation activity of crude dry extract and saponin fraction of T. terrestris, besides it demonstrated promising antioxidant properties. It also showed that the encapsulation method was efficient and maintained biological activity of bioactive compounds after microcapsule release. These results provide information for further studies on antidiabetic and antiaging potential, and data for new herbal medicine and food supplement formulations containing microcapsules with crude extract and/or saponin fraction of T. terrestris.

Hepatotoxicity-induced by the therapeutic dose of acetaminophen and the ameliorative effect of oral co-administration of selenium/Tribulus terrestris extract in rats / Hepatotoxicidad inducida por la dosis terapéutica de acetaminofén y el efecto de mejora de la administración conjunta de extracto de selenio Tribulus terrestris en ratas

SUMMARY: Over dose or long-term clinical use of therapeutic doses of acetaminophen (APAP) causes hepatotoxicity. Various strategies attempted to ameliorate APAP-hepatotoxicity have been found to be unsuitable for clinical practice. This study was aimed to illustrate the histopathological changes induced by therapeutic dose of APAP and investigate the hepatoprotective role of oral co-administration of selenium/ Tribulus terrestris (TT) extract concurrently against hepatotoxicity induced by APAP in rats. Fifty-four healthy male albino Wistar rats were randomized into nine groups (G1-G9) of six rats each, and administered with APAP and TT orally for 30 days as follows: Control (2ml normal saline), APAP (470 mg/kg), APAP (470 mg/kg) + selenium (2 mg/kg), APAP (470 mg/kg) + TT (98 mg/kg), APAP (470 mg/kg) + selenium (2mg/kg) + TT (98 mg/kg), APAP (470 mg/kg) + silymarin (200 mg/kg), selenium (2 mg/ kg), TT (98 mg/kg) and silymarin (200 mg/kg) groups. The results demonstrated that exposure of rats to therapeutic dose of APAP for 30 days caused significant histopathological changes parallel to elevated blood chemistry parameters. Co-administration of selenium/TT extract showed significantly reduced histopathological lesions and, restored or decreased levels of the examined blood chemistry parameters. Liver histology in selenium/TT extract showed normal hepatic architecture with mild changes and silymarin treated rats showed no histopathological changes. Histochemically PAS staining, showed that APAP-induced hepatotoxicity was characterized by hepatocytes glycogen depletion. Selenium/TT co-supplementation plays a potential role in preventing APAP-induced glycogen depletion by increasing detoxification and scavenging the reactive metabolites. Selenium/TT extract oral co-administration possesses a significant hepatoprotective property and mitigates APAP-induced hepatotoxicity by enhancing its antioxidant role and improving tissue integrity. Selenium/TT supplementation could represent an effective treatment against APAP-induced hepatotoxicity. Further studies are needed to elucidate the exact mechanism underlying the protective role of TT extract.

RESUMEN: La dosis excesiva o el uso clínico a largo plazo de dosis terapéuticas de acetaminofeno (APAP) causa hepatotoxicidad. Se ha descubierto que varias estrategias que intentaron mejorar la hepatotoxicidad por APAP no son adecuadas para la práctica clínica. Este estudio tuvo como objetivo ilustrar los cambios histopatológicos inducidos por la dosis terapéutica de APAP e investigar el papel hepatoprotector de la administración conjunta de extracto de selenio / Tribulus terrestris (TT) simultá- neamente contra la hepatotoxicidad inducida por APAP en ratas. Cincuenta y cuatro ratas Wistar albino machos sanas se aleatorizaron en nueve grupos (G1 - G9) de seis ratas cada una, y se administraron con APAP y TT por vía oral durante 30 días de la siguiente manera: Control (2 ml de solución salina normal), APAP (470 mg / kg), APAP (470 mg / kg) + selenio (2 mg / kg), APAP (470 mg / kg) + TT (98 mg / kg), APAP (470 mg / kg) + selenio (2 mg / kg) + TT (98 mg / kg), APAP (470 mg / kg) + silimarina (200 mg / kg), selenio (2 mg / kg), TT (98 mg / kg) y silimarina (200 mg / kg). Los resultados demostraron que la exposición de las ratas a la dosis terapéutica de APAP durante 30 días causó cambios histopatológicos significativos paralelos a parámetros elevados de química sanguínea. La administración conjunta de extracto de selenio / TT mostró lesiones histopatológicas significativamente reducidas y niveles restaurados o disminuidos de los parámetros de química sanguínea. La histología hepática en el extracto de selenio / TT mostró una arquitectura hepática normal con cambios leves y las ratas tratadas con silimarina no mostraron cambios histopatológicos. La tinción histoquímica de PAS mostró que la hepatotoxicidad inducida por APAP se caracterizó por la pérdida de glucógeno de los hepatocitos. La suplementación con selenio / TT juega un papel potencial en la prevención de la pérdida de glucógeno inducido por APAP al aumentar la desintoxicación y eliminar los metabolitos reactivos. La administración conjunta de extracto de selenio / TT posee una propiedad hepatoprotectora significativa y mitiga la hepatotoxicidad inducida por APAP al mejorar su papel antioxidante y la integridad del tejido. La suplementación con selenio / TT podría representar un tratamiento efectivo contra la hepatotoxicidad inducida por APAP. Se necesitan más estudios para dilucidar el mecanismo exacto que subyace a la función protectora del extracto TT.

Tribulus terrestris for female sexual dysfunction: a systematic review / Tribulus terrestris para disfunção sexual feminina: uma revisão sistemática

Abstract Objective We performed a systematic review to assess the effectiveness and safety of Tribulus terrestris to treat female sexual dysfunction (FSD). Data sources We performed unrestricted electronic searches in the MEDLINE, CENTRAL, EMBASE, LILACS, CINAHL, PsycINFO,WHO-ICTR, Clinicaltrials.gov and OpenGrey databases. Selection of studies We included any randomized controlled trials (RCTs) that compared T. terrestris versus inactive/active interventions. After the selection process, conducted by two reviewers, 5 RCTs (n = 279 participants) were included. Data collection Data extraction was performed by two reviewers with a preestablished data collection formulary. Data synthesis Due to lack of data and clinical heterogeneity, we could not perform meta-analyses. The risk of bias was assessed by the Cochrane Risk of Bias (RoB) tool, and the certainty of evidence was assessed with Grading of Recommendations, Assessment, Development and Evaluations (GRADE). Results After 1 to 3 months of treatment, premenopausal and postmenopausal women randomized to T. terrestris had a significant increase in sexual function scores. Three months of treatment with T. terrestris showed a significant increase in the serum testosterone levels of premenopausal women. There was no report of serious adverse events, and none of the studies assessed health-related quality of life. The certainty of the evidence was very low, whichmeans that we have very little confidence in the effect estimates, and future studies are likely to change these estimates. Conclusion MoreRCTs are needed to supportor refute the use of T. terrestris. The decision to use this intervention should be shared with the patients, and the uncertainties around its effects should be discussed in the clinical decision-making process. Number of Protocol registration in PROSPERO database: CRD42019121130

Resumo Objetivo Nós realizamos uma revisão sistemática para avaliar a efetividade e a segurança do Tribulus terrestris no tratamento da disfunção sexual feminina (DSF). Fontes de dados Nós realizados uma busca eletrônica irrestrita nas seguintes bases de dados: MEDLINE, CENTRAL, EMBASE, LILACS, CINAHL, PsycINFO, WHO-ICTR, Clinicaltrials.gov, e OpenGrey. Seleção dos estudos Nós incluímos todos os ensaios clínico randomizados (ECR) que comparou T. terrestris com controles ativos/inativos. Após o processo de seleção, conduzido por 2 revisores, 5 ECRs (n = 279 participantes) foram incluídos. Extração de dados O processo de extração de dados foi realizado por dois revisores, utilizando-se um formulário de extração de dados pré-estabelecido. Síntese de dados Devido à falta de dados disponíveis e à heterogeneidade clínica entre os estudos incluídos, nós não realizamos meta-análises. O risco de viés foi avaliado pela tabela de risco de viés da Cochrane e, a certeza do corpo da evidência foi avaliada pelo Grading of Recommendations, Assessment, Development and Evaluations (GRADE). Resultados Após 1 a três 3 meses de tratamento, mulheres na pré e pós-menopausa randomizadas ao T. terrestris tiveram um aumento significante nos escores de função sexual. O grupo com 3 meses de tratamento com T. terrestris exibiu um aumento significante dos níveis séricos de testosterona emmulheres pré-menopausa. Não houve relato de eventos adversos graves, e nenhum estudo avaliou qualidade de vida das participantes. A certeza da evidência foi considerada muito baixa, o que significa que existe pouca certeza na estimativa dos efeitos e que é provável que futuros estudos mudem estas estimativas. Conclusão Mais ECRs são importantes para apoiar ou refutar o uso do T. terrestris. A decisão de usar essa intervenção deve ser compartilhada com pacientes, e as incertezas sobre seus efeitos devem ser discutidas durante o processo de decisão clínica.

Simultaneous use of oxalate-degrading bacteria and herbal extract to reduce the urinary oxalate in a rat model: A new strategy

ABSTRACT Objective: Urinary stones with oxalate composition can cause kidney failure. Recent findings evidenced that probiotics are effective in reducing oxalate absorption in these subjects based on their high colonic absorption levels at baseline. The purpose of this study was to evaluate the effect of the simultaneous use of oxalate-degrading bacteria, Urtica dioica and T. terrestris extract in reducing urinary oxalate. Materials and Methods: Anti-urolithiatic activity of Urtica dioica and T. terrestris extract and probiotic by using ethylene glycol induced rat model. In this study, 4 strains of Lactobacillus and 2 strains of Bifidobacterium and also 2 strains of L. paracasei (that showed high power in oxalate degrading in culture media) were used. Male Wistar rats were divided into four groups (n=6). The rats of group-I received normal diet (positive control group) and groups-II (negative control group), III, IV rats received diet containing ethylene glycol (3%) for 30 days. Groups III rats received Urtica dioica and T. terrestris extract. Groups IV rats received extracts + probiotic for 30 days. Findings: The results show that the use of herbal extracts (Urtica dioica and T. terrestris) reduced the level of urinary oxalate and other parameters of urine and serum. Also, the accumulation of calcium oxalate crystals in the kidney tissue was significantly reduced. Conclusion: Considering that the formation of calcium oxalate crystals can cause inflammation and tissue damage in the kidney, the use of herbal extracts with oxalate degrading bacteria can be a new therapeutic approach to preventing the formation of kidney stones.

Improvement of fertility parameters with tribulus terrestris and anacyclus pyrethrum treatment in male rats

ABSTRACT Objective Anacyclus Pyrethrum (AP) and Tribulus Terrestris (TT) have been reported as male infertility treatment in several studies; however, in Iranian traditional medicine these two plants are prescribed simultaneously. In this study, we aimed to determine the effects of AP and TT extracts both separately and simultaneously on the male Wistar rat fertility parameters. Materials and Methods 32 male Wistar rats were divided into 4 groups: Control, TT, AP, and AT treated groups. Treatment continued for 25 days and rats were weighed daily. Their testes were dissected for histological studies. Sperm analysis including sperm count, viability and motility were performed. Serum was obtained to evaluate testosterone, LH and FSH levels. Histological studies were conducted to study Leydig, and Sertoli cells, spermatogonia and spermatid cell numbers, and to measure seminiferous diameter and epithelium thickness. Results Sperm count increased in all the treatment groups. Sperm viability and motility in AT and AP groups were elevated. TT and AT groups showed significantly increased testosterone level compared to control group (P=004, P=0.000, respectively) and TT, AP and AT treatment groups showed increased LH level (P=0.002, P=0.03 and P=0.000, respectively) compared to control, while only AT group showed increased FSH (p=0.006) compared to control. Histological studies showed significant increase of spermatogonia, Leydig and Sertoli cell numbers and epithelial thickness in AT group compared to other groups. All the treatment groups had higher number of Leydig, spermatogonia and spermatid cells. Conclusion TT and AP improved sexual parameters; however, their simultaneous administration had higher improving effects on studied parameters.

Análise histológica do fêmur de camundongos suíços fêmeas ovariectomizadas e não ovariectomizadas suplementadas com extrato de Tribulus terrestris L / Histological analysis of the fem of female swiss mice ovariectomized and not ovariectomized supplements with extract of Tribulus terrestris L

Introdução: a incapacidade de gerar filhos é chamada de infertilidade, e acomete grande parte da população, principalmente mulheres entrando no período da menopausa. Tal condição afeta a qualidade de vida, pois aumenta o desgaste ósseo, fazendo com que a busca por tratamentos de reposição hormonal aumente exponencialmente. Entretanto, tais tratamentos possuem efeitos colaterais, o que apresenta plantas medicinais como tratamentos alternativos. Objetivo: avaliar a histologia do fêmur de camundongos suíços fêmeas ovariectomizadas e não ovariectomizadas tratadas ou não com Tribulus terrestris L. (TT) Métodos: Foram utilizados 28 camundongos suíços fêmeas divididos em 4 grupos, sendo dois controles com e sem suplementação e dois que sofreram o processo de ovariectomia bilateral, com e sem suplementação. O extrato da planta foi administrado por 21 dias por gavagem. Ao final do tratamento, os animais foram eutanasiados e o fêmur coletado para análise histológica. Resultados: o TT não foi capaz de alterar significativamente o diâmetro do osso. A castração, como esperado, mostrou possível osteopenia. A planta pode ter efeito protetor aos ossos devido a efeito antiartrítico. Conclusão: na análise histológica descritiva do fêmur, foram evidenciadas alterações que se associam à osteopenia nos animais castrados e efeito ósseo-protetor nos animais suplementados com o extrato dos frutos do Tribulus terrestris L.

Introduction: inability to generate children is called infertility and affects a large part of the population, especially women entering the menopausal period. Such a condition affects the quality of life, including the use of the bone system, causing the search for hormone replacement services exponentially. However, such treatments shave light collectors, such as medicinal plants as alternative treatments. Objective: to evaluate the histology of the treatment of pairs of ovariectomized and non-ovariectomized women treated with or without Tribulus terrestris L. (TT). Methods: twenty-eight Swiss mice were divided into four groups, two controls with and without supplementation, and two with bilateral ovariectomy, with and without supplementation. The plant extract was administered for 21 days by way of gavage. After the evaluation, the animals were eutanasiated and their femur was collected for histological analysis. Results: the TT was not able to change the diameter of the bone. Castration, as expected, allowed for osteopenia. The plant may have a protective effect on bones because of an anti-arthritic effect. Conclusion: in the descriptive histological analysis of phosphorus, there were evidences alterations that associate the osteopenia in the animals and the bony-protective effects in the animals supplemented with the extract of the fruits of Tribulus terrestris L.

Valiação do efeito do extrato de Tribulus Terrestris l. Na ocorrência do ciclo estral de camundongos suíços fêmeas ovariectomizadas e não ovariectomizadas / Evaluation of the extract effect of Tribulus terrestris L. on the occurrence of the estral cycle of ovariectomized and not ovariectomized female swiss mice

Introdução: a infertilidade ou incapacidade de gerar filhos é um problema que acomete parte da população. Seu tratamento geralmente é feito pela reposição hormonal, no entanto, terapias alternativas com o uso de plantas medicinais vêm sendo adotadas. Objetivo: diante do exposto, o presente estudo teve por objetivo avaliar o efeito do extrato do Tribulus terrestris L. na ocorrência do ciclo estral em camundongos fêmea ovariectomizadas e não ovariectomizadas. Métodos: foram utilizados 28 camundongos suíços fêmeas e adultas, divididas em quatro grupos de 7 animais: grupo sem ovariectomia e sem suplementação ou controle, grupo com ovariectomia e sem suplementação, simulando a infertilidade, grupo tratado com Tribulus terrestris (10mg/kg) com ovariectomia e grupo tratado com Tribulus terrestris L. (10mg/kg) sem ovariectomia. Os extratos foram administrados por gavagem durante 21 dias. O ciclo estral foi analisado ao longo deste mesmo período. Resultados: notou-se aumento significativo na fase proestro do ciclo estral no grupo ovariectomizado e suplementado quando comparado ao grupo ovariectomizado e sem suplementação. Conclusão: o aumento significativo na ocorrência do proestro corresponde a um período do ciclo estral relacionado à ocorrência da ovulação.

Introduction: infertility or inability to generate children is a problem that affects part of the population. Its treatment is usually done by hormone replacement, however, alternative therapies with the use of medicinal plants have been adopted. Objective: in view of the above, the present study aimed to evaluate the effect of Tribulus terrestris L. extract on the occurrence of the estrous cycle in ovariectomized and non ovariectomized mice. Methods: twentyeight female and adult Swiss mice were divided into four groups of 7 animals: group without ovariectomy and without supplementation or control, group with ovariectomy and no supplementation simulating infertility, group treated with Tribulus terrestris L. (10mg / kg) with ovariectomy and group treated with Tribulus terrestris L. (10mg / kg) without ovariectomy. The extracts were administered by way of gavage for 21 days. The estrous cycle was analyzed over this same time. Results: there was a significant increase in the proestrus phase of the estrous cycle in the ovariectomized group and supplemented when compared to the ovariectomized group and without supplementation. Conclusion: the significant increase in the occurrence of proestrus corresponds to a period of the estrous cycle related to the occurrence of ovulation.

Changes and mechanisms of terrestroside B and terrestrosin K in stir-frying Tribuli Fructus / 中国中药杂志

The contents of terrestroside B and terrestrosin K in Tribuli Fructus with different degree of stir-frying were determined by high performance liquid chromatography with evaporative light-scattering detector( HPLC-ELSD). The results showed that the contents of terrestroside B and terrestrosin K were increased at first and then decreased,and both of them had the highest content at the best time of heating. The results of simulated processing of Tribulus Terrestris saponins showed that when the processing time kept constant,the contents of terrestroside B and terrestrosin K were decreased gradually with the increase of processing temperature from 180 ℃ to240 ℃. At a certain temperature,the content of terrestrosin K was increased first and then decreased with the prolongation of processing time,and reached the highest level at 5 min. However,the content of terrestroside B was increased first and then decreased with the increase of processing time only at 180 ℃,and reached the highest level at 10 min. When the processing temperature was controlled at200,220 and 240 ℃ respectively,the content of terrestroside B was decreased gradually with the increase of processing time. The simulated processing products of tribuluside A,terrestroside B and terrestrosin K were qualitatively characterized by ultra-performance liquid chromatography-time of flight mass spectrometry( UPLC-TOF/MS). It was proved that tribuluside A and terrestrosin Ⅰ containing C-22-OH were dehydroxylated in the processing of Tribuli Fructus and transformed respectively into terrestroside B and terrestrosin K containing C-20-C-22 double bond. As a result,the contents of terrestroside B and terrestrosin K were increased. The sugar chains at C-3 and C-26 positions of terrestroside B and terrestrosin K could be deglycosylated and converted into monosaccharide chain saponins and short sugar chain saponins,so the contents of terrestroside B and terrestrosin K were reduced. The study provides reference for further revealing the processing principle of Tribuli Fructus.

Protective effects of Tribulus terrestris hydroalcoholic extract against cisplatin-induced germ cell apoptosis in male mice / Efectos protectores del extracto hidroalcohólico Tribulus terrestris contra la apoptosis de células germinales inducida por cisplatino en ratones machos

SUMMARY: Toxic effects of anti-cancer and other drugs on the normal tissues could be reduced by the herbal plants and their fractions. This study investigated the protective effect of Tribulus terrestris (TT) on Cisplatin- induced cytotoxicity germ cell apoptosis in male mice. In this experimental study, thirty male Balb/c mice were divided randomly into 5 groups (n=6). A single dose of Cisplatin (5.5 mg/kg) and differ-ent concentrations of Tribulus terrestris were administrated for 14 consecutive days. Reverse transcription polymerase chain reaction (RT-PCR) of apoptosis-re-lated genes was performed with RNA extracted from testes of the mice. Statistical analysis was done using one-way ANOVA. In the Cisplatin group, there was a significant increase in mRNA expression of p53 (P=0.008), bax (P=0.004) and the ratio of bax/Bcl-2 (P=0.000), whereas there was an decrease in the expression of Bcl-2 (P=0.003), as compared to control group. In Cis+TT groups, the data showed that different concentrations of TT could improve the harmful effects caused by the Cisplatin. The best protective effects were achieved in Cis+TT (300 mg/kg). Tribulus terrestris protects testicular germ cell against Cisplatin induced apoptosis by affecting related genes regulation.

RESUMEN: Los efectos tóxicos en los tejidos normales, de los medicamentos contra el cáncer al igual que otras medicamentos podrían mejorar con el uso de plantas medicinales y hierbas. Este estudio investigó el efecto protector de Tribulus terrestris (TT) sobre la apoptosis de células germinales por citotoxicidad inducida por cisplatino en ratones machos. En este estudio se dividieron treinta ratones Balb/c macho aleatoriamente en 5 grupos (n = 6). Se administró una sola dosis de cisplatino (5,5 mg / kg) y diferentes concentraciones de Tribulus terrestris durante 14 días consecutivos. La reacción en cadena de la polimerasa de transcripción reversa de los genes relacionados con la apoptosis, se realizó con ARN extraído de los testículos de los ratones. El análisis estadístico se realizó usando ANOVA de una vía. En el grupo cisplatino, hubo un aumento significativo en la expresión de mRNA de p53 (P = 0,008), bax (P = 0,004) y la relación de bax / Bcl-2 (P = 0.000), mientras que hubo una disminución en la expresión de Bcl-2 (P = 0,003), en comparación con el grupo control. En los grupos Cis + TT, los datos mostraron que las diferentes concentraciones de TT podrían mejorar los efectos nocivos causados por el cisplatino. Los mejores efectos protectores se lograron en Cis + TT (300 mg / kg). Tribulus terrestris protege las células germinales testiculares contra la apoptosis inducida por cisplatino al afectar la regulación de los genes relacionados.

Estudo histológico dos testículos de camundongos suiços machos suplementados com propionato de testosterona e Tribulus terrestris L / Histological study of testicles of mice swiss males supplements with testosterone propionate and Tribulus terrestris L

Introdução: o declínio sérico de testosterona decorrente da idade afeta a qualidade de vida do homem, que busca meios para tratamento que não possuam tantos efeitos adversos como a testosterona sintética, como o extrato da planta Tribulus terrestris L. (TT). Objetivo: estudar a histologia dos testículos de camundongos suíços suplementados com propionato de testosterona e extrato de TT. Métodos: o procedimento utilizou 30 camundongos suíços machos divididos em 3 grupos, onde o grupo controle recebeu veículo aquoso durante o experimento. O grupo testosterona recebeu 20mg/kg do fármaco e o grupo TT recebeu 10 mg/kg do extrato das flores da planta. Resultados e Discussão: a região ependidimária foi visualizada com características de normalidade, mostrando epitélio pseudo-estratificado ciliado, intercalado por tecido muscular liso. Nos grupos controle e testosterona foi evidenciado a presença de espermatozoides no centro dos ductos. O alto incremento de testosterona sérica causado pela suplementação com o TT possivelmente leva a um mecanismo de feedback negativo no eixo hipotálamo-hipófise, fazendo com que o mesmo não secrete os hormônios necessários para a síntese de testosterona endógena e sequente produção espermática. Conclusão: o uso de TT pode causar azoospermia.

Introduction: age-related serum testosterone decline affects man's quality of life, which seeks treatment means that do not have as many adverse effects as synthetic testosterone, such as Tribulus terrestris L. (TT) extract. Objective: to study the histology of the testes of Swiss mice supplemented with testosterone propionate and TT extract. Methods: the procedure used 30 male Swiss mice divided into 3 groups, where the control group received an aqueous vehicle during the experiment. The testosterone group received 20 mg / kg of the drug and the TT group received 10 mg / kg of the plant extract. Results and Discussion: the ependidimary region was visualized with characteristics of normality, showing ciliated pseudo-stratified epithelium, interspersed by smooth muscle tissue. In the control and testosterone groups the presence of spermatozoa was evidenced in the center of the ducts. The high increase of serum testosterone caused by supplementation with TT possibly leads to a negative feedback mechanism in the hypothalamic-pituitary axis, causing it not to secrete the hormones necessary for the synthesis of endogenous testosterone and subsequent sperm production. Conclusion: the use of TT may cause azoospermia.

Estudo do efeito da castração, suplementação com propionato de testosterona e tribulus terrestris L No fígado de camundongos suíços machos / Study of effect of castration, supplementation with testosterone propionate and Tribulus Terrestris L. in males swiss mice liver

Introdução: o declínio hormonal associa-se à depressão. O uso de testosterona sintética aumentou significativamente, buscando minimizar os sintomas desse quadro. O Tribulus terrestris L. (TT) é uma planta que supostamente possui componentes análogos à testosterona. Objetivo: analisar a histologia do fígado de animais normais e com declínio reprodutivo, suplementados com propionato de testosterona e TT. Métodos: foram utilizados 40 camundongos suíços machos divididos em quatro grupos, sendo um castrado. Os grupos controle e castrado receberam o veículo aquoso, no qual as drogas dos demais grupos foram diluídas. O grupo TT recebeu extrato das flores da planta na dosagem de 10 mg/kg e o grupo testosterona recebeu propionato de testosterona na dosagem de 20 mg/kg. Todas as administrações foram via gavagem durante 30 dias. Os animais foram eutanasiados e o fígado coletado para confecção de lâminas. Resultados e Discussão: não foram encontrados parâmetros discrepantes do grupo controle em nenhuma lâmina de estudo, entretanto, o exercício físico adotado no teste concomitante de comportamento pode ter relação com os resultados. Conclusão: o exercício físico aeróbio tem a capacidade de restaurar e modular enzimas hepáticas, aumentando a glicogenólise e a gliconeogênese, diminuindo esteatose hepática e estresse oxidativo, causando efeito hepatoprotetor, aumentando mitoses e capilares sinusóides, que melhoram a irrigação e favorecem a regeneração hepática.

Introduction: hormonal decline is associated with depression. The use of synthetic testosterone increased significantly to minimize the symptoms of this condition. Tribulus terrestris L. (TT) is a plant that supposedly has components analogous to testosterone. Objective: analyze liver histology of normal and reproductive decline animals supplemented with testosterone propionate and TT. Methods: forty male Swiss mice were divided into four groups, one castrated. The control and castrated groups received the aqueous vehicle in which the drugs from the other groups were diluted. The TT group received extract of the flowers of the plant at a dose of 10 mg / kg and the testosterone group received testosterone propionate at the dosage of 20 mg / kg. All administrations were by gavage for 30 days. The animals were euthanized and the liver was collected for the preparation of slides. Results and Discussion: there were no discrepant parameters of the control group found in any study slide, however, the physical exercise adopted in the concomitant behavior test may be related to the results. Conclusion: aerobic physical exercise has the capacity to restore and modulate liver enzymes, increasing glycogenolysis and gluconeogenesis, decreasing hepatic steatosis and oxidative stress, causing hepatoprotective effect, increasing mitoses and sinusoid capillaries, which improve irrigation and favor liver regeneration.

Anti-coccidial activity of the ethanol extract of Tribulus terrestris fruits on Eimeria tenella / 한국실험동물학회지

Anti-coccidial effects of the fruits of Tribulus terrestris (Tribuli fructus) ethanol extract (TTE) were studied with animal experiment following per oral administration with Eimeria (E.) tenella. This experiment was performed on the 3-day-old chicks (n=30). The animals were divided with 3 groups; TFE 15mg per animal+infected (n=10), TTE untreated+infected (n=10) and non-infected control (n=10). Animals were administrated with or without TTE during 1 week, and then inoculated with E. tenella. The anti-coccidial activity were evaluated with oocysts shedding numbers in stools, body weights changes and food intake changes. The TTE-inoclated animals revealed significantly decreased stool oocysts numbers (P < 0.05) when compared to the TTE untreated animals. Also, TTE-treated animals showed more increased body weight gains (P < 0.05) than the TTE untreated animals. These results demonstrate that TTE produce anticoccidial activities against E. tenella. TTE could be a promising treatment for the coccidiosis.

Hepatoprotective effects of Tibulus terrestris hydro-alcholic extract on non-alcoholic fatty liver- induced rats / Efectos hepatoprotectores del extracto hidro-alcohólico de Tribulus terrestris en ratas con inducción de hígados grasos no alcólicos

Non-alcoholic fatty liver induces many complications to the liver tissue and also serum related parameters. Medicinal plants are the safe therapeutic strategy for the treatment of diseases. In this regards, the present study was conducted to evaluate the effect of Tribulus terrestris (T. terrestris) extract on non-alcoholic fatty liver in rats. In this experimental study, thirty male Wistar rats were divided into five groups (n=6). Animals in experimental groups were received high fructose diet (70 %) (HDF) daily alone or in combined with daily intraperitoneal injection of 500, 700 and 1000 mg/kg extract of T. terrestris. Control group of rats was feed with standard chow. The serum levels of biomarkers of liver and serum lipid profiles were assessed, also histopathological examination of liver tissue done. Data were analyzed using One-way ANOVA method followed by Tukey's post-hoc multiple comparison test and P<0.05 was considered statistically significant. There were significant improvements for biomarkers of liver tissue (P<0.05) and serum lipid profiles (P<0.01) in the HFD-fed rats that were treated with T. terrestris extract compare to HFD-fed group. In addition, accumulation of lipids in hepatocytes was significantly reduced in the HFD-fed + extract administrated groups in comparison to HFD-fed rats (P<0.01). T. terrestris extract has protective effects against non-alcoholic fatty liver by changing biomarkers of liver tissue, serum lipid profiles and histopathological anomalies of liver tissue, to normal range.

El hígado graso no alcohólico induce muchas complicaciones al tejido hepático y también en ciertos parámetros relacionados con el suero. Las plantas medicinales son la estrategia terapéutica segura para el tratamiento de enfermedades. En este sentido, el presente estudio se realizó para evaluar el efecto del extracto de Tribulus terrestris (T. terrestris) sobre el hígado graso no alcohólico en ratas. En este estudio experimental se dividieron 30 ratas macho Wistar en cinco grupos (n = 6). Los animales de los grupos experimentales recibieron dietas altas en fructosa (70 %) (HDF) al día o en combinación con inyección intraperitoneal diaria de 500, 700 y 1000 mg / kg de extracto de T. terrestris. El grupo control de ratas fue alimentado con alimento estándar. Se evaluaron los niveles séricos de biomarcadores hepáticos y perfiles de lípidos séricos, así como un examen histopatológico del tejido hepático. Los datos se analizaron utilizando el método ANOVA de una vía seguido de la prueba de comparación múltiple post-hoc de Tukey y el P<0,05 se consideró estadísticamente significativo. Hubo mejoras significativas en los biomarcadores del tejido hepático (P <0,05) y en los perfiles de lípidos séricos (P <0,01) en las ratas alimentadas con HFD que se trataron con extrato de T. terrestris comparado con el grupo alimentado con HFD. Además, la acumulación de lípidos en los hepatocitos se redujo significativamente en los grupos alimentados con HFD + extracto, en comparación con las ratas alimentadas con HFD (P <0,01). El extracto de T. terrestris tiene efectos protectores sobre el hígado graso no alcohólico, provocando modificaciones en los marcadores biológicos del tejido hepático, los perfiles lipídicos del suero y las anomalías histopatológicas del tejido hepático, hasta un rango normal.

Investigação do efeito do declínio reprodutivo e da suplementação com Tribulus terrestris L. no comportamento de camundongos suíços submetidos ao teste do nado forçado / Investigation of the effect of reproductive decline and supplementation with Tribulus terrestris L. on the behavior of Swiss mice submitted to the forced swimming test

Introdução: a redução dos esteroides sexuais ocasionada pelo hipogonadismo se associa a depressão. Tratamentos alternativos com plantas medicinais como o extrato do Tribulus terrestris (TT) tem sido frequentemente usado por pessoas nesta condição. Objetivo: este estudo teve por objetivo investigar a influência do declínio de testosterona, da suplementação com TT e propionato de testosterona no comportamento de animais. Método: foram utilizados 40 camundongos da linhagem Swiss, machos, divididos em quatro grupos. Os grupos controle e castrado receberam veículo aquoso; o grupo TT recebeu 10 mg/kg do extrato da planta e o grupo propionato de testosterona foi tratado com 20 mg/kg deste fármaco. A avaliação comportamental foi feita pelo teste do nado forçado. Após trinta dias de tratamento, foi coletado sangue para dosagem de testosterona livre. Resultado e Discussão: os resultados evidenciaram efeito antidepressivo significativo nos animais castrados e suplementados com propionato de testosterona. Houve também significância no efeito depressivo nos animais tratados com TT; redução significativa na concentração de testosterona nos animais castrados e aumento significativo nos animais do grupo TT e propionato de testosterona. Conclusão: conclui-se que a castração, suplementação com TT e propionato de testosterona apresentaram suposta capacidade de alterar o comportamento e modificar as concentrações sérias de testosterona.

Introcution: the reduction of sexual steroids caused by hypogonadism is associated with depression. Alternative treatments with medicinal plants like Tribulus terrestris (TT) extract have often been used by people in this condition. Objective: this study aimed to investigate the influence of testosterone decline, supplementation with TT and testosterone propionate on animal behavior. Method: fourty Swiss male mice were divided into four groups. The control and castrated groups received aqueous vehicle; the TT group received 10 mg / kg of the plant extract and the testosterone propionate group was treated with 20 mg / kg of this drug. Behavioral assessment was performed by the forced swim test. After 30 days of treatment, blood was collected for free testosterone dosing. Results and Discussion: the results showed a significant antidepressant effect in castrated animals supplemented with testosterone propionate. There was also significance in the depressive effect in animals treated with TT; significant reduction in the concentration of testosterone in castrated animals and a significant increase in the animals of the TT group and testosterone propionate. Conclusion: it was concluded that castration, supplementation with TT and testosterone propionate presented a supposed capacity to alter the behavior and modify serum concentrations of testosterone.

Vascular protective effects of aqueous extracts of Tribulus terrestris on hypertensive endothelial injury / 中国天然药物

Angiotensin II (Ang II) is involved in endothelium injury during the development of hypertension. Tribulus terrestris (TT) is used to treat hypertension, arteriosclerosis, and post-stroke syndrome in China. The present study aimed to determine the effects of aqueous TT extracts on endothelial injury in spontaneously hypertensive rats (SHRs) and its protective effects against Ang II-induced injury in human umbilical vein endothelial cells (HUVECs). SHRs were administered intragastrically with TT (17.2 or 8.6 g·kg·d) for 6 weeks, using valsartan (13.5 mg·kg·d) as positive control. Blood pressure, heart rate, endothelial morphology of the thoracic aorta, serum levels of Ang II, endothelin-1 (ET-1), superoxide dismutase (SOD) and malonaldehyde (MDA) were measured. The endothelial injury of HUVECs was induced by 2 × 10 mol·L Ang II. Cell Apoptosisapoptosis, intracellular reactive oxygen species (ROS) was assessed. Endothelial nitric oxide synthase (eNOS), ET-1, SOD, and MDA in the cell culture supernatant and cell migration were assayed. The expression of hypertension-linked genes and proteins were analyzed. TT decreased systolic pressure, diastolic pressure, mean arterial pressure and heart rate, improved endothelial integrity of thoracic aorta, and decreased serum leptin, Ang II, ET-1, NPY, and Hcy, while increased NO in SHRs. TT suppressed Ang II-induced HUVEC proliferation and apoptosis and prolonged the survival, and increased cell migration. TT regulated the ROS, and decreased mRNA expression of Akt1, JAK2, PI3Kα, Erk2, FAK, and NF-κB p65 and protein expression of Erk2, FAK, and NF-κB p65. In conclusion, TT demonstrated anti-hypertensive and endothelial protective effects by regulating Erk2, FAK and NF-κB p65.

Negative effects of bisphenol A on testicular functions in albino rats and their abolitions with Tribulus terristeris L

ABSTRACT This study was conducted to find out the ameliorative properties of Tribulus terristeris L (TT) on BPA induced spermatotoxicity in male albino rats. Mature male albino rats were divided into five groups, Group A was taken as control for comparison group, whereas the other four groups namely B(vehicle control), C (toxic), D (preventive control) and Group E (amelioration group) received distilled water, olive oil, BPA, TT, and (TT + BPA) respectively. Macroscopic results revealed decreased body weight of rats, weight of testes, and the relative tissue weight index (RTWI) in BPA induced group. Hormonal (testosterone) assay results revealed the decreased values of BPA treated group. Microscopic examination of testis of BPA treated rats showed reduction in leydig cells, decreased diameter of seminiferous tubules and low values of Johnsen's scoring. Histological examination showed discontinuity and irregularity of basement membrane and sloughing of the germinal cell linage. Group E showed the body weights of rats, weight of testes, RTWI, and increased, while reduced level of testosterone, reduced number of Leydig cells, decreased diameter of seminiferous tubules and low values of Johnsen's scoring were restored near to normal. These results demonstrate that TT might be beneficial in combating the spermatotoxicity, induced by BPA.

Tribulus terrestris hydroalcoholic extract effect on cisplatin-induced apoptosis in mice kidney / Efecto del extracto hidroalcohólico de Tribulus terrestris sobre la apoptosis Inducida por cisplatino en el riñón de ratones

Cisplatin (EBEWE Pharma, Unterach, Austria) is an anti-cancer drug used in chemotherapy. One of the limiting major side effects of cisplatin is nephrotoxicity. Tribulus terrestris (TT) has been used as an synthetic or herbal protective agents for kidney disorders. The present study amid to investigate the Tribulus terrestris Hydroalcoholic extract effect on cisplatin-induced apoptosis in mice kidney. Male adult mice (n= 30) were divided into control group and 4 experimental groups (n= 6). Control group received saline, the first experimental group received cisplatin (5.5 mg/kg) and other three experimental groups received cisplatin (5.5 mg/kg) and different doses of hydroalcoholic extact of TT (100, 300 and 500 mg/kg i.p) respectively. The kidneys were removed after 4 days of injections, and TUNEL assay on mice's kidneys were performed. Weights of body and kidneys and apoptotic index were assessed. Data analysis was performed using one-way ANOVA followed by Tukey's post hoc test. The results showed that cisplatin lead to a reduction in the weight of body and kidney (P <0.01), and increased apoptotic index significantly compared to the control group (P <0.001), while in treated groups with TT, the weights of body and kidney were significantly higher compared with cisplatin group, but apoptotic index did not show significant differences. These parameters reached normal range after administration of fruit extracts of TT for 4 days. The study demonstrates that extract of TT could have protective effect on cisplatin- induced apoptosis of kidney. This may be related to the presence of antioxidant components acting via a multitude of central and peripheral mechanisms.

El cisplatino (EBEWE Pharma, Unterach, Austria) es un medicamento contra el cáncer utilizado en quimioterapia. Uno de los principales efectos secundarios limitantes del cisplatino es la nefrotoxicidad. Tribulus terrestris (TT) ha sido utilizado como agente protector sintético o herbal para los trastornos renales. El objetivo fue investigar el efecto del extracto hidroalcohólico de TT sobre la apoptosis inducida por cisplatino en el riñón de ratones. Se utilizaron ratones adultos machos (n= 30), que fueron divididos en 4 grupos, un control y tres grupos experimentales (n= 6). El grupo control recibió solución salina; el primer grupo experimental recibió cisplatino (5,5 mg/kg) y los otros tres grupos experimentales recibieron cisplatino (5,5 mg/kg) con diferentes dosis de extracto hidroalcohólico de TT (100, 300 y 500 mg/kg vía ip) respectivamente. Los riñones fueron retirados después de 4 días de aplicadas las inyecciones, y se realizó el ensayo TUNEL en los riñones. Se evaluó el peso corporal de los ratones, el peso de los riñones y el índice de apoptosis. El análisis de datos se realizó mediante ANOVA de un factor seguido por la prueba post hoc de Tukey. Los resultados mostraron que el cisplatino con plomo provocó una reducción en el peso corporal y el riñón (P <0,01) y un aumento significativo del índice de apoptosis en comparación con el grupo control (P <0,001), mientras que en los grupos tratados con TT, los pesos corporales y de los riñones fueron significativamente mayores en comparación con el grupo de cisplatino, pero el índice de apoptosis no mostró diferencias significativas. Estos parámetros alcanzaron niveles normales después de la administración de extracto de TT durante 4 días. El estudio demuestra que el extracto de TT podría tener un efecto protector sobre la apoptosis inducida por cisplatino en el riñón, que podría estar relacionado con la presencia de componentes antioxidantes que actúan a través de múltiples mecanismos centrales y periféricos.

Tribulus terrestris hydroalcoholic extract administration effects on reproductive parameters and serum level of glucose in diabetic male rats / Efectos de la administración del extracto hidroalcohólico tribulus terrestris sobre los parámetros reproductivos y el nivel sérico de glucosa en ratas macho diabéticas

Usage of medicinal plants for the treatment of diseases is a remarkable strategy considered in both clinical and experimental studies. This study was conducted to evaluate the effect of Tribulus terrestris hydroalcoholic extract administration on the serum level of glucose and reproductive parameters in diabetic male rats. In this experimental study, 30 adult male Wistar rats (200­250 g) were divided into 5 groups (n= 6). Diabetes was induced by a single intraperitoneal injection of 50 mg/kg streptozotocin. Experimental groups received daily Intraperitoneal injection of the extract (100, 250 and 500 mg/kg) since one week after inducing diabetes for two weeks. At the end of the experiment, the serum levels of testosterone and glucose were examined by ELISA and Glucodr devices respectively. Sperm parameters including morphology, count and motility were evaluated from the cauda epididymis. The diameters of seminiferous tubules were assessed based on 5 µm paraffin section of H&E stained section of testes. The data were evaluated by One Way ANOVA followed by post-hoc test using SPSS software. In T. terrestris extract groups, there were significant reductions in the levels of blood glucose while increased sperm motility, sperm count and seminiferous tubules diameter, percentage of sperms with normal morphology, level of testosterone hormone and final body weight compared with diabetic group (p <0.001). In conclusion, T. terrestris hydroalcoholic extract decreases serum level of glucose and diminishes the side effects of diabetes on male reproductive system showing by increasing in the serum level of testosterone, improving sperm parameters and returning the seminiferous tubules to normal diameter by a dose dependent manner.

El uso de plantas medicinales para el tratamiento de enfermedades es una importante estrategia considerada en estudios clínicos y experimentales. El objetivo fue evaluar el efecto de la administración de extracto de Tribulus terrestris hidroalcohólico en el nivel sérico de glucosa y los parámetros reproductivos en ratas macho diabéticas. En este estudio experimental, se dividieron 30 ratas Wistar (200­250 g) macho adultas, en 5 grupos (n= 6). Se indujo diabetes por una sola inyección intraperitoneal (i.p.) de 50 mg/kg de estreptozotocina. Los grupos experimentales recibieron inyección i.p diaria del extracto (100, 250 y 500 mg/kg) una semana después de la inducción de la diabetes durante dos semanas. Al final del experimento, los niveles séricos de testosterona y de glucosa se examinaron por ELISA y el dispositivos Glucodr, respectivamente. Además, fueron evaluados los parámetros de morfología, conteo y motilidad espermática. Los diámetros de los túbulos seminíferos de los testículos se evaluaron sobre la base de secciones de parafina de 5 mm teñidos con H&E. Los datos fueron evaluados por ANOVA de una vía seguido de prueba post-hoc utilizando el programa SPSS (versión 20). En los grupos tratados con extracto de T. terrestris hubo una reducción significativa en los niveles de glucosa en la sangre, mientras que se observó un aumento en el recuento y motilidad espermática, el diámetro de los túbulos seminíferos, el porcentaje de espermatozoides con morfología normal, el nivel de testosterona y el peso corporal final de las ratas en comparación con el grupo de ratas diabéticas (p <0,001). En conclusión, el extracto de T. terrestris hidroalcohólico disminuye los niveles séricos de glucosa y los efectos secundarios de la diabetes en el sistema reproductivo mediante el aumento de los niveles séricos de testosterona, mejorando los parámetros de los espermatozoides y la restitución a diámetro normal de los túbulos seminíferos dependiendo de la dosis.

Assessment of the Effects of Tribulus Terrestris on Sexual Function of Menopausal Women / Avaliação dos efeitos do Tribulus Terrestris na sexualidade de mulheres no climatério

Objective The aim of this study was to study the effects of Tribulus terrestris on sexual function in menopausal women. Methods This was a prospective, randomized, double-blind, placebo-controlled clinical trial that included 60 postmenopausal women with sexual dysfunction. The women were divided into two groups, placebo group and Tribulus group, and evaluated by using the Sexual Quotient-female version (SQ-F) and Female Intervention Efficacy Index (FIEI) questionnaires. Results There was no significant difference between the groups in age, age at menopause, civil status, race, and religion. In the evaluation with the SQ-F questionnaire, there were significant differences between the placebo (7.6±3.2) and Tribulus (10.2±3.2) groups in the domains of desire and sexual interest (p d" 0.001), foreplay (3.3±1.5 versus 4.2±1.0) (p d" 0.01), arousal and harmonious interaction with the partner (5.7±2.1 versus 7.2±2.6) (p d" 0.01), and comfort in sexual intercourse (6.5±2.4 versus 8.0±1.9) (p d" 0.01). There was no significant difference between the placebo and Tribulus groups in the domains of orgasm and sexual satisfaction (p = 0.28). In the FIEI questionnaire, there was a significant improvement (p < 0.001) in the domains of vaginal lubrication during coitus and/or foreplay (20 versus 83.3%), sensation in the genitalia during sexual intercourse or other stimuli (16.7 versus 76.7%), sensation in the genital region (20 versus 70%), sexual intercourse and/or other sexual stimulations (13.3 versus 43.3%), and the ability to reach orgasm (20% versus 73.3%). There was no significant difference in adverse effects between the two groups. Conclusions After 90 days of treatment, at the doses used, we found Tribulus terrestris to be effective in treating sexual problems among menopausal women.

Objetivo Estudar os efeitos doTribulus terrestris na função sexual demulheres após a menopausa. Métodos Ensaio clínico, prospectivo, randomizado, duplo-cego, placebo controlado, com 60 mulheres após a menopausa com disfunção sexual, divididas em dois grupos: Grupo Placebo e Grupo Tribulus, avaliadas através dos questionários Quociente Sexualversão Feminina (QS-F) e Female Intervention Efficacy Index (FIEI). Resultados Não houve diferença significante entre os grupos quanto à idade, idade de menopausa, estado civil, raça e religião. Na avaliação do questionário QS-F houve diferença significante entre os grupos Placebo (7,6±3,2) e Tribulus (10,2±3,2) nos aspectos desejo e interesse sexual (p d" 0,001), preliminares (3,3±1,5 versus 4,2±1,0) (p d" 0,01), excitação da mulher e sintonia com o parceiro (5,7±2,1 versus 7,2±2,6) (p d" 0,01) e no aspecto conforto na relação sexual (6,5±2,4 versus 8,0±1,9) (p d" 0,01). O aspecto orgasmo e satisfação sexual não houve diferença significante entre o Grupo Placebo e Tribulus (p = 0,28). No questionário FIEI houve melhora significante (p < 0,001) na lubrificação vaginal durante o coito e/ou preliminares (20 versus 83,3%), na sensação nas genitálias durante a relação sexual ou outros estímulos (16,7 versus 76,7%), na sensação na área genital (20 versus 70%), nas relações sexuais e/ou outras estimulações sexuais (13,3 versus 43,3%) e na capacidade de ter orgasmo (20% versus 73,3%). Quanto aos efeitos colaterais não houve diferença significante entre os dois Grupos. Conclusões Após noventa dias, podemos concluir que o Tribulus terrestris nas doses utilizadas demonstrou ser efetivo no tratamento das queixas sexuais dasmulheres após a menopausa.