Tribulus terrestris is primarily used in traditional medicine systems, such as Ayurveda and Traditional Chinese Medicine, for a variety of male health concerns, including urinary and reproductive issues. In the context of Benign Prostatic Hyperplasia (BPH), its use is supported more by traditional practice than by robust scientific evidence. Historically, Tribulus has been valued for its supposed ability to enhance libido, support urinary tract function, and improve male vitality—indirectly relating to symptoms that may overlap with BPH, such as difficulty with urination.

The scientific evidence supporting Tribulus for BPH is minimal. Preclinical studies suggest Tribulus may have anti-inflammatory or mild diuretic properties, but there are no well-designed human clinical trials that specifically demonstrate efficacy for BPH. Most research on Tribulus focuses on its effects on testosterone, libido, or general urinary function, rather than on prostate size or BPH symptoms directly. A few animal studies indicate possible benefits on prostate health, but these findings have not been convincingly replicated or validated in humans.

In summary, Tribulus terrestris is used for BPH mainly due to traditional usage, with only a low level (1/5) of scientific evidence to support its effectiveness for this specific condition.