Reviewer ’s report  
 
Title: Effect of a multi -ingredient based food supplement on sexual function in women with low 
sexual desire. Pilot study.  
 
Version: 1 Date: 12 Dec 2018  
 
Reviewer: C Rusike  
 
Reviewer's report:  
 
GENERAL  
Authors investigated the effect of a Trigonella foenum graecum -based food supplement on 
sexual function in women with low sexual desire. Testosterone levels were measured. As a pilot, 
this study addresses an important problem. The paper is we ll written in good English and is easy 
to follow. plant names should be given in Italics.  
 
Title:  
What percent of Libicare® is Trigonella foenum graecum - seeing there are other plants namely -  
Turnera diffusa, Tribulus terrestris, and Ginkgo biloba - some of which have been shown to have  
testosterone enhancing effects. I ask for clarity - if Trigonella forms the main plant - then I 
suppose it is alright to call Libicare®  Trigonella -based - otherwise it may be prudent to leave 
title as "polyherbal food s upplement" without pointing out this particular plant.  
 
ABSTRACT  
Postmenopausal (spelling in introduction).  
Too many unexplained abbreviations in the abstract. Need to be given in full first  
 
INTRODUCTION  
Adequate background is given to motivate for this study. Arguments are clear and relevant to the 
problem being addressed. More could have been said about the timing of testosterone levels 
within the cycle relative to sexual desire and possible mechanisms of action in sexual desire 
(local vs central effect s?). 
 
METHODS  
Methods are clearly explained with inclusion and exclusion criteria clearly outline.  
The proportion contribution of plants in Libicare® should be indicated.  
There has to be clarity as to what day of menstrual cycle blood was collected to meas ure 
testosterone and SHBG since both vary over the menstrual cycle. Was menstrual timing similar 
for the whole cohort or was it per individual. I would be wary of blood collection at random days 
not synchronised by cycle day.  
 
RESULTS  
Results are clearly pr esented and are consistent with objectives of study and methods  
 
DISCUSSION  
Some discussion of mechanisms of action were expected here (testosterone, flibanserin). What 
are treatment options targeting mechanistically?  
As mentioned earlier, authors continual ly attribute observed effects to Trigonella - yet this is 
multi -herbal intervention. Indeed authors allude to studies with Tribulus terrestris as possessing 
hypoactive sexual desire improving effects and Gingko biloba and  Turnera diffusa also playing 
a role. 
This reviewer therefore feels that authors should discuss Libicare® in its entirety without 
necessarily attributing observed effects to just the one plant - Trigonella.  
 
Spelling errors  
There are several spelling errors in the document  
e.g. Methods (Laboratory tests) - sex hormone blinding globulin (should be binding)  
Results - different **ducational and economic backgrounds (missing an 'e')  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the ma nuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of writ ten English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reim bursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
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2. Do you hold any stocks or shares in an organisation that may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, fund ing, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing int erests  
 
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