Troche
Apomorphine / Sildenafil / Tadalafil / Vardenafil Troches
Quad-mix troche combining three PDE5 inhibitors with apomorphine dopamine agonist for maximum potency and comprehensive mechanism.
4, 8 or 12 troches per month
Starting at $69/mo
Women's healthDesireCompounded
Female Desire Troches
RxPrescription onlyDissolved under the tongue · As needed, 20–30 min before · Women's health · Desire · Compounded
Starting at $59/mo
A berry troche with apomorphine, bremelanotide (PT-141), oxytocin and L-theanine, dissolved under the tongue 20 to 30 minutes before intimacy.
How many troches per month?
MonthlyEvery 3 months
4 trochesper month
8 trochesper month
12 trochesper month
You'll receive 8 troches per month. $99 billed monthly. Cancel anytime.
Real prices from our pharmacy. Longer plans cost less per month and are billed up front. Pause or cancel anytime.
- Acts on desire pathways in the brain
- As needed, no daily pill
- Dissolves under the tongue
Every plan includes
- Personalized, physician-guided plan
- 4, 8 or 12 troches per month, monthly and 3-month
- Dispensed by a US-licensed compounding pharmacy
- Unlimited protocol adjustments and messaging
- Ongoing support and check-ins
- Pause or cancel anytime
- Reviewed by our in-house physicians
- Physician-guided care
- Ongoing, expert support
- 100% online
- Free, discreet shipping
What is in the troche?
(desire troche)
Bremelanotide and apomorphine act on brain pathways tied to desire and arousal; oxytocin supports bonding; L-theanine is added for calm.
- How it is taken
- Dissolved under the tongue
- How often
- As needed, 20–30 min before
- Form
- Women's health · Desire · Compounded
Vyleesi
the approved injectable form of bremelanotide for low desire in premenopausal women
This troche is a compounded, off-label combination; absorption of peptides under the tongue is variable.
How it works,
week by week.
Day 1
A physician reviews your symptoms, cycle or menopause stage, medications and goals, and chooses the product.
First uses
Use as directed; notice how your body responds and any local sensation.
Weeks 2-4
Response becomes clearer. Daily moisturizers need a few weeks for full effect.
Month 1
Check-in: adjust the product, add or change hormones if needed.
Beyond
Regular reviews as your needs change.
What you may notice,
and when.
Desire and arousal
support where it starts
Sensitivity
better local response
Comfort
less dryness and discomfort
Physician oversight
a plan built around you
Individual results vary. Benefits reflect what Zepym Health members commonly report to their physician at check-ins; they are not the results of a clinical trial.
Safety first:
what to know before you start.
Important safety information and common side effects
These products are used externally or dissolved in the mouth. Common effects are local warmth, tingling or irritation; with the desire troche, nausea, flushing and headache. Creams containing sildenafil must never be used with nitrates. Do not use during pregnancy or breastfeeding without your physician's approval. Stop and contact us if you have burning, a rash, or unusual discharge.
The research behind
arousal products for women.
These are compounded creams and troches for women, containing sildenafil, arginine, theophylline, oxytocin, apomorphine or bremelanotide. The most serious trial is of a sildenafil cream, which is still investigational. The other ingredients have no published trial in these products.
- Sildenafil cream200 women
A 2024 phase 2b placebo-controlled trial randomized 200 women with female sexual arousal disorder to sildenafil cream (101) or placebo cream (99). The intention-to-treat result showed no significant difference on the primary endpoints; a post hoc subgroup showed a rise in arousal sensation (P = .04), which is exploratory.
Johnson et al., Obstetrics and Gynecology 2024 - Safety of the creamno more side effects
In a 12-week placebo-controlled safety study, treatment-related side effects did not differ between sildenafil cream and placebo (P above .99). Side effects were mild or moderate.
Thurman et al., Journal of Sexual Medicine 2024 - Other ingredientsno trials
We found no published trial of arginine, theophylline, oxytocin, apomorphine or bremelanotide as used in these creams or troches. Their listed roles come from how each substance works, not from proven outcomes.
PubMed search, arginine and sildenafil creams for women (2026)
What the studies found
- In a post hoc subgroup, arousal sensation rose more on sildenafil cream than placebo (least-squares mean 2.03 vs 0.08, P = .04) (Johnson et al., Obstetrics and Gynecology 2024)
- In the same subgroup, sexual distress items improved more with sildenafil cream (P of .04 or less) (Johnson et al., Obstetrics and Gynecology 2024)
- Treatment-related side effects were no more frequent than with placebo over 12 weeks (Thurman et al., Journal of Sexual Medicine 2024)
The products are compounded, and their ingredient ratios have not been tested. The trial cream was a company-made product, not the products sold here. Trials of arousal measure sensation and blood flow, which do not guarantee satisfaction. The troche combines apomorphine, bremelanotide and oxytocin, each with its own effects; that combination has not been tested.
What this does not say
- The primary result in the intention-to-treat group was not significant; the positive finding is from a subgroup analysis.
- No drug is approved in the US for female sexual arousal disorder, according to the trial reporting.
- Each ingredient can cause side effects of its own, such as nausea or flushing; the prescriber reviews them.
The research
behind it.
Bremelanotide injection improved desire and reduced distress in phase 3 trials in premenopausal women with low sexual desire.
Nausea, flushing and headache are the most common effects; avoid with uncontrolled high blood pressure.
Erections as a vital sign:
what the cohorts showWhy a change in erections is worth a heart check, what the numbers say, and what they do not.Read the researchPDE5 inhibitors:
what the trials showSildenafil, tadalafil and vardenafil compared, daily and as-needed use, and the rule on nitrates.Read the research
what the cohorts showWhy a change in erections is worth a heart check, what the numbers say, and what they do not.Read the researchPDE5 inhibitors:
what the trials showSildenafil, tadalafil and vardenafil compared, daily and as-needed use, and the rule on nitrates.Read the research
Getting started
takes a few minutes.
- 1
Connect with a physician
Answer a few questions online and a US-licensed physician reviews your health, history and goals to make sure treatment is right for you. 100% online. No in-person visit required.
- 2
Get your discreet shipment
If approved, your treatment is compounded by a US-licensed, LegitScript-certified pharmacy, inspected for quality, and shipped discreetly to your door.
- 3
Receive continuous support
Start with one goal, then keep building over time. Unlimited physician messaging, easy refills and dose adjustments, all from the Zepym Health app.
Frequently asked questions
Contact supportHow do I take Female Desire Troches?
Dissolved under the tongue, as needed, 20–30 min before. The starting prescription is one troche each time. Your physician sets your own dose and it is printed on your label.
What exactly is in it?
Apomorphine, Bremelanotide, Oxytocin, L-Theanine.
How much arrives in each shipment?
8 troches at the starting strength, shipped to your door from a licensed US pharmacy.
Is it the same as Vyleesi?
No. Vyleesi is an FDA-approved injection. This troche is compounded with several ingredients; it is prescribed off-label at your physician's judgment.
What causes low desire or arousal?
Hormones, stress, sleep, medications (especially antidepressants), relationship factors and menopause all play a part. A physician looks at the whole picture.
Do I need blood work?
Sometimes. If hormones may be involved, your physician may order tests before choosing a treatment.
Can I use these with birth control?
Yes. None of these products affect contraception.
What if it does not help?
Tell your physician. There are other options, including hormone therapy and approved medicines.
Female Desire educational content reviewed by our physician
Scott Nass, MD Doctor of Medicine, board-certified in Family Medicine
Charles R. Drew University and David Geffen School of Medicine at UCLA. Family Medicine residency at Ventura County Medical Center.
More options
in this area.
Injection
Bi-Mix Injection
Combination of papaverine and phentolamine for intracavernosal injection. Vasodilator mix for erectile dysfunction. Priapism risk and rescue requirements.
Starting at $171/mo
Cream
Climax Cream
Topical cream for female sexual enhancement and orgasm support. Combination of arginine, ergoloid, pentoxifylline, sildenafil, and theophylline.
Starting at $116/mo
Cream
Ecstasy Cream for Her
Topical cream for female sexual arousal and pleasure. Contains oxytocin, theophylline, arginine, and sildenafil for enhanced sensation and response.
Starting at $138/mo
References
- 1.Bremelanotide for hypoactive sexual desire disorder: two randomized phase 3 trials. Obstet Gynecol, 2019
- 2.Hyaluronic acid vaginal gel versus estriol cream for vaginal dryness in postmenopausal women. PubMed
Prescription products require an online evaluation with a licensed medical professional who will determine if a prescription is appropriate. Products are compounded by a licensed pharmacy. The FDA has not reviewed or approved compounded products for any use for safety, efficacy, or quality. Compounded medications are not FDA-approved brand-name products.