Injection
Gonadorelin
A copy of the brain's own GnRH signal that keeps the testes producing testosterone and sperm, used alongside testosterone therapy and in fertility care. Prescribed and dosed by a licensed physician.
Starting at $159/mo
Men's healthTestosterone therapy
Testosterone Sustained-Release Troche
RxPrescription onlyTaken by mouth · Twice a day · 50–100 mg · Men's health · Testosterone therapy
Starting at $149/mo
Sustained-release testosterone troche (lozenge) 100 mg, dissolved between cheek and gum (buccal) once daily or split into 50 mg twice daily. No needles, absorbed directly into blood vessels under the mouth.
Choose your plan
Real prices from our pharmacy. Longer plans cost less per month and are billed up front. Pause or cancel anytime.
- No needles; dissolved between cheek and gum
- 100 mg once daily or 50 mg twice daily per physician direction
- Absorbed directly into blood vessels; no liver metabolism
Every plan includes
- Personalized, physician-guided plan
- Monthly, 3-month and 6-month plans
- 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 a testosterone troche?
(TES-tos-ter-own TROKE)
A troche is a small lozenge held between your cheek and gum (buccal delivery) that dissolves over 20–30 minutes, delivering testosterone directly into blood vessels under the mouth. This bypasses the liver and avoids the breakdown that happens with oral testosterone pills. Your physician sets the dose—typically 100 mg once daily in the morning or split to 50 mg twice daily (morning and evening). There are no needles, no injections, no daily cream application; you just let it dissolve. It's a good option for men who dislike injections or can't tolerate injectable oil or topical cream.
- How it is taken
- Taken by mouth
- How often
- Twice a day
- Dose range
- 50–100 mg
- Form
- Men's health · Testosterone therapy
20–30 min
time for a testosterone troche to dissolve between cheek and gum
Don't chew the troche or swallow it whole; let it dissolve slowly. Avoid eating or drinking for 30 minutes before and after to ensure full absorption.
How it works,
week by week.
Day 1
A US-licensed physician reviews your symptoms, testosterone level, health history, risk factors and labs (testosterone, hematocrit, PSA, estradiol, lipids), and sets your dose and formulation. Your treatment ships discreetly to your door.
Weeks 1–4
You begin your chosen formulation (injection, cream, or troche). Energy, mood, and libido often begin to shift. Your physician checks in by messaging.
Month 2
Lab work (usually testosterone level and hematocrit) is drawn. Your physician reviews your symptoms and adjusts the dose if needed. Most men reach stable levels by month 2–3.
Month 3
Full check-in. Your physician reviews all labs, how you feel, side effects and whether your dose is right. If acne or mood changes appear, they are usually managed by dose adjustment.
Ongoing
Testosterone therapy continues as long as it benefits you. Labs (testosterone, hematocrit, PSA, lipids) are checked at least every 6–12 months. Your physician adjusts the dose with you over time.
What you may notice,
and when.
Energy and focus
often the first change men report
Mood and confidence
as testosterone levels stabilize
Strength and recovery
lean muscle support and workout recovery improve
Sexual desire and function
often improve noticeably
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
Testosterone is a prescription hormone for symptomatic hypogonadism in men without contraindications. Common, usually temporary side effects include acne, oily skin, hair loss (or growth on the body and face), changes in mood or libido, injection-site redness or soreness, and testicular shrinkage (reversible with gonadorelin or hCG). Testosterone increases hematocrit (red blood cell concentration), which can thicken the blood and raise clot risk; your physician monitors this with lab tests and may adjust dose or suggest blood donation if hematocrit rises too high. It can worsen sleep apnea, raise blood pressure slightly, and affect cholesterol levels. Testosterone is not prescribed with a history of prostate or breast cancer, untreated or severe sleep apnea, recent heart attack or stroke, uncontrolled high blood pressure, or abnormally high hematocrit. Testosterone therapy suppresses sperm production (reversible with gonadorelin or hCG if you want to preserve fertility). If you have a partner who could be pregnant, avoid transfer of topical testosterone by washing hands thoroughly and covering the application site. Seek care immediately for chest pain, shortness of breath, unusual leg swelling, severe headache or vision changes. Tell your physician about every medication and supplement you take.
The research behind
testosterone.
Testosterone replacement is well studied in men with diagnosed low testosterone, through large randomized trials. The evidence is strongest for gels and injections; it is weaker for troches, creams and hydrogels, which were not the forms tested in those trials.
- Heart safety7.0% vs 7.3%
TRAVERSE randomized more than 5,200 men aged 45 to 80 with symptoms and low testosterone, most with heart disease or high cardiovascular risk, to daily 1.62% gel or placebo for a mean of 33 months. Major cardiac events occurred in 7.0% on testosterone and 7.3% on placebo (hazard ratio 0.96, 95% CI 0.78 to 1.17). Atrial fibrillation was more frequent on testosterone.
TRAVERSE, NEJM 2023 - Sexual functionmoderate benefit
Testosterone Trials gave men aged 65 and older with low testosterone gel for one year, raising levels to the mid-normal range of younger men. Sexual activity, desire and erectile function improved. Vitality and walking distance did not improve, and the authors said the trial was too small to judge risks.
Snyder et al., NEJM 2016 - Blood sugar12% vs 21%
In the T4DM trial, 1,007 men with overweight or obesity in a lifestyle programme received intramuscular testosterone undecanoate or placebo for two years. At two years, 2-hour glucose of 11.1 mmol/L or higher was seen in 12% of the testosterone group and 21% of the placebo group (relative risk 0.59). This was a prevention outcome in men without a hypogonadism diagnosis, not a labelled use.
Wittert et al., Lancet Diabetes Endocrinol 2021
What the studies found
- Better sexual function in older men with low testosterone: libido and, to a lesser degree, erectile function improved (Testosterone Trials, Snyder et al., NEJM 2016).
- Walking distance improved in older men with low testosterone, though vitality did not (Testosterone Trials, Snyder et al., NEJM 2016; reviewed in Snyder et al., Endocr Rev 2018).
- Mood and depressive symptoms improved slightly, while cognition did not improve (Testosterone Trials, reviewed in Snyder et al., Endocr Rev 2018).
- Hemoglobin rose in older men with unexplained anemia: 54% of treated men gained 1.0 g/dL or more, against 15% on placebo (Roy et al., JAMA Intern Med 2017).
- Lowers blood-sugar progression in overweight or obese men with impaired glucose tolerance when combined with a lifestyle programme: 12% vs 21% reached a 2-hour glucose of 11.1 mmol/L or higher at two years (T4DM, Lancet Diabetes Endocrinol 2021).
Trial results are with the studied gel or injection at the studied dose, averages across groups, not predictions for one man. Compounded and brand products were not what these trials tested. Troches, creams and hydrogels deliver the hormone differently, so the trial numbers do not transfer directly.
What this does not say
- The Endocrine Society 2018 guideline recommends testosterone for men with symptoms and consistently low levels, aiming at mid-normal values; it does not recommend it for healthy men or for preventing disease (Bhasin et al., JCEM 2018, https://doi.org/10.1210/jc.2018-00229).
- Testosterone lowers sperm production in most men, which matters if fertility is wanted.
- Long-term outcome data are limited for most forms.
The research
behind it.
Buccal testosterone delivery avoids hepatic first-pass metabolism, allowing physiologic testosterone levels with once or twice daily dosing. Clinical studies show steady testosterone levels and good patient tolerability.
Troches offer an alternative to injections and daily topical cream, with the convenience of simple dissolution. Not all men tolerate buccal delivery equally; some find it simple, others prefer injections or cream.
Testosterone beyond the gym:
what the trials show across body systemsSex drive, blood counts, bone, blood sugar and thinking: what the Testosterone Trials and T4DM found, and where the evidence stops.Read the researchTestosterone and the heart:
what TRAVERSE foundThe safety question most men ask first: heart events, fractures, prostate and blood counts, in the largest placebo-controlled trial of testosterone.Read the research
what the trials show across body systemsSex drive, blood counts, bone, blood sugar and thinking: what the Testosterone Trials and T4DM found, and where the evidence stops.Read the researchTestosterone and the heart:
what TRAVERSE foundThe safety question most men ask first: heart events, fractures, prostate and blood counts, in the largest placebo-controlled trial of testosterone.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 Testosterone SR Troche - Men?
Taken by mouth, twice a day. The starting prescription is 1 troche (50 mg) each time. Your physician sets your own dose and it is printed on your label.
What strengths does Testosterone SR Troche - Men come in?
The pharmacy carries 2: 50 mg - Berry Explosion, 100 mg - Berry Explosion. Your physician chooses which one you get.
How much arrives in each shipment?
180 troches at the starting strength, shipped to your door from a licensed US pharmacy.
Is it a controlled substance?
Yes. The law requires a live video visit with the physician before it can be prescribed.
How do I use a testosterone troche?
Place it between your cheek and upper gum (buccal) in the morning (and evening if 50 mg twice daily). Let it dissolve slowly over 20–30 minutes; do not chew or swallow. Avoid eating, drinking or rinsing your mouth for 30 minutes before and after to maximize absorption. Your physician will show you exactly where to place it.
Do I need to take gonadorelin or hCG with testosterone?
Not necessarily. Gonadorelin or hCG are used if you want to preserve sperm production and testicular size while on testosterone therapy. Without them, the testes will shrink slightly and sperm production will stop—effects that reverse if you stop testosterone. Your physician discusses your priorities.
What labs do I need on testosterone therapy?
At baseline and regularly (every 6–12 months): testosterone level, hematocrit (to check for polycythemia), PSA (to screen for prostate concerns), estradiol (some testosterone converts to estrogen), and lipids (cholesterol and triglycerides). Your physician explains what the results mean and adjusts your dose based on them.
Can I stop testosterone therapy anytime?
Yes. Testosterone therapy is not a lifetime commitment; you can pause or stop. If you stop suddenly, testosterone levels will fall over days to weeks (depending on formulation) and you may feel the original hypogonadism symptoms return. Your physician helps you taper if you choose, and many men simply stop and restart later if they need to.
Testosterone troche 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.
Capsule
Anastrozole - Men
A low-dose aromatase inhibitor for men on testosterone therapy whose blood work shows high estradiol, easing breast tenderness and water retention. Slow-release capsule, prescribed and dosed by a licensed physician.
9 capsules per month
Starting at $63/mo
Capsule
Anastrozole Capsules
Anastrozole, an aromatase inhibitor used in men to control estrogen levels during testosterone therapy. Prescribed and dosed by a licensed physician.
9 capsules per month
Starting at $63/mo
Tablet
Anastrozole Tablets
FDA-approved anastrozole tablets, an aromatase inhibitor used at low doses in men on testosterone therapy whose estradiol runs high. Prescribed by a licensed physician only after blood work.
5 tablets per month
Starting at $63/mo
References
- 1.Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab, 2018
- 2.Cardiovascular Safety of Testosterone-Replacement Therapy (TRAVERSE). N Engl J Med, 2023
- 3.Pharmacology of testosterone replacement therapy preparations. Transl Androl Urol, 2016
- 4.New testosterone buccal system (Striant) delivers physiological testosterone levels: pharmacokinetics study in hypogonadal men. J Clin Endocrinol Metab, 2004
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.