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
TestosteroneOralCompounded
Testosterone Troches
RxPrescription onlyDissolved under the tongue · Once a day · 10–200 mg · Testosterone · Oral · Compounded
Starting at $149/mo
Compounded testosterone troches (lozenges): dissolved slowly in the mouth, absorbed through oral mucosa. Daily or twice daily dosing, customized compounding. Off-label, mimics steady testosterone.
How many troches per month?
MonthlyEvery 3 months
30 trochesper month
You'll receive 30 troches per month. $199 billed monthly. Cancel anytime.
Real prices from our pharmacy. Longer plans cost less per month and are billed up front. Pause or cancel anytime.
- Troches (lozenges) dissolve in mouth; absorbed through mucosa
- Daily dosing, customizable strength
- Alternative to injections or topical cream
Every plan includes
- Personalized, physician-guided plan
- 30 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 are testosterone troches?
(TRO-keez)
Testosterone troches are small lozenges containing compounded testosterone. You hold them in your mouth and let them dissolve slowly, 15–30 minutes. The testosterone is absorbed through the oral mucosa (inside of the mouth). Typical dose: 5–25 mg daily or twice daily, customized by compounding pharmacy. Off-label use, popular because it avoids injections and is easier than measuring sublingual liquid.
- How it is taken
- Dissolved under the tongue
- How often
- Once a day
- Dose range
- 10–200 mg
- Form
- Testosterone · Oral · Compounded
Compounded
customizable strength; oral mucosa absorption
Testosterone troches are not FDA-approved; they are compounded to order. Absorption varies based on saliva flow, mouth lesions, and individual anatomy. Your physician adjusts dose based on blood testosterone levels.
How it works,
week by week.
Day 1
US-licensed physician reviews your symptoms, medical history, and testosterone goals. Blood pressure and baseline labs (testosterone, hematocrit, PSA, liver function) are obtained.
Week 1
Start oral testosterone (Kyzatrex with meals, sublingual, or troches). No needles, no daily patch. Daily or twice-daily dosing provides steady testosterone.
Week 4
Blood work checks testosterone level. If low, dose is increased. If target is reached, dose is maintained.
Month 2–3
Follow-up labs (testosterone, hematocrit, PSA, liver function, blood pressure). Symptoms like energy, mood, libido, and erectile function are reviewed.
Beyond
Testosterone monitored every 3–6 months; hematocrit and PSA yearly. Blood pressure checked every visit. Dose adjusted as needed to keep testosterone in target range.
What you may notice,
and when.
Sustained energy and libido
steady daily testosterone supports mood and sexual function
Improved muscle and strength
testosterone builds lean mass over weeks and months
Lab-monitored safety
hematocrit, PSA, BP tracked at every visit
Close physician oversight
oral therapy requires careful management of absorption and dose
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
Oral testosterone (Kyzatrex, sublingual, troches) carries the same risks as all testosterone therapy: elevated hematocrit (polycythemia), blood pressure rise, PSA elevation, reduced fertility, and clotting concerns. Kyzatrex is FDA-approved; sublingual and troches are compounded off-label. Blood pressure must be monitored every 3–6 months; hematocrit checked at baseline and every 6–12 months. Liver function tests (AST, ALT) required before and during use. Tell your physician about high blood pressure, blood clotting disorders, heart disease, or PSA concerns. Stop and seek care for chest pain, shortness of breath, leg swelling, or signs of stroke.
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.
Troches deliver testosterone via sublingual/buccal absorption (through the rich blood supply of the oral mucosa), bypassing first-pass liver metabolism. This allows effective oral delivery without injections.
Compounded troches offer flexibility in dosing and strength. Your physician works with the pharmacy to customize your dose. Testosterone levels are checked 4–6 weeks after starting to ensure the dose is right.
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 Troches?
Dissolved under the tongue, once a day. The starting prescription is one troche (10 mg) each time. Your physician sets your own dose and it is printed on your label.
What strengths does Testosterone Troches come in?
The pharmacy carries 4: 10 mg, 25 mg, 75 mg, 200 mg. Your physician chooses which one you get.
How much arrives in each shipment?
30 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 testosterone troches?
Place the troche in your mouth between your cheek and gum, or under your tongue. Allow it to dissolve slowly over 15–30 minutes without chewing. Do not swallow pieces; let the mucosa absorb the testosterone. Avoid eating or drinking for 30 minutes before and after. Take at the same time each day.
Which oral testosterone is best, Kyzatrex or troches?
Kyzatrex is FDA-approved and pharmaceutical-grade; sublingual and troches are compounded off-label. Kyzatrex must be taken with meals (essential for absorption). Sublingual and troches offer flexibility and faster adjustments. Your physician chooses based on your preference, absorption, and response.
Will my blood pressure go up on oral testosterone?
Many men see a small rise in blood pressure on testosterone therapy (oral, injection, or topical). Some have no change. Check your BP at baseline and every 3–6 months. If it rises >10 mmHg, your physician may adjust testosterone dose, add a BP medication, or recommend lifestyle changes.
Can I switch from injections to oral testosterone?
Yes. If you have been on injections, your physician can transition you to oral testosterone. Your dose may change because absorption is different. Blood work at 4–6 weeks confirms the dose is right.
Testosterone troches 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.Kyzatrex (testosterone undecanoate) oral formulation: pharmacokinetics and clinical efficacy. J Clin Endocrinol Metab, 2018
- 2.Sublingual and buccal testosterone delivery: routes of administration for testosterone therapy. Endocrine Rev, 2018
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.