Abstract

Testosterone replacement therapy (TRT) is evolving, with oral testosterone pills emerging as a convenient alternative to injections and topical treatments. This article explores Testosterone Undecanoate (Kyzatrex), Bioidentical Testosterone, and Oxandrolone (Anavar)—three widely used oral options for managing low testosterone (hypogonadism). We discuss the mechanisms, benefits, safety profiles, and ideal candidates for each type, as well as the differences between bioidentical vs. synthetic testosterone formulations. Additionally, we compare testosterone troches vs. pills, outlining absorption rates and treatment efficacy. As more men seek FDA-approved and doctor-prescribed TRT solutions online, this resource serves as a practical guide to making informed decisions about testosterone therapy and hormone optimization.

Introduction

Testosterone pills are becoming a popular treatment option for testosterone replacement therapy (TRT) to treat low T, medical condition known as hypogonadism [1]. Thanks to the recent attention by Department of Health and Human Services leaders and national scientific community leaders bringing more attention to the issue of hypogonadism, or “andropause,” more people are on TRT today than ever before; popularized by celebrities and figures such as Robert F. Kennedy Jr. and Alan Ritchson [2]. With the advancements in TRT, new options like testosterone undecanoate tablets (Kyzatrex) combined with tried and tested gold standard therapies like oxandrolone (Anavar), the landscape has been changing for testosterone health. 

Along with the changing landscape, the other challenge for men seeking treatment for low T is that the average primary care physicians are not traditionally trained to detect and treat symptoms advanced such as testosterone and hormone health. This is because medical education curriculums have the highest burdens of proof and evidence required (appropriately so, considering it is the basis for training hundreds of thousands of doctors worldwide, dictating the future of medicine) which results in medical education frequently lagging 10 years behind to latest advancements [3].

Without men being able to talk to their doctors about these sensitive concerns, many people frequently end up trying to get their health education from Google searches for medical topics which is about as useful as every headache being called “potentially brain tumor” on websites such as WebMD. Add to the fact that the latest published researches and sciences is usually limited to access by the lay public as the high powered papers and articles will be behind paywalls if published exclusively through some of the highest impact factor medical journals (have the highest prestige for the institution and the authors to donate their work for publication in these journals). Resultantly, millions of men now seek to get their health education and insights from trusted figures online such as celebrity doctors Dr. Mark Huberman and Joe Rogan, who share their findings on health facts after their team of researchers does the primary research on topics of health for their listeners and audience. Our team of expert medical professionals, scientists, and doctors here will discuss the types, benefits, side effects, and profiles of treatment options on the topic of testosterone pills.

What Are Testosterone Pills?

Testosterone pills are an oral form of TRT designed to boost testosterone levels in men experiencing symptoms like fatigue, low libido, and reduced muscle mass. They work by supplementing or stimulating natural testosterone production, helping restore hormonal balance. Depending on the formulation and type of testosterone pill the mechanisms are different. For instance, bioidentical testosterone pills vs non-bioidentical testosterone (aka synthetic) pills.

 

Most Popular Testosterone Pills

1. Testosterone Undecanoate (Kyzatrex):
• What It Is: Kyzatrex is a new FDA-approved oral testosterone replacement therapy that uses testosterone undecanoate, a safer formulation that bypasses the liver and is absorbed through the lymphatic system.
• Why It’s Important: Unlike older testosterone pills, Kyzatrex offers improved safety, fewer liver-related side effects, and consistent hormone delivery.
• Who It’s For: Men seeking a convenient, non-invasive option to address low testosterone for benefits such as improving quality of life [4].
• Where to buy oral testosterone online
2. Bioidentical testosterone:
• What It Is: Form of testosterone that has the exact same molecular structure as the hormone naturally produced by the body. Not FDA approved. Lower bioavailability.
• Why It’s Important: Balance of potentially lower side effect profile compared to synthetic but also has less reliable absorption (milder brother of the synthetic testosterone family)
• Who It’s For: Men that have a tendency to be more sensitive to the side effects caused by medications like synthetic testosterone.
• Where to buy bioidentical testosterone online
3. Oxandrolone (Anavar):
• What It Is: A synthetic anabolic steroid often used off-label to support testosterone therapy. Considered more so a testosterone derivative than a true testosterone pill used for TRT.
• Why It’s Important: As a synthetic testosterone derivative, this medication is made to be targeted for anabolic muscle growth with potency rather than the all-purpose general effects of testosterone pills.
• Who It’s For: Due to the high potency effects of anabolic muscle growth, oxandrolone is most frequently used by bodybuilders and athletes.
• Where to buy anavar online

 

Troche vs. Pills: What’s the Difference?

When looking at oral testosterone (as opposed to injection, topical gels creams or patches) options, in addition to pills there are also testosterone troches as an alternative to those that don’t like to swallow pills:

• Troches (Sublingual Lozenges):
• Troches dissolve under the tongue, allowing testosterone to enter the bloodstream directly (think sucking on a hard candy – usually troches have a mild sweetness to them) [6-7].
• Benefits: Avoids liver metabolism, provides faster absorption [8-9].
• Who Should Consider: Men who want the fastest-acting alternative to pills.
• Pills:
• Testosterone pills are swallowed and metabolized through the digestive system or lymphatic system.
• Benefits: Easy to use and discreet, offering a longer-acting effect compared to troches.
• Who Should Consider: Men who prefer a once-a-day dosing routine without the hassle of dissolving lozenges [10].

Benefits of Testosterone Pills

1. Convenience: No needles or messy applications required.
2. Discretion: Easy to carry and take without drawing attention.
3. Safety of others around you: No chance of cross contamination or transference as is with gels and creams.
4. Improved Testosterone Levels: Boosts energy, libido, and mood.
5. Muscle Growth: Supports strength and recovery for active men.

Side Effects of Testosterone Pills

While testosterone pills are generally safe when prescribed by a healthcare provider, they may cause:

1. Common Side Effects:
• Acne
• Hair thinning
• Fluid retention
• Increased red blood cell count
2. Rare Risks:
• Liver toxicity (with older formulations like methyltestosterone)
• Worsened sleep apnea
• Cardiovascular issues if misused [5]
3. Troche-Specific Risks:
• Gum irritation or sensitivity
• Fluctuations in testosterone levels

Regular monitoring with blood tests ensures safe and effective treatment.

Are Testosterone Pills Safe?

Yes, newer formulations like Kyzatrex and testosterone troches are considered safe when prescribed by a healthcare provider. They bypass the liver, reducing risks of liver damage, and provide more stable hormone levels compared to older options like methyltestosterone.

However, improper use of testosterone pills or non-prescription alternatives can lead to serious health risks, including hormonal imbalances and cardiovascular complications. Always consult a healthcare provider before starting TRT.

 

Who Should Consider Testosterone Pills?

You may benefit from testosterone pills if you:

• Have symptoms of low testosterone confirmed by blood tests.
• Prefer a non-invasive treatment over injections or gels.
• Want a convenient and discreet option for managing hormone levels.
• Are looking for a safer oral alternative, like Kyzatrex, with fewer side effects.

 

FAQs About Testosterone Pills

Are Oral Testosterone Pills as Effective as Injections?

Yes, new oral formulations like Testosterone Undecanoate (Kyzatrex) bypass the liver, offering a safer, more convenient alternative to testosterone injections.

Where Can I Buy Testosterone Pills Online?

You can buy FDA-approved testosterone pills like Kyzatrex online through licensed telehealth providers like Forty Health, ensuring safe, legal, and effective TRT.

Can Testosterone Pills Help Build Muscle?

Yes, testosterone pills can support muscle growth and recovery as they are most popularly known for. However, TRT has many other benefits such as reducing brain fog, increasing mental cognition, and increasing energy and stamina.

What is the Best Testosterone Pill for Low T?

The best testosterone pill depends on your needs—Testosterone Undecanoate (Kyzatrex) for FDA-approved TRT, bioidentical testosterone for a natural approach, or Oxandrolone for muscle enhancement.

How Do Troches Compare to Pills?

Troches dissolve under the tongue for faster absorption, while pills offer longer-lasting effects. The choice depends on your preferences and lifestyle.

What About Oxandrolone for Testosterone Therapy?

Oxandrolone is not a primary TRT medication but is sometimes used to enhance muscle mass and performance alongside TRT.

Why Choose Forty Health for Testosterone Replacement Therapy?

At Forty Health, we are leaders in men’s health, offering cutting-edge solutions tailored to your needs.

• Comprehensive Options: From Testosterone Undecanoate, Kyzatrex, oxandrolone, Anavar, stanozolol, and trenbolone, we provide the latest and safest treatments.
• Expert Team: Our world-renowned clinical team ensures you receive the highest quality care, prescribing medications only to those patients and customers that medically qualify.
• Proven Results: Our doctors have helped to save the lives of countless men around the country.

Take the Next Step Toward Better Health

If you’re considering buying oral TRT online, Forty Health is here to guide you. With proven solutions and personalized care plans, we’ll help you feel like your best self again.

Buy TRT online today and discover the Forty Health difference—the #1 premium American men’s health clinic.

 

 

References

1. Kresch E, Patel M, Lima TFN, Ramasamy R. An update on the available and emerging pharmacotherapy for adults with testosterone deficiency available in the USA. Expert Opin Pharmacother. 2021 Sep;22(13):1761-1771. doi: 10.1080/14656566.2021.1918101. Epub 2021 Apr 23. PMID: 33866902.

2. Mulhall JP, Trost LW, Brannigan RE, Kurtz EG, Redmon JB, Chiles KA, Lightner DJ, Miner MM, Murad MH, Nelson CJ, Platz EA, Ramanathan LV, Lewis RW. Evaluation and Management of Testosterone Deficiency: AUA Guideline. J Urol. 2018 Aug;200(2):423-432. doi: 10.1016/j.juro.2018.03.115. Epub 2018 Mar 28. PMID: 29601923.

3. Qaseem A, Horwitch CA, Vijan S, Etxeandia-Ikobaltzeta I, Kansagara D; Clinical Guidelines Committee of the American College of Physicians; Forciea MA, Crandall C, Fitterman N, Hicks LA, Lin JS, Maroto M, McLean RM, Mustafa RA, Tufte J. Testosterone Treatment in Adult Men With Age-Related Low Testosterone: A Clinical Guideline From the American College of Physicians. Ann Intern Med. 2020 Jan 21;172(2):126-133. doi: 10.7326/M19-0882. Epub 2020 Jan 7. Erratum in: Ann Intern Med. 2023 Apr;176(4):584. doi: 10.7326/L23-0043. PMID: 31905405.

4. Elliott J, Kelly SE, Millar AC, Peterson J, Chen L, Johnston A, Kotb A, Skidmore B, Bai Z, Mamdani M, Wells GA. Testosterone therapy in hypogonadal men: a systematic review and network meta-analysis. BMJ Open. 2017 Nov 16;7(11):e015284. doi: 10.1136/bmjopen-2016-015284. PMID: 29150464; PMCID: PMC5701987.

5. Lincoff AM, Bhasin S, Flevaris P, Mitchell LM, Basaria S, Boden WE, Cunningham GR, Granger CB, Khera M, Thompson IM Jr, Wang Q, Wolski K, Davey D, Kalahasti V, Khan N, Miller MG, Snabes MC, Chan A, Dubcenco E, Li X, Yi T, Huang B, Pencina KM, Travison TG, Nissen SE; TRAVERSE Study Investigators. Cardiovascular Safety of Testosterone-Replacement Therapy. N Engl J Med. 2023 Jul 13;389(2):107-117. doi: 10.1056/NEJMoa2215025. Epub 2023 Jun 16. PMID: 37326322.

6. Salehian B, Wang C, Alexander G, Davidson T, McDonald V, Berman N, Dudley RE, Ziel F, Swerdloff RS. Pharmacokinetics, bioefficacy, and safety of sublingual testosterone cyclodextrin in hypogonadal men: comparison to testosterone enanthate--a clinical research center study. J Clin Endocrinol Metab. 1995 Dec;80(12):3567-75. doi: 10.1210/jcem.80.12.8530600. PMID: 8530600.

7. Stuenkel CA, Dudley RE, Yen SS. Sublingual administration of testosterone-hydroxypropyl-beta-cyclodextrin inclusion complex simulates episodic androgen release in hypogonadal men. J Clin Endocrinol Metab. 1991 May;72(5):1054-9. doi: 10.1210/jcem-72-5-1054. PMID: 1902483.

8. Dinsmore WW, Wyllie MG. The long-term efficacy and safety of a testosterone mucoadhesive buccal tablet in testosterone-deficient men. BJU Int. 2012 Jul;110(2):162-9. doi: 10.1111/j.1464-410X.2011.10837.x. Epub 2012 Jan 31. PMID: 22288877.

9. Ross RJ, Jabbar A, Jones TH, Roberts B, Dunkley K, Hall J, Long A, Levine H, Cullen DR. Pharmacokinetics and tolerability of a bioadhesive buccal testosterone tablet in hypogonadal men. Eur J Endocrinol. 2004 Jan;150(1):57-63. doi: 10.1530/eje.0.1500057. PMID: 14713280.

10. Kresch E, Patel M, Lima TFN, Ramasamy R. An update on the available and emerging pharmacotherapy for adults with testosterone deficiency available in the USA. Expert Opin Pharmacother. 2021 Sep;22(13):1761-1771. doi: 10.1080/14656566.2021.1918101. Epub 2021 Apr 23. PMID: 33866902.

 

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Article Information

Author: Hisham M. Valiuddin, DO, MBA
Affiliations: Department of Men's Health, Forty Health, Ellicott City, Maryland.

Accepted for Publication: February 21, 2025
Published: March 4, 2025
DOI: 10.6084/m9.figshare.28462595

Open Access: This is an open-access article distributed under the terms of the CC-BY License. © 2025 Hisham M. Valiuddin, Forty Health.

Corresponding Author:
Hisham M. Valiuddin, MD
Forty Health, Ellicott City, MD
support@fortyhealth.com

Author Contributions

Concept and Design: Valiuddin
Drafting of the Manuscript: Valiuddin
Critical Review for Intellectual Content: Valiuddin
Data Acquisition, Analysis, and Interpretation: Not applicable (informational review).

Conflict of Interest Disclosures

Dr. Valiuddin is affiliated with Forty Health, a telehealth provider specializing in testosterone replacement therapy (TRT) and men’s health optimization. No external conflicts of interest were reported.

Funding/Support

This article was independently developed by Forty Health. No external funding sources were involved.

Role of the Sponsor

Forty Health had no influence over the research, writing, or conclusions of this publication beyond general topic guidance.