Description

Overview

Testosterone troches are sublingual or buccal tablets that dissolve in the mouth, delivering bioidentical testosterone directly into the bloodstream. They are used for testosterone replacement therapy (TRT) in men with low testosterone (hypogonadism) and sometimes in women for hormone balancing at much lower doses.

Unlike injections or topical gels, troches offer a non-invasive and convenient way to maintain stable testosterone levels. They are typically compounded at specialized pharmacies and customized based on patient needs.

Mechanism of Action

Testosterone troches are absorbed through the mucous membranes in the mouth, bypassing the liver’s first-pass metabolism (which occurs with oral testosterone pills). This allows for:

• Faster absorption compared to oral tablets
• More stable testosterone levels compared to injections
• Reduced risk of liver toxicity

Once absorbed, testosterone binds to androgen receptors in target tissues, influencing:

• Muscle and bone development
• Sexual function and libido
• Mood, energy, and cognitive function
• Red blood cell production

Benefits & Indications

1. Hypogonadism (Low Testosterone) in Men

• Improves energy levels and mood
• Increases libido and erectile function
• Enhances muscle mass and fat loss
• Supports bone density and cardiovascular health

2. Hormone Therapy in Women (Low Dose Use)

• Sometimes prescribed for low libido, mood changes, or menopausal symptoms
• Used in bioidentical hormone replacement therapy (BHRT)

3. Alternative to Testosterone Injections or Gels

• No need for painful injections
• Avoids skin contact issues seen with testosterone gels

Possible Side Effects

• Increased red blood cell production (polycythemia), raising clot risk
• Acne, oily skin, and hair loss
• Mood changes, aggression, or irritability
• Gum irritation or mouth sores (from prolonged buccal use)
• Possible suppression of natural testosterone production

Drug Interactions

• Blood thinners (Warfarin): Increased risk of bleeding
• Insulin & Diabetes Medications: May alter glucose metabolism
• Corticosteroids: Can lead to fluid retention
• Aromatase Inhibitors (Anastrozole): Sometimes prescribed alongside troches to prevent estrogen conversion