No needles. No gel to rub in. No cream to apply and wait for it to dry. For a lot of men searching for testosterone replacement therapy (TRT), a tablet sounds ideal. And it’s why ‘testosterone pills’ is one of the most searched terms in men’s health.

Testosterone pills do exist. At Leger, we prescribe Kyzatrex, which is a modern oral testosterone capsule now available in the UK. But pills aren’t exactly a shortcut. They still need the same blood tests, clinical assessment, and ongoing monitoring like any other form of TRT[1]. This guide explains how oral testosterone works, why it’s been underused in the past, and whether it might be appropriate for you.

Contents

• What are testosterone pills?
• Do testosterone pills work?
• Are testosterone pills safe?
• Why aren’t testosterone pills used more often?
• Am I suitable for oral TRT?
• Can you buy testosterone pills online in the UK?
• FAQs

Firstly, what are testosterone pills?

When someone searches for testosterone pills, they could mean one of three different things:

• Prescribed oral testosterone, a licensed medication, like Kyzatrex, which is a form of TRT.
• Testosterone boosters, over-the-counter supplements marketed for energy or libido, often containing zinc, D-aspartic acid or herbal extracts.
• Anabolic steroids, androgenic drugs, often bought online or through gym contacts, used outside a medical framework.

These are not the same thing, and they carry different risks and expectations. In this article, testosterone pills means Kyzatrex, a prescribed oral TRT.

Testosterone pills vs boosters vs anabolic steroids

You can read more about the difference between the two in our blog, TRT vs steroids. 

Do testosterone pills work?

Yes, modern oral testosterone can work, but only if the formulation is right. Here’s why that matters.

When you swallow most medicines, they pass through the gut and then the liver before reaching the bloodstream. For testosterone, this is a problem. The liver breaks most of it down before it can do anything useful. That’s why older oral testosterone options were either unreliable or linked to liver toxicity. Some earlier tablets, known as 17-alpha-alkylated compounds, carried real risks for the liver [2].

Kyzatrex solves this problem. Its capsule is made with lipids, or fats, that allow the testosterone to be absorbed through the intestinal lymphatic system, essentially bypassing much of the liver [3]. Once in the circulation, the testosterone is released and becomes active.

How effective is Kyzatrex?

In a clinical trial of 127 men, Kyzatrex restored testosterone to normal levels in 96% of men with low testosterone by day 90 [4]. Using a more conservative “worst-case” analysis, 88% had normal testosterone levels at day 90 [5].

In the same trial, mean free testosterone levels approximately doubled by day 90, while mean SHBG fell by around 30%. This suggests Kyzatrex increased not only total testosterone, but also the amount of testosterone more readily available to the body. Individual responses vary, which is why treatment still needs follow-up blood tests and symptom review.

How is it taken?

Kyzatrex is taken twice daily with food and comes in three capsule strengths: 100 mg, 150 mg and 200 mg. Your clinician can adjust the prescribed dose based on your response and blood testosterone levels [6].

Are testosterone pills safe?

Kyzatrex can be safe for suitable men when prescribed and monitored correctly. But just like any TRT, it comes with risks, especially if it’s not properly monitored.

Before and during testosterone replacement therapy (TRT), your clinician will usually monitor your testosterone levels, red blood cell counts, haematocrit, blood pressure and prostate specific antigen (PSA), where appropriate. This helps check whether treatment is working and whether it may increase the risk of side effects over the long term [1].

Blood pressure

The most commonly reported side effect of Kyzatrex is an increase in blood pressure [7]. High blood pressure matters because it’s one of several factors linked with cardiovascular risk, including heart attacks and strokes. That doesn’t mean TRT directly causes heart attacks, but it does mean blood pressure and wider risk factors should be reviewed before and during treatment.

Studies suggest blood pressure increases tend to plateau around 120 days [8]. It’s more pronounced in men who already have treated high blood pressure. If you have uncontrolled high blood pressure, oral TRT is unlikely to be appropriate for you.

Standard TRT risks still apply

Oral TRT is still TRT. The same monitoring considerations apply as with injections or gels: haematocrit, prostate health, oestrogen levels, symptoms and wellbeing. This is why TRT requires regular blood tests rather than a one-off prescription.

Other potential side effects include:

• Raised haematocrit, which can increase blood clot risk
• Acne or oily skin
• Fluid retention
• Mood changes or irritability
• Changes in oestrogen levels
• Reduced sperm production and fertility, important if you are planning to have children
• Worsening of sleep apnoea in susceptible men

Find out more about the risks of TRT.

Do testosterone pills damage the liver?

Kyzatrex isn’t a 17-alpha-alkylated androgen, the older class of oral androgen associated with liver toxicity. It’s designed to avoid first-pass liver metabolism that made earlier oral testosterone products problematic. We still assess liver function as a safety precaution, but liver toxicity is not considered a key concern with Kyzatrex in the way it was with older oral formulations [8].

Why aren’t testosterone pills used more often for TRT?

If it’s effective and convenient, you might be wondering why oral testosterone isn’t more popular. The short answer is history and formulation.

For decades, oral testosterone wasn’t a viable option. Early formulations were unreliable, either absorbed too inconsistently to maintain stable levels, or toxic to the liver. Injectable and transdermal options became the established standard because they worked reliably.

Modern oral testosterone undecanoate, the type used in Kyzatrex, has solved the absorption problem. It’s a newer formulation with a well-characterised safety and efficacy profile [3]. But prescribing habits and clinical familiarity tend to lag behind the evidence, and gels and injections remain more widely used in TRT pathways.

Kyzatrex has been available in the US since 2022 and is now accessible in the UK, where Leger offers it as an oral TRT option for suitable patients.

Am I suitable for Kyzatrex?

Oral TRT may be a good fit if you:

• Have confirmed testosterone deficiency and relevant symptoms
• Strongly prefer to avoid injections or find gels inconvenient
• Are comfortable taking two capsules daily with meals
• Are willing to have regular blood tests and monitoring

Who might not be suited to testosterone pills?

Medications like Kyzatrex are less likely to be appropriate if you [7]:

• Haven’t had blood tests confirming low testosterone
• Are primarily looking for performance enhancement rather than treating a deficiency
• Have poorly controlled high blood pressure
• Have or might have prostate cancer
• Are planning to conceive in the near future and haven’t discussed fertility options

Find out more about the pros and cons of different treatment types.

Can you buy testosterone pills online in the UK?

Be careful. There’s a big difference between prescribed oral testosterone through a regulated service and testosterone from an unregulated website or gym supplier. At Leger, testosterone pills are only offered when blood tests and a clinical assessment support a diagnosis of testosterone deficiency.

Any source that doesn’t require blood testing, doesn’t involve a prescribing clinician, or can’t confirm the medicine comes from a licensed pharmacy is not a safe route to TRT. The absence of monitoring is where the real risk lies, not just in what you’re taking, but in what you’re not checking.

The bottom line

Testosterone pills are real, they can work, and, with the right formulation, they can be a safe and convenient form of TRT. Kyzatrex represents a genuine step forward in oral testosterone therapy: better absorbed than older oral options, not a 17-alpha-alkylated androgen, and backed by clinical trial data. But a pill isn’t a shortcut. If your testosterone is genuinely low and you’re looking for an option that doesn’t involve needles or daily gel, Kyzatrex is worth discussing.

If you’re considering TRT but aren’t sure where to start, use our Get Started tool.

FAQs

Can you get testosterone pills in the UK?

Yes, oral testosterone exists, and testosterone undecanoate is listed by the BNF as an oral option for androgen deficiency. In practice, gels, creams and injections are often more commonly used, and the right option depends on clinical suitability, availability and monitoring needs.

Do testosterone pills work?

Some prescription oral testosterone formulations can work. Clinical studies of newer oral testosterone undecanoate formulations have shown that they can restore testosterone levels in men with hypogonadism. However, they need to be prescribed, taken correctly and monitored.

Are testosterone pills safe?

They can be safe for some men when prescribed appropriately, but they are not risk-free. Oral testosterone may affect blood pressure in some men, and all TRT requires monitoring of symptoms, testosterone levels, haematocrit and prostate risk where appropriate.

Are testosterone pills the same as testosterone boosters?

No. Testosterone pills used in TRT are prescription medicines. Testosterone boosters are supplements and are not the same as TRT.

Are testosterone pills safer than injections?

Not necessarily. Pills may avoid needles, but they’re not automatically safer. The safest TRT option depends on your diagnosis, blood results, medical history, dose, response to treatment and monitoring.

Can you buy testosterone pills online?

You shouldn’t buy testosterone from unregulated websites, social media sellers, gym contacts or overseas suppliers. Legitimate testosterone treatment should involve blood testing, a medical review, prescription and ongoing monitoring.

Do testosterone tablets damage the liver?

Some older oral androgens were associated with liver toxicity, which is one reason oral testosterone historically had a cautious reputation. Modern testosterone undecanoate is formulated differently, but it still needs proper prescribing and monitoring.

Do you need blood tests before taking testosterone pills?

Yes. TRT should not be started without appropriate blood testing and clinical assessment. Guidelines recommend diagnosing testosterone deficiency only when symptoms and consistently low testosterone levels are both present.

Are testosterone pills available on the NHS?

Testosterone treatment may be available through the NHS for men who meet clinical criteria, but the treatment offered varies by local pathway, specialist recommendation and formulary availability. Gels and injections are more commonly used than oral testosterone in many pathways.

References

1. British Society for Sexual Medicine. Guidelines on male adult testosterone deficiency, with statements for UK practice. https://pmc.ncbi.nlm.nih.gov/articles/PMC10307648/
2. Kyzatrex prescribing information. Hepatic adverse effects and distinction from 17-alpha-alkylated androgens. https://www.kyzatrex.com/wp-content/uploads/2025/10/KYZATREX-PI-2025-UPDATED-PDF.pdf
3. Kyzatrex prescribing information. Oral testosterone undecanoate formulation and absorption. https://www.kyzatrex.com/wp-content/uploads/2025/10/KYZATREX-PI-2025-UPDATED-PDF.pdf
4. Kyzatrex clinical efficacy data. https://www.kyzatrex.com/why-kyzatrex/
5. Marius Pharmaceuticals. Published phase 3 data for Kyzatrex. https://mariuspharma.com/news/marius-pharmaceuticals-announces-final-published-phase-3-data-from-mrs-tu-2019ext-studying-the-safety-and-efficacy-of-fda-approved-kyzatrex-testosterone-undecanoate-ciii-capsules/
6. Kyzatrex prescribing information. Dosing, strengths and administration with food. https://www.kyzatrex.com/wp-content/uploads/2025/10/KYZATREX-PI-2025-UPDATED-PDF.pdf
7. Kyzatrex prescribing information. Contraindications, warnings, adverse reactions and blood pressure monitoring. https://www.kyzatrex.com/wp-content/uploads/2025/10/KYZATREX-PI-2025-UPDATED-PDF.pdf
8. White WB, Dobs A, Carson C, et al. Effects of a novel oral testosterone undecanoate on ambulatory blood pressure in hypogonadal men. https://pmc.ncbi.nlm.nih.gov/articles/PMC8678838/