Alternatives to Testosterone If You Can't Fill Your Prescription

When Your Testosterone Prescription Can't Be Filled

If your pharmacy keeps telling you that Testosterone is out of stock, you're dealing with a problem that's affected thousands of patients since 2023. The ongoing Testosterone shortage — particularly for Testosterone Cypionate injections — has left many people scrambling for options.

The good news is there are alternatives. Some involve switching to a different Testosterone formulation. Others involve different medications entirely that can help manage low testosterone symptoms. Let's walk through your options.

What Is Testosterone and How Does It Work?

Testosterone is the primary male sex hormone produced mainly in the testes. It plays a key role in muscle mass, bone density, red blood cell production, fat distribution, sex drive, and mood.

When your body doesn't produce enough — a condition called hypogonadism — testosterone replacement therapy (TRT) supplements what your body can't make on its own. Exogenous Testosterone binds to androgen receptors in your cells and triggers the same effects as naturally produced Testosterone.

For a deeper dive, check out our article on how Testosterone works.

Alternative Testosterone Formulations

If your specific Testosterone product is unavailable, the first step is usually switching to a different formulation. All of these deliver the same hormone — they just differ in how it gets into your body.

Topical Testosterone Gel

Examples: Generic Testosterone gel, AndroGel (1% and 1.62%), Testim, Fortesta, Vogelxo

Gels are applied daily to the shoulders, upper arms, or abdomen. They provide a steady level of Testosterone throughout the day. Generic Testosterone gel can cost as little as $41–$80 per month with a GoodRx or SingleCare coupon.

Pros: Steady hormone levels, easy to use, widely available
Cons: Risk of skin-to-skin transfer to others, daily application required, can be more expensive than injections

Testosterone Patches (Androderm)

Patches are applied to the skin nightly and deliver Testosterone over 24 hours. They cost approximately $200–$500 per month without insurance.

Pros: Consistent hormone delivery, no injection required
Cons: Skin irritation at application site, cost, visible patch

Oral Testosterone Capsules

Examples: Jatenzo, Tlando, Kyzatrex

These newer oral formulations are taken with food twice daily. They avoid the liver toxicity issues associated with older oral androgens because they're absorbed through the lymphatic system. Monthly costs range from $500–$900 for brand-name versions.

Pros: No needles, no skin transfer risk
Cons: Must be taken with food, expensive, carry a boxed warning about blood pressure and cardiovascular risk

Testosterone Nasal Gel (Natesto)

Applied inside the nostrils three times daily, Natesto is a unique delivery method. It may have less impact on fertility suppression than other forms, though more research is needed.

Pros: May preserve fertility better, no skin transfer risk
Cons: Three-times-daily dosing, nasal irritation, cost

Subcutaneous Autoinjector (Xyosted)

Xyosted is a pre-filled autoinjector that you use weekly at home, injecting under the skin rather than into the muscle. It comes in 50 mg, 75 mg, and 100 mg doses.

Pros: Easy self-injection, weekly dosing, subcutaneous (less painful than IM)
Cons: Cost, may not be covered by all insurance plans

Non-Testosterone Alternatives

If you'd rather explore options beyond exogenous Testosterone — or if your doctor thinks a different approach might be better for your situation — there are a few alternatives worth discussing.

Clomiphene Citrate (Clomid)

Clomiphene is an oral medication originally developed for female fertility. When used off-label in men, it stimulates the brain (hypothalamus and pituitary) to produce more luteinizing hormone (LH), which tells your testes to make more Testosterone.

Key advantage: Unlike exogenous Testosterone, Clomiphene preserves — and may even improve — sperm production. This makes it a popular choice for younger men who want to maintain fertility.

Cost: Generic Clomiphene is inexpensive, often $10–$30 per month.

Enclomiphene

Enclomiphene is the active isomer of Clomiphene and is being used off-label and in clinical development for male hypogonadism. It works similarly to Clomiphene but with potentially fewer side effects. It's available through some compounding pharmacies and telehealth clinics.

Human Chorionic Gonadotropin (hCG)

hCG mimics LH and directly stimulates the testes to produce Testosterone. It's often used alongside TRT to prevent testicular atrophy and maintain fertility, or as a standalone treatment for men with secondary hypogonadism.

Note: hCG availability has also been affected by regulatory changes. Since 2020, the FDA has restricted compounding of hCG by some pharmacies, making it harder to obtain.

DHEA (Dehydroepiandrosterone)

DHEA is an over-the-counter supplement that serves as a precursor to both Testosterone and estrogen. Evidence for its effectiveness in treating clinically low Testosterone is limited, and it's generally not considered a replacement for TRT. However, some men with mild symptoms explore it as a supplement.

How to Choose the Right Alternative

The best alternative depends on your specific situation:

• If you want to stay on Testosterone: Switch formulations. Gels and patches are more available than injections right now.
• If fertility is a concern: Consider Clomiphene or hCG instead of exogenous Testosterone, which suppresses sperm production.
• If cost is the main issue: Generic Testosterone Cypionate with a coupon ($14–$30) or generic Clomiphene ($10–$30) are the most affordable options.
• If you want convenience: Oral capsules (Jatenzo) or the Xyosted autoinjector may work, though they're pricier.

Always discuss any changes with your doctor. Switching medications without medical guidance can lead to dosing issues, side effects, or gaps in treatment. For more information, read our guide on Testosterone drug interactions and side effects.

Final Thoughts

Not being able to fill your Testosterone prescription is stressful, but you have real options. Whether you switch to a different Testosterone formulation or explore alternatives like Clomiphene, you don't have to go without treatment.

Use Medfinder to check which Testosterone products are available at pharmacies near you, and talk to your doctor about the best next step for your situation.