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Evidence review · Searched 2026-07-31

Best peptides for men, and the one that costs something nobody quotes you

We ran 11 PubMed searches for this page and 2 returned nothing; every query and count is printed below. The finding that matters most is not about a peptide at all. The thing most men in this market end up taking is testosterone, and it suppresses sperm production — which is on the label, is measurable, and reverses on a timeline that has been quantified in 1,549 men.

The fork almost every man in this market walks into

Carrying extra weight suppresses testosterone; losing it raises the number back. So the weight-loss decision and the hormone decision arrive together, and the two ways of answering the second one are not equivalent.

Testosterone: faster, and it costs sperm

Depo-Testosterone, Precautions: “Oligospermia may occur after prolonged administration or excessive dosage.” The Clinical Pharmacology section names the mechanism — exogenous androgen suppresses pituitary LH and, at larger doses, FSH. In the classic trials, 65% of 271 men reached azoospermia at a mean of 120 days. Median recovery to 20 million per millilitre after stopping: 3.4 months, 90% within a year, across 1,549 men in 30 studies — slower with longer treatment and longer-acting esters.

The GLP-1: slower, and it leaves the axis intact

In the one randomised head-to-head — 25 men with type 2 diabetes and functional hypogonadism, semaglutide against testosterone undecanoate over 24 weeks — normal sperm morphology rose from 2% to 4% on semaglutide while sperm concentration and total count fell in the testosterone arm. Both raised total testosterone. Erectile function improved only on testosterone. A ten-study review found LH and FSH preserved or increased on GLP-1s against suppression in the testosterone comparators. Small — 25 men, open-label — and a direct comparison of exactly these two options.

Which is a real decision, and it is a lab decision. We rank providers on whether one of them can run both sides of it — most cannot. Label text read on DailyMed and trials pulled from PubMed on 2026-07-31; none of it carries over to a compounded product, which has no FDA label at all.

The muscle question, answered with the whole dataset instead of half of it

Pooled across 20 randomised trials and 15,782 people measured by DXA or MRI, lean tissue was 25.4% of the weight lost on tirzepatide, 26.8% on liraglutide and 35.2% on semaglutide. If body composition is why you are here, that molecule gap is the most actionable number on this page — and it is the reason our men's provider board prefers tirzepatide while the women's board prefers semaglutide for a completely different reason.

Now the half that usually gets left out. In the same analysis, lifestyle-only weight loss ran 26.2% lean — statistically indistinguishable from the incretins as a group. So “these drugs eat your muscle” is not what the data says. Losing weight costs lean tissue whatever causes it. The only intervention that moved the number was resistance training, at 17.5%. That is the least profitable sentence on this website and the most useful one on this page.

On the sex angle specifically, be careful what you take from it: the only sex-stratified body-composition result is a post-hoc analysis of the tirzepatide substudy — 73% fat and 27% lean in men against 75% and 25% in women, with no significant difference detected in about 43 men. That is an underpowered null, which means no difference was found, not that none exists. No equivalent analysis has been published for semaglutide.

Two men's claims we went looking for and had to drop

Hair loss is not a men's topic here. We expected it to be. In Wegovy's own §6.1 it is reported in 0.9% of men against 4% of women at 2.4 mg, and 0.2% against 8.4% at 7.2 mg; Zepbound reports 0.5% against 7.1%. Both labels attribute it to the weight reduction, not the drug. On testosterone the men's hair question is real but bounded: in trans men on long-term therapy about a third developed androgenetic alopecia, and a 37,826-patient cohort found masculinising therapy brought incidence up to — not significantly above — cisgender male baseline. Exogenous testosterone is not adding a risk men do not already carry.

There is no cardiovascular boxed warning on testosterone any more. Xyosted's and Jatenzo's labels both record it being removed in March 2025, after the TRAVERSE outcomes trial found major adverse cardiac events in 7.0% on testosterone gel against 7.3% on placebo, hazard ratio 0.96. Depo-Testosterone never had one. The only testosterone boxed warning we found still in force is on topical gels and concerns secondary exposure — virilisation reported in children who contacted an unwashed application site. What is under-reported is the rest of that same table: bone fracture 3.5% against 2.5%, non-fatal arrhythmias warranting intervention 5.2% against 3.3%, acute kidney injury 2.3% against 1.5%. Different testosterone products currently say different things about cardiovascular risk, so read the label for the product you were actually prescribed.

Every compound, and the searches behind the verdict

Ordered by the strength of the human evidence in men, not by popularity. Nothing here is a product we can be paid for, so no row carries a commercial link — the only links out of a row go to our own evidence pages and to PubMed.

  1. Testosterone (TRT)

    The one thing on this page with an approved product, a real label, and a real cost.

    Clinical outcomes

    Exogenous testosterone suppresses sperm production, and the label says so: "Oligospermia may occur after prolonged administration or excessive dosage." In 271 men on a weekly injection, 65% reached azoospermia, at a mean of 120 days. It reverses — pooled across 1,549 men in 30 studies, the median return to 20 million per millilitre was 3.4 months, with 67% recovered by six months and 90% by twelve. That is a cost you can plan around, and it is a cost nobody selling this quotes you.

    2 searches run · 1 returned nothing
    • testosterone spermatogenesis suppression recovery integrated analysis1 record

      The 1,549-man pooled analysis, still the reference for how long recovery takes and what makes it slower — longer treatment and longer-acting esters both do.

    • testosterone replacement therapy boxed warning cardiovascular 20250 records

      Nothing, because there is nothing to find: the cardiovascular boxed warnings were REMOVED from Xyosted and Jatenzo in 03/2025 after TRAVERSE. The only testosterone boxed warning still standing is on topical gels, about secondary exposure to children and women.

    PubMed, run 2026-07-31. Paste any query above to check it yourself — these are the searches behind the claim that no evidence in men exists, and a claim like that is worth nothing if you cannot repeat it.

    Sources: Pharmacia & Upjohn / Pfizer 2025; Liu PY 2006; World Health Organization Task Force on Methods for the Regulation of Male Fertility 1990; Ly LP 2005; Antares Pharma 2026

    What online TRT actually costs

  2. Semaglutide and tirzepatide

    The molecule choice, which for a man is a body-composition question.

    Clinical outcomes

    Pooled across 20 randomized trials and 15,782 people, lean tissue was 25.4% of the weight lost on tirzepatide and 35.2% on semaglutide — a real molecule-level difference on the outcome a lifter cares about. The line that does not survive the same dataset is that these drugs are unusually catabolic: lifestyle-only weight loss ran 26.2%, statistically indistinguishable from the incretins. Only resistance training moved it, to 17.5%.

    2 searches run · 1 returned nothing
    • incretin lean mass versus lifestyle intervention meta-analysis randomised20 records

      Twenty randomized trials with DXA or MRI. This is the figure to use — the widely quoted STEP 1 body-composition numbers come from a conference abstract with no PMID, and it never published a lean-fraction figure at all.

    • semaglutide lean mass sex stratified0 records

      No sex-stratified lean-mass result exists for semaglutide. Only tirzepatide has one, post hoc, in about 43 men — see below.

    PubMed, run 2026-07-31. Paste any query above to check it yourself — these are the searches behind the claim that no evidence in men exists, and a claim like that is worth nothing if you cannot repeat it.

    Sources: Eisa N 2026; Look M 2025

    Which provider can handle both sides of this

  3. GLP-1s and male fertility

    The reason the fork above is a fork and not a preference.

    Clinical outcomes

    In the one head-to-head randomized trial — 25 men with type 2 diabetes and functional hypogonadism, semaglutide against testosterone undecanoate over 24 weeks — morphologically normal sperm rose from 2% to 4% on semaglutide while sperm concentration and total count fell significantly in the testosterone arm. Both raised total testosterone. Erectile function improved only in the testosterone arm. A systematic review of ten studies found LH and FSH preserved or increased on GLP-1s, against the suppression seen in the testosterone comparators.

    2 searches run
    • semaglutide versus testosterone functional hypogonadism randomized sperm1 record

      One randomized head-to-head, n=25, open-label. That is the entire direct evidence base, and it is small — but it is a randomized comparison of exactly the two choices this page is about.

    • GLP-1 receptor agonist male reproductive hormones semen parameters systematic review10 records

      Ten studies, 639 men. Two meta-analyses disagree on whether the testosterone rise is a direct drug effect or simply the weight loss; the page reports the disagreement rather than picking one.

    PubMed, run 2026-07-31. Paste any query above to check it yourself — these are the searches behind the claim that no evidence in men exists, and a claim like that is worth nothing if you cannot repeat it.

    Sources: Gregorič N 2025; Deameh MG 2026; Salvio G 2025; Corona G 2013

  4. Hair loss — the one the brief got backwards

    Listed as a men's topic; in the labelling it is overwhelmingly a women's one.

    Clinical outcomes

    In WEGOVY's own adverse-reaction section, hair loss occurred in 0.9% of men against 4% of women on the 2.4 mg dose, and 0.2% of men against 8.4% of women on 7.2 mg. The label attributes it to the weight reduction rather than to the drug. On testosterone the men's hair question is real but modest: in trans men on long-term therapy about a third developed androgenetic alopecia, and a 37,826-patient cohort found masculinising hormone therapy brought rates up to — not above — cisgender male baseline.

    2 searches run
    • GLP-1 receptor agonist hair loss meta-analysis placebo controlled9 records

      Nine interventional studies, 4,114 GLP-1 users, pooled risk ratio about 3.3 against placebo. Real, but causality is unestablished and the leading mechanism is rapid weight loss.

    • testosterone therapy androgenetic alopecia cohort2 records

      The comparison that matters: against cisgender men the difference was not significant. Testosterone is not adding a risk men do not already carry.

    PubMed, run 2026-07-31. Paste any query above to check it yourself — these are the searches behind the claim that no evidence in men exists, and a claim like that is worth nothing if you cannot repeat it.

    Sources: Novo Nordisk 2026; Wierckx K 2014; Gao JL 2023

  5. Sermorelin and the GH-releasing peptides

    The GHRH analogues sold as the men's anti-ageing stack.

    Surrogate endpoints

    One genuinely sex-split human result exists, and it favours men: in a 1997 single-blind trial of nine men and ten women aged 55 to 71, a GHRH(1-29) analogue increased lean body mass in men only, improved insulin sensitivity in men only, and improved well-being and libido in men only — the authors' own phrase was anabolic effects favouring men more than women. Nineteen people, thirty years ago, on an analogue rather than sermorelin itself, and the authors called for further work that has not been done.

    3 searches run
    • sermorelin[Title]3 records

      Three papers: a glioma study, a 2006 editorial, a 1999 paediatric review. No adult body-composition trial.

    • (ipamorelin OR "CJC-1295") AND (men OR women OR sex)3 records

      Three records, none reporting an outcome by sex.

    • ipamorelin[Title]16 records

      Rats, ferrets, fish, doping assays and chemistry. The only human study is a pharmacokinetic one in 40 healthy men — no women were enrolled, so no sex comparison was possible.

    PubMed, run 2026-07-31. Paste any query above to check it yourself — these are the searches behind the claim that no evidence in men exists, and a claim like that is worth nothing if you cannot repeat it.

    Sources: Khorram O 1997; Teichman SL 2006; Gobburu JV 1999; Mendias CL 2026

    Sermorelin for muscle growth: what is actually known

What the providers we cover can and cannot do about this

Three of the sixteen compounded telehealth providers we review sell a GLP-1 alongside an androgen line, and only one of those sells both real testosterone and enclomiphene. Every one of the three advertises treatment guided by bloodwork, and none of them sells a blood panel at any price — so the test that should drive the decision on this page is the one thing the market has not built. Our TRT board covers the two providers that do lead with bloodwork; on both of them the medication price is the number that is never published.

For the GH-releasing peptides the routing is honest but thin: several providers sell sermorelin at a published price, and the evidence behind it is a nineteen-person trial from 1997. We rank the sellers on price transparency and say the same thing about the evidence there that we say here.

Questions we get asked

What are the best peptides for men?

Judged on evidence rather than on marketing, 4 of the 5 groups on this page have human data worth acting on, and the one with an approved product, a real label and a real cost is testosterone — which is not a peptide at all. Among the peptides, the GLP-1s have randomised evidence on outcomes people notice. The GH-releasing peptides have one sex-split result from 1997 in nineteen people. Ipamorelin's only human study was pharmacokinetics in 40 men. CJC-1295's human data stops at hormone concentrations, with no body-composition endpoint anywhere in it.

Does TRT make you infertile?

It suppresses sperm production, and the effect is usually reversible. Depo-Testosterone's Precautions section states that oligospermia may occur after prolonged administration or excessive dosage; Xyosted's section 5.7 spells out the mechanism — feedback suppression of pituitary FSH — and instructs that patients be told before deciding to start. In the classic contraception trials 65% of 271 healthy men on weekly injections reached azoospermia at a mean of 120 days. Pooled across 1,549 men in 30 studies, the median time back to 20 million sperm per millilitre after stopping was 3.4 months, with 67% recovered by six months, 90% by twelve and 96% by sixteen. Recovery was slower with longer treatment duration and longer-acting esters. Those trials used healthy men on supraphysiologic doses, so treat the numbers as a guide, not a promise. If fertility matters to you, this is a conversation to have before you start, not after.

Is there a fertility-friendly alternative to TRT?

Enclomiphene is the option usually raised. It acts at the pituitary to raise your own production rather than replacing the hormone, so it does not carry the labelled suppression of sperm output that replacement does. It is not testosterone replacement and should not be sold as though it were — one provider on our roster markets a category called Testosterone whose actual product is enclomiphene, which we call out on our TRT board. The other route is treating the cause: obesity suppresses testosterone, and weight loss raises it back, with the degree of weight loss the best predictor in a 24-study meta-analysis.

Do GLP-1s lower testosterone or cause erectile dysfunction?

No label says anything about it in either direction — searches for testosterone, erectile function and libido across the Wegovy, Zepbound, Mounjaro and Ozempic labels return nothing, so any page claiming a labelled effect is inventing it. The published evidence points the other way: a seven-study meta-analysis of 680 men found total testosterone, free testosterone, SHBG, LH and FSH all rose on GLP-1s, and a ten-study review found gonadotropins preserved or increased, against suppression in testosterone comparators. Two meta-analyses disagree on whether that rise is a direct drug effect or simply the weight loss, and we report the disagreement rather than resolving it for them. The honest limit: in the one randomised head-to-head, erectile function improved only in the testosterone arm.

Do GLP-1s cause hair loss in men?

Far less than in women, and the label puts numbers on it. Wegovy's section 6.1 reports hair loss in 0.9% of men against 4% of women on the 2.4 mg dose, and 0.2% of men against 8.4% of women on 7.2 mg. Zepbound reports 0.5% against 7.1%. Both labels attribute it to the weight reduction rather than the drug, consistent with telogen effluvium after rapid loss. On testosterone the picture is different and modest: in trans men on long-term therapy about a third developed androgenetic alopecia, but a 37,826-patient cohort found masculinising hormone therapy brought rates up to — not significantly above — cisgender male baseline.

Sources

Every label was read on DailyMed and every paper pulled from PubMed on 2026-07-31. Identifiers come from the record itself, never from recall.

  1. 1.Pharmacia & Upjohn / Pfizer DEPO-TESTOSTERONE (testosterone cypionate) injection — prescribing information U.S. Food and Drug Administration / DailyMed, 2025 — Clinical Pharmacology; Precautions — General; Adverse Reactions
  2. 2.Liu PY, Swerdloff RS, Christenson PD, Handelsman DJ, Wang C Rate, extent, and modifiers of spermatogenic recovery after hormonal male contraception: an integrated analysis. The Lancet, 2006 · PMID 16650651 · doi:10.1016/S0140-6736(06)68614-5
  3. 3.World Health Organization Task Force on Methods for the Regulation of Male Fertility Contraceptive efficacy of testosterone-induced azoospermia in normal men. The Lancet, 1990 · PMID 1977002
  4. 4.Gregorič N, Šikonja J, Janež A, Jensterle M Semaglutide improved sperm morphology in obese men with type 2 diabetes mellitus and functional hypogonadism. Diabetes, Obesity and Metabolism, 2025 · PMID 39511836 · doi:10.1111/dom.16042
  5. 5.Eisa N, Barood O Lean Mass Changes With Incretin Therapy Versus Lifestyle Intervention: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. Diabetes, Obesity and Metabolism, 2026 · PMID 41877354 · doi:10.1111/dom.70666
  6. 6.Look M, Dunn JP, Kushner RF, et al. Body composition changes during weight reduction with tirzepatide in the SURMOUNT-1 study of adults with obesity or overweight. Diabetes, Obesity and Metabolism, 2025 · PMID 39996356 · doi:10.1111/dom.16275
  7. 7.Deameh MG, Ghorbani M, Sheikhi S, et al. Effects of glucagon-like peptide-1 receptor agonists on male reproductive hormones, semen parameters, and metabolic outcomes: a systematic review. The Journal of Sexual Medicine, 2026 · PMID 41498523 · doi:10.1093/jsxmed/qdaf381
  8. 8.Salvio G, Ciarloni A, Cordoni S, et al. Effects of glucagon-like peptide 1 receptor agonists on testicular dysfunction: A systematic review and meta-analysis. Andrology, 2025 · PMID 40105090 · doi:10.1111/andr.70022
  9. 9.Corona G, Rastrelli G, Monami M, et al. Body weight loss reverts obesity-associated hypogonadotropic hypogonadism: a systematic review and meta-analysis. European Journal of Endocrinology, 2013 · PMID 23482592 · doi:10.1530/EJE-12-0955
  10. 10.Khorram O, Laughlin GA, Yen SS Endocrine and metabolic effects of long-term administration of [Nle27]growth hormone-releasing hormone-(1-29)-NH2 in age-advanced men and women. The Journal of Clinical Endocrinology and Metabolism, 1997 · PMID 9141536 · doi:10.1210/jcem.82.5.3943
  11. 11.Novo Nordisk WEGOVY (semaglutide) injection and tablet — full prescribing information (revised 6/2026) U.S. Food and Drug Administration / DailyMed, 2026 — §6.1 Adverse Reactions — Hair Loss; §13.1 Impairment of Fertility
  12. 12.Ascend Therapeutics ANDROGEL 1.62% (testosterone gel) — full prescribing information U.S. Food and Drug Administration / DailyMed, 2025 — Boxed Warning — Secondary Exposure; §6.1 TRAVERSE results; §6.2 Postmarketing
  13. 13.Antares Pharma XYOSTED (testosterone enanthate) injection — full prescribing information U.S. Food and Drug Administration / DailyMed, 2026 — §1 Limitations of Use; §5.2 VTE; §5.4 Blood Pressure; §5.7 Spermatogenesis; Recent Major Changes 03/2025
  14. 14.Teichman SL, Neale A, Lawrence B, et al. Prolonged stimulation of GH and IGF-I secretion by CJC-1295, a long-acting analog of GH-releasing hormone, in healthy adults. The Journal of Clinical Endocrinology and Metabolism, 2006 · PMID 16352683 · doi:10.1210/jc.2005-1536
  15. 15.Gobburu JV, Agersø H, Jusko WJ, Ynddal L Pharmacokinetic-pharmacodynamic modeling of ipamorelin, a growth hormone releasing peptide, in human volunteers. Pharmaceutical Research, 1999 · PMID 10496658 · doi:10.1023/a:1018955126402
  16. 16.Wierckx K, Van de Peer F, Verhaeghe E, et al. Short- and long-term clinical skin effects of testosterone treatment in trans men. The Journal of Sexual Medicine, 2014 · PMID 24344810 · doi:10.1111/jsm.12366
  17. 17.Gao JL, Sanz J, Tan N, et al. Androgenetic alopecia incidence in transgender and gender diverse populations: A retrospective comparative cohort study. Journal of the American Academy of Dermatology, 2023 · PMID 36780950 · doi:10.1016/j.jaad.2023.01.037
  18. 18.Mendias CL, Rodeo SA, Hannafin JA, et al. Safety and Efficacy of Approved and Unapproved Peptide Therapies for Musculoskeletal Injuries and Athletic Performance. Sports Medicine, 2026 · PMID 41966639 · doi:10.1007/s40279-026-02437-0
  19. 19.Ly LP, Liu PY, Handelsman DJ Rates of suppression and recovery of human sperm output in testosterone-based hormonal contraceptive regimens. Human Reproduction, 2005 · PMID 15860500 · doi:10.1093/humrep/deh834

Medical disclaimer: This content is for general educational purposes only and is not medical advice, diagnosis, or treatment. Always consult a licensed healthcare professional before starting, stopping, or changing any treatment.