The U.S. military has elevated testosterone testing to a core component of service member health care. Male troops aged 30 and older must now undergo blood tests even without symptoms. The Pentagon says the aim is to detect hormonal abnormalities early and improve combat readiness, but the policy is drawing growing criticism from physicians who say there is insufficient scientific basis for screening the entire force.
Mandatory Testing for Men Over 30, Separate Standards for Women
According to Reuters, the U.S. Department of Defense issued detailed clinical guidance on testosterone deficiency screening and treatment for active-duty and reserve troops, taking effect immediately. The guidance follows a policy announced in July by Defense Secretary Pete Hegseth.
Under the new guidance, male service members aged 30 and older must receive blood tests to check testosterone levels. Men under 30 will be tested only if they request it or if medical staff identify signs of a problem.
Female service members are not subject to mandatory routine testosterone testing. Instead, medical staff are directed to look for symptoms associated with hormonal imbalance or low energy, such as fatigue and irregular menstrual cycles.
The guidance also sets criteria for prescribing testosterone to certain women. For postmenopausal women with abnormally low libido, medical staff may prescribe testosterone off-label at their discretion.
The Defense Department said the measure is intended to strengthen combat readiness by identifying and managing hormonal abnormalities and energy availability problems among troops.
Why Test Without Symptoms? Physicians Warn of Overtreatment
Physicians, however, are questioning whether blanket testing of male troops aged 30 and older actually translates into improved combat performance.
Testosterone levels in men can decline naturally with age, and low levels are known to be associated with reduced libido, erectile dysfunction, loss of muscle mass and mood changes. Current medical guidelines, however, recommend considering treatment only when relevant symptoms are present and low levels are confirmed in two separate blood tests.
Some doctors are concerned that broad testing extending to troops without symptoms could lead to unnecessary or potentially harmful treatment. They argue there is not enough evidence that universal screening for low testosterone among service members improves U.S. military combat readiness.
The policy comes amid an ongoing debate in the United States over expanding testosterone use. Health and Human Services Secretary Robert F. Kennedy Jr. and other Trump administration officials have argued for broader access to testosterone replacement therapy.
The Food and Drug Administration in July also proposed easing prescription restrictions on testosterone gels, pills, patches and injections. The FDA currently approves the drugs for men with abnormally low testosterone levels caused by hypogonadism.
The debate over the medical use of testosterone is expected to continue. The FDA plans to convene a panel of experts in the middle of this month to discuss the issue. With large-scale mandatory testing now underway in the U.S. military, the dispute over the benefits of expanded screening and the risk of overtreatment appears set to reignite.
