The U.S. Department of Defense has released comprehensive guidelines outlining a new compulsory testosterone deficiency screening policy for active-duty and reserve members aged 30 and above. This initiative follows an announcement made by U.S. Secretary of Defense Pete Hegseth in July. The guidelines are now in effect and aim to standardize screening and treatment protocols for both male and female service members, with the goal of enhancing military readiness by identifying and addressing hormonal and energy-related issues.
Hegseth, a proponent of testosterone use, introduced the mandate last month, sparking debates among experts regarding the scientific rationale behind such a policy. The U.S. Food and Drug Administration is scheduled to convene a panel of experts in mid-September to deliberate on the medical application of testosterone.
Under the new guidance, men aged 30 and over will undergo mandatory testosterone blood tests, while younger men will only be tested upon request or if symptoms are flagged by healthcare providers. For women, routine testosterone blood tests are not mandated, but screening will focus on symptoms like fatigue and irregular menstrual cycles, which can indicate hormonal imbalances and conditions such as low-energy availability and relative energy deficiency in sport.
The guidelines also outline criteria for prescribing off-label testosterone to women, particularly postmenopausal individuals experiencing significantly low libido. Some medical professionals have expressed concerns over the broad implementation of testosterone testing, citing potential risks of unnecessary or harmful treatments. They argue that the efficacy of universal screening for low testosterone in military personnel in enhancing U.S. combat readiness remains unsubstantiated.