The Pentagon is moving ahead with mandatory testosterone-deficiency screening for U.S. service members aged 30 and older, lifting an early September pause on published medical guidance, officials said Thursday.
Chief Pentagon spokesman Sean Parnell said the Defense Health Agency’s (DHA’s) director issued comprehensive clinical guidance to military departments and medical providers on Sept. 17.
“Effective immediately, this guidance addresses male testosterone deficiency, establishing uniform screening and treatment pathways across the DHA enterprise and assigning responsibility for compliance,” Parnell said in a statement.
Screening is tied to annual periodic health assessments for troops 30 and older. Those younger than 30 may still request it. Treatment, if recommended, has been described as voluntary.
In early September, the Pentagon temporarily rescinded published medical guidance on the screenings “to allow for updates.” Thursday’s action puts testing back on track.
On Sept. 2, ahead of that withdrawal, the DHA posted the 35-page implementing guidance, which required testosterone-deficiency screening for male active-duty and reserve members 30 and older during the yearly health assessment.
The questionnaire asked men about diminished physical or work performance, “brain fog” or trouble concentrating, reduced endurance or muscle mass, or decreased sexual health or interest. A “yes” on any item prompted a standardized diagnostic workup.
The same Sept. 2 guidance said female service members of all ages would be screened annually for hormonal dysregulation. Those reporting fatigue, musculoskeletal pain, or menstrual changes could be evaluated for relative energy deficiency in sports, which occurs when food intake is not enough to support the body after training demands.
Women 35 and older were also to be checked for symptoms tied to perimenopause and menopause. Depending on severity, the guidance allowed modified training, limits on physical duties, or limited-duty status.
The military said the effort was meant to spot conditions that can weaken strength, endurance, and performance in the field.
Defense Secretary Pete Hegseth ordered the broader screenings in a July 15 memorandum titled “Health and Human Performance Optimization to Enhance Military Readiness.” He announced the mandate the same day in a video released on X, titled “The High-T Department of War.”
“While we invest heavily in our weapon systems, platforms, and gear, our most decisive tactical advantage will always be the individual warfighter,” Hegseth said. “We have a sacred duty to maintain that advantage, which is why we must constantly look for new ways to optimize your performance, your resilience, and your long-term health.”
He said the program was meant to ensure troops have “the right testosterone levels to operate at [their] absolute best because it’s well-established science that as we age, testosterone levels often naturally drop.”
“If treatment is recommended, it’s entirely your choice to receive testosterone replacement therapy,” Hegseth said. “By addressing these health markers early, we’re keeping you on the leading edge of lethality and giving you the same level of support that you give this nation—the absolute best.”
Parnell’s statement Thursday covered similar points.
“By proactively identifying and treating suboptimal hormone levels, the Department continues to invest in the health of its warfighters, strengthen their performance, and maximize force readiness,” he said.
The plan has drawn sharp questions from some clinicians and at least one member of Congress.
Rep. Chrissy Houlahan (D-Pa.), an Air Force veteran, criticized the new initiative.
“Secretary of Defense Hegseth wants Congress to send him another $60 billion,” she said on X on July 15. “Now he’s announcing a new government-funded testosterone screening program for every service member over 30. I’m sure the testosterone industry is thrilled. Taxpayers should ask who benefits from this latest culture-war obsession.”
Dr. Helen Bernie, a urologist and director of the Male Sexual and Reproductive Medicine Program at Indiana University, said an abnormal result should lead to more evaluation, including a second early-morning fasting test and a search for underlying causes.
“Screening for testosterone deficiency does not equal treatment,” she said.
Dr. Mohit Khera, a professor of urology at Baylor College of Medicine, recalled a service member who skipped official testing for fear a low result might snarl a deployment and force a waiver.
The man used testosterone without monitoring.
“We just take the testosterone. This way we feel better. We don’t have to worry about it,” Khera recalled him saying.
Khera called that dangerous.
“Testosterone is one of the best markers of a man’s current and future health,” he said. “If you want to know the health status of your military person, this is the best marker for a man’s overall health.”
We had a problem loading this article. Please enable javascript or use a different browser. If the issue persists, please visit our help center.