Defense Secretary Pete Hegseth announced Wednesday a new policy requiring military members aged 30 and older to undergo annual testosterone screenings as part of their Periodic Health Assessments. Troops under 30 will have the option to request a screening during their assessment. This initiative is intended to combat testosterone deficiency, which can undermine a service member's health.
The announcement follows other recent fitness-related changes within the military services during Hegseth's tenure, including adjustments to physical fitness tests and body composition measurements.
Testosterone, the primary male sex hormone, plays a role in various bodily functions. According to the American Urological Association, approximately 2% of men in the United States experience low testosterone. Symptoms can include decreased libido, mood changes, fatigue, depression, anger, reduced muscle mass and strength, decreased body hair, and a decline in bone density, potentially leading to osteoporosis. Testosterone replacement therapy (TRT) may help alleviate these symptoms and has been shown in clinical trials to improve libido, anemia, bone density, lean body mass, depression, and erectile function.
Diagnosing low testosterone involves a blood test that measures total testosterone, which includes both testosterone bound to proteins and free testosterone that is more readily available for the body to use. Accurate diagnosis requires at least two separate blood draws, both conducted between 7 and 10 a.m., as testosterone levels naturally peak in the morning and fluctuate daily. Experts emphasize that a low testosterone result should initiate a broader evaluation, considering symptoms and potential reversible causes, rather than automatically indicating a need for TRT.
Testosterone replacement therapy is a prescription treatment designed to restore hormone levels to a normal range for individuals diagnosed with a deficiency. It is typically administered through gels, injections, or pellets and aims to reverse symptoms such as fatigue, mood changes, muscle loss, and low libido. However, doctors caution that increasing testosterone levels is not necessarily beneficial for longevity or athletic performance and is not approved by the FDA for such purposes. Using testosterone without a diagnosed deficiency can lead to health problems including acne, sleep apnea, skin reactions, mood disturbances, and enlarged breast tissue. It also increases red blood cell production, potentially raising the risk of blood clots, stroke, and heart attack, and can affect fertility by decreasing sperm production.
While the specifics of the Pentagon's acceptable testosterone levels and potential professional consequences for troops with lower levels remain unclear, Hegseth indicated that service members diagnosed with low testosterone would have the option to pursue testosterone replacement therapy. Experts suggest that knowing one's baseline testosterone level can be an important indicator of overall health, particularly for certain patient populations with conditions like diabetes, or those who have undergone chemotherapy, radiation, or narcotic use. Any individuals experiencing symptoms of low testosterone are also advised to get tested.
Females also produce testosterone, albeit at much lower levels. Low testosterone in females can signal underlying adrenal, pituitary, or ovarian disorders.