The Pentagon has implemented a new policy requiring all active-duty and reserve service members aged 30 and older, both male and female, to undergo annual screening for testosterone deficiency. This directive, ordered by Secretary of War Pete Hegseth, aims to establish a comprehensive baseline of hormone levels across the force and allow for medically appropriate testosterone therapy.
Service members younger than 30 will have the option to request this screening as part of their regular health assessments. The mandate is expected to affect hundreds of thousands of troops, though the exact number has not been specified by the Pentagon. In 2023, more than 451,000 active-duty service members were 31 or older, a figure that does not include 30-year-olds or members of reserve components. While approximately 82% of the active-duty force is male, the directive also applies to women, though the Pentagon has not yet detailed how testosterone deficiency will be defined for them.
The new protocol stems in part from advocacy by veterans like Chad Robichaux, a former Marine who experienced irritability, depression, and cognitive difficulties. Robichaux reported that his symptoms improved significantly after his hormone levels were corrected, leading him to advocate for military and veterans' health providers to investigate hormonal deficiencies as a potential cause for such issues.
"Once I got my hormones in check, I didn’t need to be on SSRIs anymore," Robichaux told Fox News Digital. "I felt like I knocked 10 to 15 years off the way I felt."
The Pentagon's policy aligns with a broader medical discussion about whether symptoms like fatigue and depression are sometimes treated with medication before underlying physiological causes, including hormonal disorders, are ruled out. Previously, testosterone testing was available but typically ordered only when a physician deemed it necessary based on a patient's symptoms or medical history.
An alliance of former special operators, members of Congress, physicians, and private hormone-treatment executives supported the screening requirement. Representative Eli Crane, a former Navy SEAL, noted that doctors had detected low testosterone among special operations members as early as 2014, attributing it to stress, physical demands, and sleep deprivation.
Factors that can contribute to low testosterone include age, obesity, diabetes, certain medications, severe illness, poor nutrition, and excessive exercise. These risk factors are particularly relevant to military personnel due to demanding training, irregular sleep patterns, and exposure to stress and injuries.
Advocates emphasized that the goal is not to place all service members on testosterone therapy. Dr. Gerry Stanley, a family physician and advisor to Core Medical, stressed the importance of evaluating a patient's symptoms alongside laboratory results and considering other potential causes. Treatments may include lifestyle changes or addressing underlying conditions, with testosterone replacement being one option when medically appropriate.
Medical guidelines generally require multiple early-morning readings, symptom evaluation, and consideration of reversible causes before diagnosing testosterone deficiency. The Endocrine Society has expressed caution, stating there is insufficient evidence to support population-level screening in asymptomatic individuals and warning of potential overdiagnosis or missed diagnoses due to variability in testosterone measurements. The organization also highlighted that testosterone therapy can reduce sperm production and recommended against it for men planning to have children in the near future.
The Pentagon has stated that military doctors will offer "targeted testosterone therapy" but has not specified the treatments or whether fertility counseling will be provided. The directive calls for updated policies by August 15, testing availability across the Military Health System, and the establishment of an advisory council of outside experts to guide implementation. The policy will also address hormonal issues in female service members, though specific details are pending.