US Pentagon issues clinical guidelines on troop testosterone screening to start immediately

The U.S. Pentagon issued detailed guidance on ​Wednesday for a new, mandatory ​testosterone deficiency screening policy for active-duty ‌and ​reserve service members age 30 and older, a follow-up to Defense Secretary Pete Hegseth's July announcement. The guidance, which ‌is effective immediately, establishes standardized screening and treatment pathways for men and women that the Pentagon says are aimed at improving military readiness by identifying and managing hormonal and ‌energy-availability issues.

Hegseth, who has promoted the use of testosterone, announced the mandate last month, ‌raising questions among experts about whether there was a scientific basis for such a policy. The U.S. Food and Drug Administration plans to hold a meeting of experts to discuss medical use ⁠of ​testosterone in mid-September. According ⁠to the guidance, men age 30 and older will receive mandatory testosterone blood tests, while younger ⁠men will be tested only on request or if clinicians identify warning signs.

For women, the ​guidance does not mandate routine testosterone blood tests, but it calls for ⁠screening for fatigue and disrupted menstrual cycles that can be associated with hormonal dysregulation and conditions called ⁠low-energy availability ​and relative energy deficiency in sport. The document lays out guidelines for when it is appropriate to prescribe off-label testosterone in women, namely for postmenopausal women ⁠with unusually low sexual desire.

Doctors have raised concerns that broad testosterone testing could lead ⁠to unnecessary, or ⁠potentially harmful, treatment, saying there is little evidence that universal screening for low testosterone among military personnel would improve U.S. combat readiness.