The Pentagon has issued detailed clinical guidelines for mandatory testosterone deficiency screening among US service members aged 30 and older, putting into effect a policy that the military says is designed to improve health and combat readiness.
The guidance took effect immediately after being issued on Wednesday and applies to active-duty and reserve personnel. It follows a July directive from US Defence Secretary Pete Hegseth establishing an expanded screening programme focused on hormonal health and human performance.
Under the guidelines, male service members aged 30 and above will receive mandatory testosterone blood testing. Men younger than 30 will not undergo universal testing but may request screening during their periodic health assessment or be tested when clinicians identify symptoms or other warning signs.
The Pentagon says the broader initiative is intended to identify and manage hormonal and energy-availability problems that could affect the health and performance of military personnel. The July directive described the screening programme as part of a wider effort focused on “Human Performance Optimization.”
The approach differs for female service members. Routine testosterone blood testing is not mandated for women. Instead, clinicians are instructed to screen for symptoms such as fatigue and menstrual-cycle disruption that can be associated with hormonal dysregulation, low energy availability and relative energy deficiency in sport.
The guidelines also address circumstances in which testosterone could be prescribed off-label to women, including certain cases involving postmenopausal women experiencing unusually low sexual desire.
The policy has, however, generated debate among medical experts.
Some doctors have questioned whether universal testosterone testing among military personnel will translate into improved combat readiness. They have also warned that broad screening could identify hormonal readings that do not necessarily require medical intervention, potentially leading to unnecessary treatment.
The timing adds to the scrutiny. The US Food and Drug Administration is expected to convene experts in mid-September to discuss the medical use of testosterone, according to Reuters reporting carried by Dawn.
Hegseth has publicly promoted testosterone and has increasingly emphasised physical fitness and performance standards across the armed forces. The screening programme therefore forms part of a broader Pentagon push to connect personnel health more directly with military readiness.
Still, screening does not mean every service member found to have low testosterone will automatically receive testosterone therapy. Testing, clinical assessment and treatment are separate stages, and the new guidance establishes pathways for clinicians to evaluate personnel before determining an appropriate response.
The policy marks an unusual expansion of hormone screening across the US military and could provide a significant pool of health data as the Pentagon assesses whether identifying testosterone deficiency and related conditions produces measurable improvements in service-member performance.
For now, the programme moves from policy to implementation. Its longer-term significance will depend on how many personnel are identified with clinically meaningful deficiencies, how frequently treatment is recommended and whether the Pentagon can demonstrate that the initiative produces the readiness improvements it is designed to achieve
