Pentagon orders mandatory testosterone tests for male troops 30 and older

The Pentagon has issued new guidelines requiring mandatory testosterone deficiency screening for male service members ages 30 and older, with younger men only being tested if requested or if warning signs are identified.

Women in the military will not be required to undergo routine testosterone blood tests, but will be screened for fatigue and disrupted menstrual cycles, with guidelines in place for prescribing off-label testosterone for postmenopausal women with low sexual desire.

The standardized screening and treatment pathways for men and women aim to enhance military readiness by addressing hormonal and energy-availability issues, although some medical experts have expressed concerns about potential unnecessary or harmful treatment resulting from broad testosterone testing.

The Pentagon on Wednesday issued clinical guidelines establishing a new mandatory testosterone deficiency screening policy for active-duty and reserve service members ages 30 and up.

This comes after Defense Secretary Pete Hegseth announced in July that he was authorizing the screening program for troops to ensure "you have the right testosterone levels to operate at your absolute best."

"Taking care of your long-term health means ensuring you remain strong, resilient and capable — not just for your next deployment, but for the rest of your life, so you can thrive long after you take off the uniform," he said at the time.

According to the new guidance, which is effective immediately, men ages 30 and older will undergo mandatory testosterone blood tests, while younger men will be tested only if requested or if clinicians identify warning signs.

Men found to have low testosterone levels may undergo further evaluation and, if clinically appropriate, may be offered voluntary hormone replacement therapy .

Levels of testosterone naturally increase during puberty. The hormone helps boys develop muscle strength and body hair as well as make sperm. Between ages 30 and 40, testosterone levels in men naturally start to decline.

Women will not be required to take routine testosterone blood tests under the new guidance, but they will be subject to 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.

Guidelines were put into place for when it is appropriate to prescribe off-label testosterone in women, particularly for postmenopausal women with unusually low sexual desire .

Testosterone use for non-medical purposes, including performance enhancement without a doctor's prescription, remains prohibited in the military.

The Pentagon said the standardized screening and treatment pathways for men and women seek to boost military readiness by identifying and managing hormonal and energy-availability issues.

Some endocrinologists and other medical experts have raised concerns that broad testosterone testing could lead to unnecessary or potentially harmful treatment, saying there is a lack of evidence to support the claim that universal screening for low testosterone among service members would improve military readiness.

The Food and Drug Administration intends to hold a meeting later this month with experts to discuss the medical use of testosterone.