U.S. Military’s Testosterone Mandate Raises Concern Among Experts

• Protection Secretary Pete Hegseth introduced that the U.S. navy will start annual screening for testosterone deficiency amongst service members ages 30 and older.
• Testosterone alternative remedy (TRT) could profit individuals with a confirmed deficiency, however there are dangers, together with impaired fertility.
• A single blood check can’t diagnose low testosterone; different signs should even be current.

Protection Secretary Pete Hegseth introduced that the U.S. navy will start screening service members ages 30 and older for testosterone deficiency as a part of their annual well being assessments.

In a video posted on X, Hegseth framed the initiative as a option to “optimize” well being and fight readiness.

“Below the supervision of our world-class medical professionals, battle fighters age 30 and older are going to be examined yearly as a part of their periodic well being evaluation,” Hegseth mentioned.

Testosterone is a vital intercourse hormone that helps regulate muscle mass, libido, temper, vitality, and extra. Ranges have a tendency to say no steadily with age, however low testosterone, which is clinically often known as hypogonadism, can even end result from a wide range of elements, together with damage, way of life, and illness.

Hegseth mentioned this system would assist maintain troops on the “vanguard of lethality” by supporting their bodily and psychological readiness. Nevertheless, consultants interviewed by Healthline raised considerations about this system.

“I don’t consider routine testosterone screening of each service member starting at age 30 is medically justified primarily based on the proof at the moment accessible,” mentioned Philip Werthman, MD, board licensed urologist, males’s well being specialist, and director of the Heart for Male Reproductive Medication and Vasectomy Reversal in Los Angeles.

S. Adam Ramin, MD, board licensed urologist, urologic oncologist, and medical director of Urology Most cancers Specialists in Los Angeles, equally cautioned {that a} testosterone blood check could supply little helpful data when carried out in youthful males who wouldn’t have signs.

“In males who aren’t exhibiting medical indicators and symptoms of low testosterone, and are underneath the age of 40, checking a blood check testosterone degree will not be informative or required from a medical standpoint,” he mentioned.

Below the brand new coverage, testosterone deficiency screening shall be integrated into an annual well being go to often known as a periodic health assessment for service members ages 30 and older.

Testing shall be non-obligatory for youthful service members. If further analysis confirms testosterone deficiency, a person can elect to obtain TRT.

Hegseth has mentioned the purpose is to not push testosterone above its pure vary or use the hormone as a performance-enhancing drug. As an alternative, he described this system as an effort to guard longevity and guarantee “the organic basis to maintain the battle.”

Nevertheless, the specifics of this system, together with what the screening protocol would entail weren’t clear from the announcement. Consultants say these specifics matter, since a single low testosterone studying from a blood check shouldn’t be adequate to diagnose testosterone deficiency.

“Making a analysis shouldn’t be primarily based on only one check,” mentioned Lawrence Jenkins, MD, Affiliate Chair of Urology & Director of Males’s Well being at Tulane College Faculty of Medication. “It’s primarily based on two low ranges plus signs. So, simply doing one screening check shouldn’t be going to satisfy any analysis standards.”

Testosterone ranges fluctuate all through the day and may fluctuate from at some point to a different. They’re influenced by many way of life elements, together with sleep, meals consumption, sickness, medicines, physique weight, and bodily exercise.

For navy service members, the bodily and psychological calls for of coaching and deployment might briefly suppress hormone ranges.

“An irregular testosterone degree obtained throughout deployment, sleep deprivation or extreme coaching shouldn’t mechanically result in lifelong remedy. Repeat testing ought to usually happen after reversible elements have been addressed,” Werthman cautioned.

And not using a rigorous screening protocol, this system might probably expose wholesome service members to pointless remedy.

However Ramin informed Healthline that the proper of screening, and never simply counting on a blood check, may be applicable.

“If by testosterone screening we imply asking questions on signs of low testosterone and performing a physical exam, then the screening is indicated as a part of a yearly males’s well being examination,” Ramin mentioned. “In sufferers who do exhibit signs or bodily indicators of low testosterone, then the blood check can be indicated.”

TRT can enhance signs in males who’ve constantly low testosterone.

• lowered sexual want
• erectile dysfunction
• decreased muscle mass
• fatigue
• lowered bone density
• infertility

Many of those signs are nonspecific, that means they’ll have causes unrelated to testosterone.

Nevertheless, the remedy additionally carries dangers that require particular person evaluation and ongoing monitoring.

For youthful service members, consultants mentioned fertility is among the many most urgent considerations.

“My biggest concern on this younger inhabitants is fertility,” Werthman mentioned. “Exogenous testosterone suppresses regular sperm production and will end in infertility or extended subfertility. Many service members haven’t but accomplished their households.”

Fertility could get better after remedy is discontinued, however that course of shouldn’t be at all times predictable.

“It’s recoverable typically, however not 100%,” mentioned Jenkins.

For that purpose, Werthman informed Healthline that fertility counseling must be obligatory previous to remedy.

Different severe risks of TRT embrace lowered HDL (“good”) ldl cholesterol, zits, and sleep apnea.

Since 2015, TRT has carried a warning about elevated danger of cardiovascular occasions, together with heart attack and stroke.

Nevertheless, in 2025, the Meals and Drug Administration (FDA) really useful removing that warning following the outcomes of the TRAVERSE trial, a big randomized, placebo-controlled trial that discovered TRT was not related to the next fee of heart attack or stroke than placebo.

Prostate well being is one other consideration.

“Whereas testosterone alternative doesn’t trigger growth of prostate most cancers, if a person already has prostate most cancers and that man is positioned on testosterone remedy, then his prostate most cancers could develop quicker,” Ramin mentioned. “Subsequently, it is very important carry out prostate cancer screening in sufferers who’re positioned on testosterone alternative.”

Testosterone performs a transparent position in bodily well being. Consultants informed Healthline that figuring out and treating it in service members who genuinely have the situation might assist them perform higher.

“There’s good proof that low testosterone results in many suboptimal bodily and psychological issues,” Ramin mentioned. “These bodily and psychological issues will immediately have an effect on the job efficiency of anybody, particularly these within the navy.”

Nevertheless, sustaining wholesome testosterone ranges is totally different from pursuing an unusually excessive degree. Extra testosterone doesn’t essentially translate into higher well being or improved fight efficiency, significantly when an individual’s ranges are already typical.

“There’s proof that testosterone can enhance muscle mass and power,” Werthman mentioned. “Nevertheless, there’s far much less proof that routine population-wide screening and remedy of asymptomatic service members improves navy readiness, fight effectiveness, or long-term well being outcomes.”

A profitable screening program have to be evaluated as an entire, together with the variety of true instances they determine, the potential for false or deceptive outcomes, remedy outcomes, prices, and unintended harms.

These considerations don’t rule out focused testing. A service member experiencing signs per low testosterone ought to focus on them with a clinician, who can assess different potential causes and order correctly timed laboratory assessments when indicated.

For the broader navy program, consultants mentioned the central query shouldn’t be whether or not testosterone issues to well being. It’s whether or not routinely testing each service member after age 30 produces significant advantages.

“Earlier than implementing a broad screening program, the federal government ought to exhibit that it meaningfully improves readiness whereas outweighing the medical, reproductive, and moral dangers,” Werthman mentioned.