US Defense Secretary Pete Hegseth has ordered mandatory annual testosterone-deficiency screening for active-duty and reserve service members aged 30 and older, aiming to maintain military readiness.
The mandate, reported by The Guardian, has drawn sharp criticism from medical experts who argue the policy lacks scientific basis and could lead to unnecessary treatments with serious side effects.
Five out of six men's health experts contacted by Reuters expressed confusion, warning that widespread testing might trigger inappropriate hormone prescriptions.
Medical Experts Warn of Overtreatment Risks
Dr. Kevin McVary, a urologist on the medical advisory board of Rugiet, said that while some patients report improvements in cognitive alertness and stamina, clinical data remains limited to specific symptomatic cases.
He cautioned that administering testosterone without clear medical symptoms leads to overtreatment, which carries severe reproductive risks for younger personnel.
"Many in our armed forces are young men who are not done having their families," McVary said. "If you just dole out the testosterone, the testes will shrink.
And you can't reliably count on them coming back."
Organizations like the American Urological Association and the Endocrine Society only recommend testosterone supplementation for patients with confirmed deficiencies and explicit symptoms such as reduced libido or bone density.
Dr. Haleem Mohammed, chief medical officer of Gameday Health, noted that age 30 is not an appropriate screening benchmark despite natural biological declines of about 1% per year after ages 30-40.
However, he acknowledged that broader screening could help identify reversible health causes like obesity among military reservists.
"Testosterone is one of the most useful blood tests we have to gauge health in men," Mohammed said.
"Broader screening would identify many men with reversible causes and some with true deficiency."
Dr. Ugis Gruntmanis, an endocrinologist at Dartmouth Hitchcock Medical Center, pointed out that most testosterone studies have focused on older demographics, not younger service members.
He added that implementing widespread screening without preliminary study data would be "putting the carriage before the horse."
The screening mandate partly aims to address "operator syndrome" in special forces like Delta Force and Navy Seals, which involves hormonal dysregulation alongside traumatic brain injuries.
Dr. B.
Christopher Frueh of the University of Hawaii, who first described the syndrome in 2020, cautioned that special forces operators face extreme combat exposures not representative of the broader military.
"These operators are at an extreme end of a spectrum," Frueh said.
"They have much higher exposures to blasts, airplane jumps, firing all kinds of different weapons, shoulder-fired rockets, machine guns."
Frueh suggested younger soldiers could regulate hormones through lifestyle adjustments rather than immediately relying on medical replacement therapies.
He questioned whether screening 100% of personnel is necessary, noting that female soldiers would unlikely need testosterone replacement but broad screening could reveal data on other hormonal interventions for women.
The Pentagon declined to comment beyond its brief official statement and has not provided detailed guidance on evaluating abnormal results or whether screenings will apply equally to male and female personnel.
