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

The US Pentagon has issued detailed guidance for a new, mandatory testosterone deficiency screening policy for active-duty and ​reserve service members aged 30 and older, a follow-up ‌to US Defence Secretary Pete Hegseth’s July announcement.

The guidance, which was issued on Wednesday and is effective immediately, establishes standardised 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 US Food and Drug Administration plans to hold a meeting of experts to discuss the medical use of testosterone in mid-September.

According ​to the guidance, men aged 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 US combat readiness.