What is testosterone screening, and why is the U.S. military introducing it? | Explained
The story so far The U.S. Department of Defense has announced mandatory annual testosterone screening for all active-duty service members aged 30 years and above
The story so far The U.S. Department of Defense has announced mandatory annual testosterone screening for all active-duty service members aged 30 years and above. Announced by U.S. Defence Secretary Pete Hegseth on July 15, the policy will make testosterone testing part of routine annual medical assessments. Personnel found to have low testosterone may undergo further clinical evaluation and can choose whether to receive testosterone replacement therapy (TRT), while those below 30 years may request testing voluntarily. Hegseth said maintaining healthy testosterone levels could help personnel “operate at their absolute best”. The announcement comes weeks after the U.S. Department of Health and Human Services (HHS) said it would seek to ease some restrictions on testosterone replacement therapy, including expanding access for men with age-related low testosterone. The move has also prompted political debate. Democratic lawmakers have questioned how expanding access to testosterone therapy for some service members aligns with the military’s broader policies affecting transgender personnel who receive gender-affirming hormone therapy. The Department of Defense has maintained that the screening programme is intended to improve troop health and readiness. What is testosterone? According to the U.S. Institutes of Health (NIH), testosterone is the principal male sex hormone, although it is also produced in smaller amounts in women. Produced mainly by the testes, it plays a key role in puberty, muscle and bone growth, red blood cell production, fertility, sexual function and mood. Testosterone levels usually peak during late adolescence and early adulthood before gradually declining with age.
However, hormone levels vary widely between individuals, and this decline is a normal part of ageing. What is testosterone deficiency? The Endocrine Society defines testosterone deficiency, or male hypogonadism, as a condition in which the body does not produce enough testosterone to maintain normal physiological functions. It may result from disorders affecting the testes, pituitary gland or hypothalamus, as well as certain genetic conditions, cancer treatment, obesity, type 2 diabetes, chronic kidney disease, obstructive sleep apnoea or some medications. Symptoms include reduced sexual desire, erectile dysfunction, infertility, fatigue, loss of muscle mass, increased body fat, low bone density, depressed mood and poor concentration. Because these symptoms can also occur in several other medical conditions, diagnosis cannot be based on symptoms alone. How is testosterone deficiency diagnosed? According to the Endocrine Society’s Clinical Practice Guideline, testosterone deficiency should be diagnosed only in men with symptoms consistent with the condition and consistently low testosterone levels confirmed through laboratory testing. Blood samples are usually collected in the morning, when testosterone levels are highest, and the test is repeated on a separate day to confirm the diagnosis. Additional investigations may be needed to identify the underlying cause. The American Urological Association (AUA) also advises against diagnosing testosterone deficiency on the basis of a single laboratory result. Why is the Pentagon’s screening policy unusual? Screening involves testing people who do not necessarily have symptoms to detect a condition early, whereas diagnosis evaluates people with symptoms.
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