The Pentagon’s new plan to screen military personnel for testosterone deficiency every year is drawing criticism from medical specialists who say the policy lacks strong scientific support and could expose service members to unnecessary or harmful treatment.
Defense Secretary Pete Hegseth ordered annual testosterone testing for active-duty and reserve personnel aged 30 and older. He argued that identifying hormonal deficiencies could improve troops’ resilience, longevity, physical performance and combat readiness. Treatment would remain voluntary, and the Pentagon says personnel would receive medical advice before deciding whether to pursue therapy. However, the department has not yet released detailed guidance explaining how abnormal results will be interpreted or how the program will apply to male and female service members.
Five of the six men’s-health experts questioned the policy, while four said there was no solid evidence that routinely screening every service member over 30 would improve military readiness. Current recommendations from the American Urological Association and the Endocrine Society generally support testosterone treatment only when patients have both consistently low hormone levels and symptoms such as fatigue, reduced sexual function, declining muscle mass or low bone density.
Testosterone levels naturally tend to decline with age, often beginning between the ages of 30 and 40. But doctors cautioned that reaching 30 is not, by itself, a medical reason for universal screening. Hormone levels vary considerably among individuals and can be influenced by poor sleep, stress, obesity, diet, illness and demanding physical conditions. Some service members with low readings may therefore benefit more from lifestyle changes or treatment of an underlying condition than from testosterone replacement.
The specialists’ principal concern is that broad screening could lead to overtreatment. Once testing identifies a low number in an otherwise healthy person, that person may feel pressure to begin therapy despite having no symptoms. Externally supplied testosterone can suppress the body’s natural hormone production and sharply reduce sperm production. Doctors warned that this presents a serious concern for younger service members who may still want to have children. In some cases, the testicles may shrink, and fertility may not fully recover after treatment ends.
Other possible side effects include thickened blood, prostate complications, acne, hair loss, breast-tissue growth and mood changes. A major study involving more than 5,200 older men helped persuade the Food and Drug Administration to remove a warning linking testosterone treatment to increased heart-attack and stroke risks. Nevertheless, participants receiving testosterone experienced higher rates of abnormal heart rhythms and bone fractures, findings doctors said could be relevant in a physically demanding military population.
Hegseth has partly connected the policy to “Operator Syndrome,” a combination of hormonal, neurological, metabolic and sleep-related problems observed among special-operations personnel repeatedly exposed to explosions, heavy weapons, parachute jumps and other extreme conditions. Yet one of the researchers who helped describe the syndrome said elite operators are not representative of the entire armed forces and questioned whether their experiences justify screening everyone.
Some experts acknowledged that broader testing might produce useful health information. Screening could identify genuine hormone disorders or reversible causes such as obesity, insufficient sleep and excessive physical stress. It could also create valuable research data on younger men and potentially reveal hormonal problems among female personnel. However, doctors argued that the Pentagon should first establish evidence-based testing standards, repeat abnormal measurements and require careful clinical evaluations before recommending treatment.
Overall, the dispute is not about whether testosterone deficiency can be a legitimate medical condition. It concerns whether universal annual screening is an effective way to strengthen military readiness. Without clearer protocols and stronger supporting research, critics fear the policy could transform normal hormonal variation into a medical problem and expose thousands of service members to avoidable risks.
