Pentagon mandates testosterone screening for older US troops

Washington: The Pentagon has released new clinical guidelines requiring mandatory testosterone deficiency screening for US military personnel aged 30 and above, while placing strict boundaries on treatment to prevent the hormone from being used purely as a performance enhancer.

Issued on September 17 by the Defence Health Agency, the guidance creates standardized screening and treatment protocols for active-duty and reserve male service members under a directive established in July. Personnel under the age of 30 may also request screening.

Defence officials explicitly connected the program to operational readiness, with the chief Pentagon spokesman stating that the military remains focused on building a "ready, lethal fighting force prepared to dominate the battlefield."

However, the medical guidelines strictly differentiate between treating a genuine clinical deficiency and prescribing the hormone to boost battlefield capability. The document notes that prescribing testosterone for performance enhancement rather than a diagnosed medical condition is not supported by current scientific evidence.

Under the new process, screening begins with an evaluation of symptoms and risk factors, followed by blood tests if the initial assessment is positive. The Pentagon emphasized that mandatory screening does not equate to automatic hormone therapy. A formal diagnosis requires both persistent symptoms and consistently low lab results across two separate early-morning, fasting blood samples.

Recognized symptoms include lower muscle mass, reduced sex drive, decreased energy, impaired focus, and depressed mood. However, clinicians are advised to consider that these symptoms frequently overlap with standard military stressors such as sleep deprivation, high stress, and poor calorie intake.

Military surveillance data cited in the document shows that under 1 per cent of male service members received an active testosterone deficiency diagnosis annually between 2018 and 2025.

While the guidelines acknowledge that testosterone therapy yields proven benefits for bone density, body composition, and sexual function, they stress there is no evidence it improves general cognitive function, energy, or overall physical performance.

Participation in the screening and subsequent treatment remains voluntary. An accompanying patient information sheet confirms that opting out carries no negative consequences for a service member's career. Those currently stable on treatment are generally cleared for deployment without requiring a waiver, provided adequate medication reserves or resupply plans are arranged. Specialized operational duties will remain subject to separate medical regulations.

(Inputs from IANS)