Mandatory testosterone tests: Pete Hegseth's move to strengthen American troops

The US Department of Defense has issued detailed clinical guidelines establishing a new mandatory policy for testing testosterone deficiency among active-duty personnel and reservists.

The move, which takes effect immediately, follows Secretary of Defense Pete Hegseth's active promotion of testosterone use, which he announced earlier this summer in a social media video titled "The Testosterone-Rich Department of War."

Hegseth explained that the initiative is not about artificial enhancement, but about restoring and optimizing the natural capabilities of fighters, maintaining their longevity, and ensuring the biological foundation required to continue fighting. He added that caring for long-term health means ensuring that soldiers remain strong and resilient not only for their next deployment, but for the rest of their lives.

According to the new guidelines, men aged 30 and older will undergo mandatory periodic blood tests to diagnose testosterone levels as part of their routine health assessments. Younger men, under the age of 30, will not be required to undergo routine testing but may request it annually or be tested if attending physicians identify warning signs.

For women in military service, the policy is different, as they will not be required to undergo routine blood tests for testosterone. Instead, the guidelines state that women will undergo screenings to detect symptoms of hormonal disorders, chronic fatigue, or menstrual cycle disruptions, which may indicate hormonal imbalance or syndromes related to low energy availability.

However, the document includes defined criteria for cases where it would be appropriate to prescribe testosterone treatment to women outside of official indications, mainly for post-menopausal women suffering from low libido. The Department of Defense explains that the goal is to invest in the health of fighters and strengthen force readiness by managing hormonal and energy problems.

The guidelines define testosterone as a critical biomarker affecting physical strength, bone density, aerobic fitness, depression symptoms, and heart health. Military medical personnel have previously noted that fighters are at increased risk for hormone level drops due to the nature of their service.

Major Theodore Chrysostomo-Winn, a military urologist at Madigan Medical Center, explained at a previous FDA discussion that the high tempo of operations and immense pressure experienced by soldiers can lead to a sharp drop in testosterone levels.

Studies show that soldiers in high-intensity roles, such as special forces, face an increased risk of "operator syndrome," which Chrysostomo-Winn linked to chronic stress, exposure to blast waves, traumatic brain injuries, and sleep disorders.

Alongside support from Pentagon officials, the new policy is sparking concern among medical experts and endocrinologists. These experts warn that mass, sweeping testosterone screenings could lead to unnecessary and even harmful treatments, noting that there is insufficient scientific evidence to support the claim that universal screening will improve operational readiness.

To discuss the implications of this move, the US Food and Drug Administration plans to hold a special meeting of experts in mid-September.

Meanwhile, the Pentagon clarifies that if a hormone deficiency is diagnosed, receiving testosterone replacement therapy will be entirely voluntary and depend on the soldier's choice, while the use of the hormone for performance-enhancing purposes without a doctor's prescription remains strictly prohibited.