Pentagon's New Testosterone Screening Plan Draws Skepticism from Medical Experts

The Department of Defense announced that all active-duty and reserve personnel aged 30 and older will undergo an annual screening for low testosterone, a move the defense secretary says is intended to support combat readiness and overall performance. The testing will be paired with voluntary counseling on treatment options.

Five of six men’s-health physicians consulted by Reuters expressed doubt about the scientific basis for universal screening, noting that existing guidelines from the American Urological Association and the Endocrine Society recommend testosterone therapy only for men with confirmed deficiency and related symptoms such as reduced libido, fatigue or low bone density.

"We hear from patients that when you treat low T, things like cognitive alertness and stamina improve. But the evidence is not concrete, and it comes from patients who were treated because they were symptomatic," said Dr. Kevin McVary, a urologist.

Experts highlighted that testosterone levels naturally decline with age and that the rate of decline varies among individuals. Dr. Haleem Mohammed, chief medical officer of Gameday Health, said the 30-year threshold does not align with current medical practice. An endocrinologist at Dartmouth Hitchcock, Dr. Ugis Gruntmanis, noted the lack of data on younger men and cautioned that widespread screening without prior research could be premature.

The FDA recently removed a cardiovascular-risk warning from testosterone product labels after a study of older men showed mixed outcomes, including higher rates of atrial arrhythmia and bone fractures. Physicians also warned that inappropriate testosterone use can affect fertility and cause side effects such as blood thickening, prostate issues, acne and mood changes.

"Many in our armed forces are young men who are not done having their families. If you just dole out the testosterone, the testes will shrink. And you can’t reliably count on them coming back," Dr. McVary added.

The Pentagon declined further comment. Critics also questioned the relevance of the screening to special-forces personnel, who experience a distinct set of stressors known as "operator syndrome," and whether the same approach is appropriate for the broader force.

While some clinicians see potential value in identifying reversible causes of low testosterone, such as obesity, they emphasized that any treatment should be guided by clinicians and based on individual assessment rather than a blanket policy.