Pentagon posts new guidance for mandatory testosterone screening. Here's what it may mean
It comes two weeks after guidelines for screening were "temporarily rescinded."
The Pentagon posted new guidance on Thursday for mandatory testosterone deficiency screening among male service members over age 30 in active duty or in the reserves.
It comes two weeks after guidelines for mandatory screening were "temporarily rescinded" from a Department of Defense website.
The guidelines that were pulled two weeks ago also provided guidance that female service members be asked about fatigue and disrupted menstrual cycles that could be associated with hormonal dysregulation.
No other reason was offered as to why the guidance was temporarily rescinded, but a top adviser to Defense Secretary Pete Hegseth described the documents posted on the website as a "draft" document that had been "inadvertently" posted.
"This guidance addresses male testosterone deficiency, establishing uniform screening and treatment pathways across the DHA enterprise and assigning responsibility for compliance," Sean Parnell, chief Pentagon spokesman, said in a statement on the new guidelines.
"By proactively identifying and treating suboptimal hormone levels, the Department continues to invest in the health of its warfighters, strengthen their performance, and maximize force readiness," Parnell's statement added.
Under the clinical practice guidelines, all male service members over age 30 will be screened with a "structured symptom and risk assessment." Service members under age 30 may be screened upon request.
Service members will have testosterone levels measured on two separate days in the morning while they are fasting.
The repeat draw will include an LH/FSH blood test panel, which measures the luteinizing hormone and the follicle-stimulating hormone, two key reproductive hormones produced by the pituitary gland.
Additionally, when total testosterone levels are in range, levels of free testosterone will be tested. Total testosterone is the entire amount of testosterone circulating in the body, both bound and unbound to proteins and is biologically active, while free testosterone refers only to the hormone not bound to proteins and is biologically active.
The new guidelines posted on Thursday said guidance for female service members are "being reviewed and will be posted upon approval."
Earlier this year, Hegseth announced that troops would be tested annually for testosterone levels, a significant shift on a health issue that has gained momentum in recent years.
Low testosterone levels have been a concern in the military, particularly in the special operations community, where high stress and extreme physical labor, paired with not getting enough calories, could negatively impact testosterone levels -- though research is still ongoing.
As of 2023, between 4.0 million and 13.8 million men in the U.S. have testosterone deficiency, according to the American Urological Association (AUA), though the full scope of the issue is unclear, and there are different thresholds used to measure whether someone has a deficiency.
Testosterone issues are most common among older men, and those with diabetes or obesity.
Some doctors are concerned that the online popularity of "low-T" as a medical problem creates a false impression that this is a bigger problem than it really is.
Testosterone testing and prescribing have tripled in recent years. However, some studies suggest that up to 25% of men who receive testosterone therapy do not have their levels properly tested, according to the AUA.
The AUA estimates up to a third of men who are put on testosterone therapy do not meet the criteria for a medical diagnosis, previously telling ABC News in a statement "a testosterone deficiency diagnosis requires both symptoms and/or signs of low testosterone and at least two separate early-morning total testosterone measurements demonstrating low testosterone levels."
Meanwhile, up to one-third of men who are put on testosterone therapy do not meet the criteria for a medical diagnosis.
Service members have long had access to testosterone testing and replacement therapy through Tricare, the health insurance program for military personnel and their families. But the screenings have never been part of the military's annual health assessments, which have traditionally focused on vaccinations, vision and hearing tests, and other routine medical evaluations.
It's unclear what testosterone levels the Pentagon would find acceptable. It's also unclear whether troops with lower levels could face professional consequences.
ABC News' Steven Beynon contributed to this report.
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