The US Pentagon has issued clinical guidelines for mandatory testosterone deficiency screening of active-duty and reserve service members aged 30 and above, with the new policy taking effect immediately, as the Defence Department seeks to identify hormonal and energy-related issues that could affect military readiness.
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Under the guidance issued on Wednesday, all male service members aged 30 and older will undergo mandatory blood tests to measure testosterone levels. Men under 30 will be tested only if they request it or if doctors identify warning signs.
The policy follows Defence Secretary Pete Hegseth's announcement in July that the military would introduce testosterone screening. Hegseth has repeatedly promoted testosterone use, prompting questions from medical experts about the scientific basis for broad screening.
The new guidance also sets out separate screening and treatment pathways for women. Routine testosterone blood tests will not be mandatory for female service members. Instead, doctors are instructed to screen for symptoms such as fatigue and disrupted menstrual cycles.
These symptoms can be linked to hormonal problems and conditions known as low-energy availability and relative energy deficiency in sport.
The Pentagon has also provided guidance on when doctors may prescribe testosterone to women for uses not specifically approved by regulators. This includes postmenopausal women with unusually low sexual desire.
For men, the guidelines set out pathways for evaluating and treating low testosterone after screening. The Pentagon says the approach is intended to identify and manage conditions that could affect energy, health and readiness.
