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Pentagon orders annual testing
U.S. Defense Secretary Pete Hegseth ordered annual testosterone-deficiency screening for active-duty and reserve service members age 30 and older, saying it would help maintain military readiness.
The Guardian reports that “Five of six men’s health experts contacted by Reuters for this story said they were puzzled by the announcement on testosterone testing,” and warned the policy could increase service members’ risk of infertility or other consequences if testosterone is prescribed inappropriately.
Hegseth said testing would be accompanied by advice to help soldiers make decisions about treatment, which would be voluntary, and he framed the goals as ensuring troops have the right testosterone levels to operate at their “absolute best.”
TIME described Hegseth’s video “The High T Department of War,” where he said service members found to have “testosterone deficiency” could choose to receive testosterone replacement therapy (TRT), and TIME said the Pentagon told it it had no additional information beyond Hegseth’s video and a department statement.
Doctors quoted in the coverage said medical guidelines do not recommend testing testosterone levels unless a man has signs or symptoms that suggest a deficiency, such as low libido or erectile dysfunction, or has a high-risk medical condition that can cause low testosterone.
Doctors split on evidence
The Guardian quoted Dr Kevin McVary, a urologist on the medical advisory board of Rugiet, saying, “The evidence is not concrete, and it comes from patients who were treated because they were symptomatic.”
McVary also warned that giving testosterone without medical symptoms leads to overtreatment, and the coverage tied that concern to risks including infertility and other adverse consequences.
UnionLeader reported that five of six men’s health experts contacted by Reuters were puzzled by the announcement and concerned it may lead to unnecessary—or even harmful—treatment.
UnionLeader also quoted Dr. Haleem Mohammed, chief medical officer of Gameday Health, saying, “There is a population-level decline of 1% per year after ages 30-40 that accelerates as you get older,” while adding that patterns are not the same for all.
TIME quoted Dr. Jeff Morrison, a urologist at the University of Colorado, saying, “There’s no free lunch. There are side effects,” and Morrison said TRT can stall sperm production and cause infertility.
Operator Syndrome and fallout
Hegseth linked the screening mandate to efforts to address operator syndrome, described in The Guardian as afflicting special forces such as Delta Force members and Navy Seals and including low testosterone along with traumatic brain injury, hormonal and metabolic dysregulation, and sleep dysregulation.
The Guardian quoted Dr B Christopher Frueh of the University of Hawaii saying, “These operators are at an extreme end of a spectrum,” and added that other soldiers might have elements of the syndrome while raising the question of whether “should we be screening 100% of everybody? Maybe. I don’t know.”
UnionLeader reported that the Pentagon declined to comment beyond its brief official statement, while also describing how the FDA revised testosterone labels to remove a warning of increased risks of heart attack or stroke.
UnionLeader said the FDA change was partly based on a study led by Dr. Steven Nissen of the Cleveland Clinic involving more than 5,200 men aged 45 to 80 with low testosterone and high risk of heart disease, and it noted that the participants showed higher rates of atrial arrhythmia and bone fractures.
TIME added that Hegseth did not specify whether females would be screened and have access to TRT, and it quoted Dr. Ajay Nangia of the University of Kansas Health System saying, “It’s not recommended by the American Urological Association or the Endocrine Society to routinely screen people,” while TIME said the recommendation by Hegseth goes against those guidelines.
