Defense Secretary Pete Hegseth has ignited a national conversation about men's health by ordering the Pentagon to implement mandatory testosterone-deficiency screening for active-duty and reserve personnel aged 30 and older. The directive, issued on July 15, requires testing as part of periodic health assessments, with younger service members able to request screening voluntarily. Testosterone replacement therapy (TRT), when clinically indicated, will be offered on a voluntary basis, according to the Associated Press.
The screening protocol aims to «optimize performance, combat ‘Operator Syndrome' and maximize mission readiness,» according to a statement from the U.S. Department of War provided by Hegseth's office to Fox News Digital. Dr. Marc Siegel, Fox News senior medical analyst, endorsed the initiative, noting that he already screens for testosterone deficiency in men over 50 and that it «makes sense to check for it in men who rely on tip-top physical performance.»
Low testosterone, medically known as hypogonadism, affects roughly 2% of men overall, though rates vary by age and underlying health conditions, according to the Endocrine Society. The condition becomes more common as men age, and factors such as obesity and diabetes can increase risk. Common symptoms include chronic fatigue, weight gain, bone and muscle loss, cognitive difficulties, and increased body fat, as Dr. Siegel explained. Sexual symptoms like reduced libido and erectile dysfunction are considered more specific indicators than general fatigue or concentration problems.
There is no single ideal testosterone level for every man. The Endocrine Society cites a harmonized reference range of 264 to 916 ng/dL for healthy, non-obese men aged 19 to 39, though ranges can vary by laboratory and testing method. The American Urological Association considers a total testosterone level below 300 ng/dL, when accompanied by symptoms, to be deficient. Diagnosis typically requires symptoms plus low results on at least two separate early-morning, preferably fasting blood tests, as testosterone fluctuates with time of day, food intake, and illness.
If low testosterone is confirmed, doctors may order additional tests to determine the underlying cause, including luteinizing hormone (LH) to distinguish whether the problem originates in the testes, pituitary, or hypothalamus. Follicle-stimulating hormone (FSH) may be measured when infertility or impaired sperm production is a concern. Elevated prolactin levels can suppress testosterone and may indicate a pituitary disorder. Free testosterone — the amount available for the body to use — may also be measured if total levels are borderline.
Before prescribing TRT, doctors typically look for reversible factors such as obesity, certain medications, untreated obstructive sleep apnea, acute illness, or excessive alcohol use. For men whose low testosterone is primarily linked to obesity, weight loss is the first-line treatment, per the Endocrine Society. When consistently low levels and significant symptoms persist, TRT may be considered after reviewing benefits, risks, and treatment goals. TRT can be administered via topical gels, transdermal patches, injections, buccal tablets, nasal gel, or subcutaneous pellets.
In June 2026, the U.S. Department of Health and Human Services (HHS) announced it had asked the FDA to update prescribing information for TRT based on a comprehensive review of new clinical data and scientific evidence. The proposed changes would remove labeling language stating that the safety and effectiveness of TRT have not been established in men with age-related hypogonadism and would update information about prostate cancer risk based on newer research. HHS Secretary Robert F. Kennedy, Jr., stated, «We are putting science back at the center of men’s healthcare,» adding that updated labels would give patients and physicians clearer information and improve care for millions of American men. The announcement pertains only to drug labeling and does not change existing clinical guidelines.
The Pentagon's policy differs from the Endocrine Society's stance, which does not recommend routine testosterone screening for men without symptoms, citing insufficient evidence for population-level screening. Nonetheless, Hegseth's directive has drawn attention to the importance of identifying and treating testosterone deficiency, particularly among service members whose physical performance is critical to mission readiness. As the conversation continues, experts emphasize that men experiencing symptoms should consult a healthcare provider for proper evaluation and individualized care.
