Department of Defense announces annual testosterone deficiency screening for service members

The US Department of Defense (DoD) plans to implement annual testosterone deficiency screening for active-duty service members aged 30 years and older as part of the military's routine periodic health assessment, according to an announcement by Defense Secretary Pete Hegseth.¹

Service members younger than 30 years will have the option to undergo testing voluntarily, and those found to have testosterone deficiency may elect to receive testosterone replacement therapy (TRT) following evaluation by military health care professionals.

Until now, routine biochemical screening for testosterone has not previously been incorporated into annual health assessments. In a video released by the Department of Defense, Hegseth said the initiative is intended to support both military readiness and long-term health.

"This initiative [is] not about artificial enhancement; it's about restoring and optimizing your natural capabilities, protecting your longevity, and ensuring you have the biological foundation required to sustain the fight,” he stated. “We owe our warriors the absolute best medical care in the world, and this program delivers on that obligation.”

Response from clinicians

The announcement has prompted discussion among men's health specialists regarding both the opportunities and challenges associated with expanding testosterone deficiency screening in a military population.

Amy Pearlman, MD, a men's health and sexual medicine urologist, said that while the initiative serves as recognition of testosterone deficiency in men’s helath, successful implementation will depend on ensuring appropriate counseling and long-term management.

"Screening military men for low testosterone is the easy part. Making sure they’re treated the right way is the hard part. Many of these men are still in their reproductive years, and testosterone therapy can significantly reduce sperm production, sometimes all the way to zero. If we’re going to diagnose more men with low testosterone, we also have to ask who is counseling them about fertility before treatment starts. Who is offering a baseline semen analysis so we know what we’re trying to preserve or restore? And when these men come home from deployment ready to start a family, who is going to help them navigate the fact that restoring fertility after testosterone can take several months?”

She added, "There is also the question of what type of testosterone therapy they will actually have access to. There is no single best option for every patient. Injectable, oral, topical, and pellet therapy all have a place, and the right choice depends on the individual. Some men also need medications such as hCG or an aromatase inhibitor to truly optimize treatment. Prescribing testosterone is not the same thing as practicing hormone optimization.”

Overall, she concluded, "I applaud the effort to recognize low testosterone as an important health issue in military men. My concern is whether we have enough clinicians with the training to manage these patients thoughtfully. The success of this initiative will depend on much more than screening. It will depend on making sure these men have access to providers who understand the nuances of hormone therapy, fertility preservation, and long term reproductive health."

Landon Trost, MD, also noted that existing professional guidelines do not recommend routine testosterone screening in the general population, and the military setting represents a distinct clinical environment.

"Testosterone plays an important role in overall health and physical readiness. Although routine screening is not recommended for the general population, the military's mission and performance requirements are distinct. Because active-duty personnel receive care within the Military Health System, the approach to diagnosis, treatment, and follow-up may also differ from civilian practice. From a scientific standpoint, it would therefore be inappropriate to simply extrapolate data and recommendations developed for the general population to this unique setting."

Industry response

Following the announcement, Marius Pharmaceuticals issued a statement supporting the DoD initiative and arguing that routine testosterone screening should ultimately be expanded beyond military populations.

"This is a landmark moment for men's health in America," said Shalin Shah, CEO of Marius Pharmaceuticals, in a company news release.² "For too long, testosterone deficiency has gone undiagnosed and undertreated, even though it can affect strength, energy, metabolic health, and long-term well-being. By making testosterone screening a standard part of the care our service members already receive, the Department of Defense is putting real, evidence-based practice ahead of stigma. We commend Secretary Hegseth and the Department for recognizing that maintaining our troops' hormonal health is inseparable from maintaining their readiness."

The company also referenced testimony presented during an FDA advisory meeting on testosterone therapy in late 2025, during which Helen L. Bernie, DO, MPH, an associate professor of urology at Indiana University School of Medicine, Indianapolis, discussed the potential value of serum testosterone as a biomarker in men's health.

“Secretary Hegseth just proved out, at scale, exactly what Dr. Bernie told the FDA in December: routine testosterone screening is overdue, and the only thing that's been holding it back is outdated policy, not outdated science,” said Shah. “If it makes sense to screen every soldier over 30, it makes sense to screen every American man over 30. We don't think this should stop with service members. We see today's announcement as further momentum toward the policy change this country needs: routine testosterone screening as a standard part of preventive care for all men, not just those in uniform.”

Clinical context

The DoD announcement follows recent federal efforts to update the regulatory landscape surrounding testosterone therapy.

In March 2025, the FDA announced class-wide labeling changes for testosterone products following findings from the phase 4 TRAVERSE trial and postmarketing ambulatory blood pressure monitoring studies, removing the boxed warning regarding increased cardiovascular risk while adding updated warnings about increased blood pressure.³

In June 2026, the US Department of Health and Human Services (HHS) announced that the FDA had requested additional revisions to prescribing information for TRT products based on newer clinical evidence.⁴ The proposed changes would remove the longstanding limitation of use stating that the safety and effectiveness of testosterone therapy had not been established in men with age-related hypogonadism and revise labeling related to prostate cancer and benign prostatic hyperplasia. Under the proposed labeling, testosterone therapy would remain contraindicated in men with metastatic prostate cancer, while recommendations for prostate cancer risk assessment, screening, and monitoring during treatment would continue.

HHS officials said the requested updates are intended to better align product labeling with the current body of clinical evidence while supporting informed decision-making by clinicians and patients.

REFERENCES

1. @SecWar. The High-T Department of War. Posted July 15, 2026. Accessed July 17, 2026. https://x.com/SecWar/status/2077425458430230838

2. Marius Pharmaceuticals welcomes Department of Defense's new testosterone screening initiative for U.S. Service Members. News release. Marius Pharmaceuticals LLC. July 16, 2026. Accessed July 17, 2026. https://www.globenewswire.com/news-release/2026/07/16/3328481/0/en/marius-pharmaceuticals-welcomes-department-of-defense-s-new-testosterone-screening-initiative-for-u-s-service-members.html

3. FDA issues class-wide labeling changes for testosterone products. News release. FDA. February 28, 2025. Accessed July 17, 2026. https://www.fda.gov/drugs/drug-safety-and-availability/fda-issues-class-wide-labeling-changes-testosterone-products

4. HHS announces requested updates to testosterone therapy product labels. News release. US Department of Health and Human Services. June 18, 2026. Accessed July 17, 2026. https://www.hhs.gov/press-room/fda-requests-updates-testosterone-therapy-labeling.html