US troops ages 30 and up will get tested for testosterone levels annually, Defense Secretary Pete Hegseth Pete Hegseth announced Wednesday.
The new T check would be added to an existing annual physical for military members. Hegseth says by “addressing these health markers early, we’re keeping [troops] on the leading edge of lethality.”
It’s true that men begin experiencing a gradual drop in testosterone starting earliest at age 30, though for most men, it’s later, around age 40. By age 50-55, symptoms of low T may become more obvious.
But do men actually need routine testing — especially if they aren’t exhibiting any symptoms?
This automatic annual check goes against recommendations from several medical bodies, including the American Urological Association and Endocrine Society, who say doctors should not measure T in patients who don’t have symptoms.
“We recommend against routine screening of men in the general population for hypogonadism,” reads the Endocrine Society’s official recommendations.
Thirty, too, is cited by some experts as young.
“Age 30 is earlier than we would typically screen the general population because clinically significant testosterone deficiency is relatively uncommon in otherwise healthy men at that age,” said Dr. Raj Patel, a urologist at Associated Urological Specialists, told The Post.
He notes, though, that troops have unique demands that may “appropriately differ from the general population.” In fact, Dr. Justin Houman told The Post he thinks the new testing could even be a “welcome step.”
“Thirty is actually a sensible starting point, not too young at all,” said Houman, a board-certified urologist and men’s health specialist at Tower Urology at Cedars-Sinai. “Since the prevalence of low testosterone in this age group is meaningfully high while symptom awareness is low, 30 is precisely when establishing a baseline becomes valuable.”
Houman points to symptoms beyond just sex drive — testosterone affects mood, focus, muscle, bone density, and red blood cell production.
“Recent data suggests roughly 1 in 4 men over 30 has low testosterone, yet only about 1 in 20 recognizes symptoms, meaning many men are quietly living below their potential without ever connecting the dots.”
This new testosterone check could be great for people who actually aren’t producing enough testosterone and would’ve otherwise gone undiagnosed, Patel said. It could improve their quality of life dramatically.
But he worries about overdiagnoses.
As many as 11 million Americans are on testosterone replacement therapy, or TRT. Recent research shows as few as 12% of men on TRT met standards for prescribing T — the other 88% were given the drug inappropriately.
Some of the emblematic symbols of low T could be symptoms of other health conditions that require different treatment.
Testing testosterone levels via a blood test is required for a TRT prescription. That blood test is “low-risk, inexpensive, and easy to fold into a routine physical,” Houman said.
But a low T level alone “doesn’t automatically mean someone needs treatment,” said Patel.
“Testosterone replacement therapy has important risks and requires ongoing monitoring, including effects on fertility, red blood cell counts, prostate health, and potential cardiovascular risk,” Patel said. “The goal should be treating a medical condition—not optimizing performance in otherwise healthy individuals.”
Testosterone can stimulate prostate growth and make existing cancer there worse, or stimulate too much red blood cell production, forming a clot that could be deadly.
Testosterone-boosting drugs also carry risks to fertility by limiting your body’s natural production of testosterone. This can result in decreased sperm count and shrunken testicles. TRT could permanently affect the production of sperm.
Houman agrees that monitoring is essential. “Testosterone therapy is safe and effective when it’s genuinely indicated, but it’s a medical decision that should be individualized and monitored, not applied reflexively.”
If they’re found to be low in T, troops can choose whether they want to take testosterone replacement therapy with the new policy.
Houman also encourages men even younger than 30 to get screened if they’re symptomatic. Hegseth’s new test will also be available, but not required, for troops younger than 30.
“While we invest heavily in our weapon systems, platforms and gear, our most decisive tactical advantage will always be the individual warfighter,” Hegseth said. “We have a sacred duty to maintain that advantage, which is why we must constantly look for new ways to optimize your performance, your resilience and your long-term health.”
