US service members are required to undergo testosterone screening A quarter of active-duty male soldiers in the US Army have low testosterone, according to a study of nearly 500 personnel. This has implications for the recent ruling that all US service members aged 30 and older must undergo annual testosterone screening and be offered voluntary replacement therapy if they have low levels. Among the 479 male personnel tested, 26 per cent had testosterone levels below 300 nanograms per decilitre, classified as low by the American Urological Association.
Based on this, the researchers estimate that 100,691 male soldiers in the US Army could have low testosterone readings. Older male personnel were more likely to have low testosterone, with 33 per cent of those aged 30 and older being classified in this group. Female personnel weren’t included in the analysis because their testosterone levels were often below the limits of detection.
When announcing the testosterone-boosting initiative in July, Pete Hegseth, the US defence secretary, noted that testosterone levels naturally decline with age and said the decision to offer replacement therapy to soldiers with low levels was “about restoring and optimising your natural capabilities, protecting your longevity, ensuring you have the biological foundation required to sustain the fight”. There are no ramifications for choosing not to have the therapy, he said, adding that personnel under the age of 30 will also be able to opt for testosterone screening. But a single testosterone test isn’t a reliable measure of deficiency, says Katz.
Even if testosterone levels are consistently low in blood tests, that doesn’t necessarily mean someone has a deficiency, says Katz. The American Urological Association recommends that a clinical diagnosis be made only if an individual also has related symptoms, such as reduced energy, motivation, libido and erectile function. It also increases the risk of bone fractures and pulmonary embolism (blood clots in the lungs) in older men.
Timothy Piatkowski at the University of Queensland in Australia says there is a risk that high testosterone levels will be conflated with being a good soldier.
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