The Pentagon issued formal clinical guidance on Thursday, September 17, 2026, requiring mandatory testosterone deficiency screening for all male active-duty and reserve service members over the age of 30. The updated policy establishes uniform screening and treatment pathways across the Defense Health Agency (DHA), which oversees medical care for the U.S. military. Service members under the age of 30 may also be screened upon request or if a healthcare provider identifies clinical indicators.
This final guidance follows a temporary rescission of a previous version earlier in September after officials described it as an inadvertently posted draft. Defense Secretary Pete Hegseth first announced the initiative in July 2026, stating the program is intended to maintain a decisive tactical advantage by optimizing warfighter performance and long-term health. The Department of Defense stated the screenings would be incorporated into annual medical assessments to ensure force readiness.
The screening process involves a structured assessment of symptoms and risk factors. According to the DHA, symptoms include erectile dysfunction, reduced sexual desire, loss of muscle mass, disturbed sleep, and diminished physical endurance. If symptoms are present, service members will undergo blood tests on two separate days between 7 a.m. and 10 a.m. while fasting. The guidelines specify that a diagnosis will not be made based on a single test result and require specific follow-up panels to measure reproductive hormones.
Service members will notice these screenings integrated into their yearly health evaluations. If a deficiency is confirmed through the mandated two-step blood testing, the DHA may offer testosterone replacement therapy (TRT). The guidance specifies that injection therapy would typically start at 100 mg once weekly. Personnel on TRT must achieve clinical stability for four to six weeks before deployment, after which they would move to a six-month monitoring schedule. The Pentagon noted that stable service members should be deployable without requiring a waiver, potentially reducing administrative barriers for those receiving treatment.
The implementation sets a precedent for how the military manages hormonal health as a component of combat readiness. The DHA is currently reviewing a separate clinical practice guideline for female service members, though it has not yet been approved or posted. While the Pentagon aims to improve performance, the guidance acknowledges medical risks, such as potential drops in sperm count, and advises against starting therapy for those planning to conceive. The mandatory screenings were effective as of the issuance of the guidance on September 17, 2026.