Pentagon introduces testosterone deficiency screening for military personnel — The Hill
The U.S. Department of Defense has released new guidelines for mandatory screening for testosterone deficiency among male active-duty and reserve service members over the age of 30. The document was issued after previous guidelines were temporarily withdrawn earlier this month, The Hill reports.
The new rules are intended to standardize approaches to identifying and treating testosterone deficiency within the U.S. Department of Defense’s Defense Health Agency. Pentagon chief spokesperson Sean Parnell said the department seeks to identify and treat insufficient hormone levels early in order to support service members’ health, performance, and combat readiness.
Assessment of symptoms and risks
The screening involves a structured assessment of symptoms and risk factors. Male service members under the age of 30 will undergo it at their own request or if there are clinical indications determined by a medical professional.
Symptoms that medical professionals will consider include erectile dysfunction, reduced sex drive, unexplained loss of muscle mass or an increase in body fat, depressed mood, low motivation, sleep disturbances, impaired concentration or memory, and reduced physical endurance unrelated to injury. Risk factors include, among others, obesity, type 2 diabetes or metabolic syndrome, prolonged use of opioids or glucocorticoids, traumatic brain injuries involving loss of consciousness, and suspected obstructive sleep apnea.
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Testing and therapy conditions
A diagnosis will not be made based on the result of the first laboratory test: a second test will be conducted on a different day under the same conditions. Testing must take place between 7:00 a.m. and 10:00 a.m., while for service members working night or rotating shifts, it must be conducted within three hours of waking after adequate sleep. Fasting is required before the test; it will also not be performed within 30 days after recovery from an illness.
If testosterone replacement therapy is prescribed, the agency will consider the service member’s preferences and convenience regarding the medication form, the ability to adhere to treatment, and the appropriateness of the selected treatment. For injectable therapy, the guidelines provide for testosterone cypionate or enanthate at a starting dose of 100 mg once a week, or dividing the weekly dose into two administrations.
Therapy may be initiated within 90 days before a service member’s deployment. To continue treatment during deployment, a follow-up assessment after four to six weeks is required to confirm clinical stability and a testosterone level within the target range of 300–600 ng/dL. A stable patient receiving therapy may be eligible for deployment without special authorization, depending on the medication form.
