Higher testosterone has been associated with higher levels of aggression and power, thought to be positive attributes of active duty soldiers.
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Recently, Secretary of Defense Pete Hegseth declared that male military personnel on active duty over the age of 30 will undergo annual screenings for testosterone levels. Typically, men’s testosterone peaks in their 20s and gradually declines thereafter. To address any potential deficiency post-30, testosterone supplementation will be offered voluntarily. This testing will become a standard part of the yearly physical exam for all active-duty male personnel.
Testosterone, a hormone found in both males and females, is produced in the testes for males and in the ovaries and adrenal glands for females. In men, it influences testicular growth, sperm production, libido, facial hair growth, deeper voice, and body hair. It also strengthens bones and muscles. Insufficient testosterone at any age can lead to weakened muscles and bones, fatigue, and reduced libido. For women, testosterone supports ovarian function, libido, and bone and muscle health.
Both genders can experience medical issues if testosterone levels are imbalanced, resulting in sexual dysfunction, weakened muscles and bones, and general fatigue. In women, elevated testosterone levels can cause PMOS, or polyendocrine metabolic ovarian syndrome, formerly known as polycystic ovary syndrome (PCOS). Affecting up to one in eight premenopausal women, this condition can cause irregular periods, ovarian cysts, and infertility.
PMOS, associated with high testosterone levels in women, is remarkably common and often underrecognized.
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While testosterone supplements for men are not new, the Defense Department has introduced the testosterone testing and treatment plan as part of the “High T Department of War” as described by Hegseth in a video dated July 15, 2026. The “High T” concept links higher testosterone levels with increased strength, virility, and fighting capability. Testosterone replacement therapy (TRT) is favored by men with both normal and low testosterone levels, as it is associated with longer life, improved libido, and better musculoskeletal health. Women also use TRT during perimenopause and menopause.
TRT is readily available, including as “off-label” over-the-counter medications, but it’s classified as a controlled substance when requiring a prescription. Opinions among doctors vary on monitoring testosterone levels and administering TRT for low levels. Men with low testosterone but no symptoms should receive guidance on potential risks, ranging from mild issues like acne and breast tenderness to serious concerns such as blood clots, fertility changes, and mental health alterations. There are no established medical guidelines for routine testosterone testing in asymptomatic men as young as 30.
Low testosterone symptoms in men—including fatigue, erectile dysfunction, reduced libido, and bone and muscle issues—can be effectively treated with TRT. An FDA expert panel on testosterone replacement therapy convened in December 2025 to refine protocols for monitoring and treating men with low testosterone, regardless of symptoms. The US Department of Health and Human Services requested updated treatment guidelines and data on cardiovascular and prostate cancer risks of TRT, noting that recent studies show these risks may be less than previously reported.
Counseling is critical in deciding to initiate TRT.
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For young men, especially those in their 30s as testosterone levels naturally begin to decline, it remains unclear what options will be available for enlisted military personnel. TRT is a lifelong commitment, and even if some risks, like cardiovascular disease and prostate cancer, are lower than previously thought, ongoing monitoring for side effects and testosterone levels is necessary. Potential fertility decline and signs of high testosterone—including sleep issues, excess body hair, liver disease, weight gain, and mood disorders—also require consideration.
As with any new medication, understanding both its benefits and risks is crucial, and should be thoroughly discussed between the patient and their healthcare provider.
