Study Warns Low Testosterone Screening Could Affect Up to 25% of U.S. Army Personnel

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New research reveals mandatory testosterone screenings in the U.S. Army may yield low-testosterone results in up to a quarter of soldiers, raising concerns over unnecessary diagnoses and treatments.

A recent study published in JAMA highlights potential drawbacks of the U.S. Army’s new mandatory low testosterone screening program, which could flag as many as 25 percent of active-duty soldiers with low testosterone levels. This finding has prompted caution from medical experts who advise against broad screening for low testosterone without symptoms.

The study, conducted by researchers at Louisiana’s Pennington Biomedical Research Center and the U.S. Army Research Institute of Environmental Medicine in Massachusetts, analyzed data from a military health survey involving 479 male soldiers. Blood samples collected between August 2024 and January 2026 showed a weighted average testosterone level of 405 nanograms per deciliter (ng/dL). Using the Department of Defense’s clinical threshold of below 300 ng/dL to define low testosterone, the researchers estimate that about 26 percent of service members might test below that level, while a slightly lower cutoff from the Centers for Disease Control and Prevention (264 ng/dL) would still flag approximately 15 percent.

Medical experts have long warned that testosterone levels can fluctuate due to various non-disease factors including age, obesity, physical stress, illness, sleep quality, trauma, and medications. Clinically significant hypogonadism, which warrants treatment, is rare—affecting roughly 1 percent of men—and is typically diagnosed based on persistent symptoms and confirmatory testing rather than a single blood test. The American Urological Association and the Endocrine Society recommend against universal screening because of the risks of false positives, unnecessary follow-up, and overtreatment that can lead to side effects, including infertility.

The Army’s screening program, announced by Defense Secretary Pete Hegseth in July 2026 and accompanied by Pentagon clinical guidance in September, initially screens men aged 30 and above, with younger soldiers allowed to opt in. The screening process begins by assessing symptoms and risk factors such as obesity, type 2 diabetes, low-trauma fractures, disturbed sleep, low motivation, and diminished physical performance—symptoms that are often nonspecific and common among military personnel.

Given that testosterone replacement therapy is a long-term treatment with potential adverse effects, the study's authors stress the importance of distinguishing between a single low test result and a true clinical diagnosis of hypogonadism. They emphasize that positive screening results will require comprehensive follow-up, including repeated testing, detailed clinical evaluation, counseling on modifiable lifestyle factors, and careful consideration before initiating treatment.

Overall, the study raises concerns that the new mandatory screening could lead to a cascade of unnecessary medical evaluations in a substantial fraction of Army personnel, underscoring the tension between proactive health monitoring and the risks of overdiagnosis in large populations.