Military Testosterone Screening Could Flag Up to 26% of Army Service Members

Experts generally caution against routinely screening all men for low testosterone because testosterone levels can vary significantly and may not provide a clear diagnosis. Levels can fall for many reasons, including age, time of day, obesity, illness, physical stress, lack of sleep, trauma, and certain medications.

Clinically significant low testosterone, known as male hypogonadism, is also rare, affecting no more than 1% of men. Causes can include genetic conditions and problems involving the pituitary gland.

Why universal testosterone screening can be difficult

Because testosterone levels are influenced by so many factors, experts recommend that patients report symptoms before undergoing an evaluation. Doctors typically use repeated testosterone tests along with a comprehensive medical assessment to diagnose male hypogonadism.

Researchers are unsure what the military’s new all-purpose screening program will produce because it differs from that current diagnostic approach.

Army study suggests widespread low testosterone results

New data suggests that a substantial share of military personnel could receive test results indicating low testosterone. The weighted average morning total testosterone level among Army members in the study was 405 ng/dL.

Department of Defense clinical guidance defines low testosterone as less than 300 ng/dL, consistent with recommendations from the American Urological Association. Using that cutoff and extrapolating the study data to the entire Army population, researchers estimate that approximately 26% of active-duty Army service members could receive results suggestive of low testosterone.

The Centers for Disease Control and Prevention cites a slightly lower harmonized standard cutoff of 264 ng/dL. Using that threshold, researchers estimate that approximately 15% of Army personnel would have low testosterone results.

Age and weight increase the likelihood of low readings

The likelihood of a low testosterone result increased with both weight and age. The higher a person’s BMI and the older they were, the more likely their testosterone measurement was to fall below one of the clinical thresholds.

About 19.5% of men under age 30 had low readings, compared with 33% of men over age 30.