五角大楼于周四发布最新指引，要求现役及预备役 30 岁以上男性军人接受睾酮缺乏强制筛查。
两周前，这套强制筛查相关指引曾从美国国防部网站 “临时撤销”。
此前被撤下的旧版指引还提出，要询问女性军人是否存在疲劳、月经紊乱等可能和激素失调相关的症状。
当时官方并未给出临时撤稿理由。国防部长皮特・赫格塞思的一名高级顾问称，这份文件只是一份草案，属于意外误发上网。
五角大楼首席发言人肖恩・帕内尔就新版指引发表声明：“本指引针对男性睾酮缺乏问题，在国防卫生局体系内建立统一筛查与诊疗流程，并明确合规责任。”
帕内尔补充表示：“通过主动发现并干预激素水平异常问题，国防部持续投入军人健康建设，改善身体状态，最大化部队战备能力。”
根据这份临床诊疗指引，所有 30 岁以上男性军人将完成一套标准化症状与风险评估；30 岁以下军人可自行申请筛查。
睾酮采血检测要求连续两个清晨空腹取样；第二次抽血还会同步检测促黄体生成素（LH）与促卵泡激素（FSH）两项垂体分泌的关键生殖激素。
此外，如果总睾酮数值处于正常区间，还会进一步检测游离睾酮。总睾酮指人体血液内全部睾酮总量，包含蛋白结合态与游离态；游离睾酮专指不与蛋白结合、具备生物活性的那一部分激素。
周四公布的新版指引写明，针对女性军人的相关方案 “尚在审核，获批后对外发布”。
今年早些时候，赫格塞思曾宣布军人将每年进行睾酮检测，这也是近年备受关注的健康领域一项重大政策转向。
睾酮水平偏低是美军颇为关注的健康问题，特种部队尤为突出。长期高压、高强度体力消耗，再加上热量摄入不足，都可能压低睾酮水平，相关研究仍在持续推进。
据美国泌尿协会数据，截至 2023 年，美国有 400 万‑1380 万男性存在睾酮缺乏，但整体真实患病规模尚不明确，业界判定缺乏症的参考标准也并不统一。
睾酮问题更多见于年长男性，以及糖尿病、肥胖人群。
部分医生提出担忧：网络上大肆炒作 “低睾酮” 概念，容易造成认知误导，放大该问题的普遍性。
近些年睾酮检测以及激素处方量翻了三倍。但美国泌尿协会指出，接受睾酮替代治疗的男性当中，高达 25% 并未经过完整规范检测。协会还表示，大约三分之一接受睾酮疗法的男性并不满足医学确诊标准：确诊睾酮缺乏，既要存在相关症状，还至少要有两次清晨总睾酮化验结果偏低。
长期以来，美军及其家属的医保计划 Tricare 已经可以为军人提供睾酮检测和激素替代治疗，但该项检查此前从未纳入年度体检；传统年度体检项目主要为疫苗接种、视力听力以及其他常规查体。
目前五角大楼尚未对外公布合格睾酮参考值，睾酮指标偏低是否会对军人职业发展造成影响，也尚无明确说法。
Pentagon posts new guidance for mandatory testosterone screening． Here＇s what it may mean
The Pentagon posted new guidance on Thursday for mandatory testosterone deficiency screening among male service members over age 30 in active duty or in the reserves．
It comes two weeks afterguidelines for mandatory screening were ＂temporarily rescinded＂from a Department of Defense website．
The guidelines that were pulled two weeks ago also provided guidance that female service members be asked about fatigue and disrupted menstrual cycles that could be associated with hormonal dysregulation．
No other reason was offered as to why the guidance was temporarily rescinded， but a top adviser to Defense Secretary Pete Hegseth described the documents posted on the website as a ＂draft＂ document that had been ＂inadvertently＂ posted．
＂This guidance addresses male testosterone deficiency， establishing uniform screening and treatment pathways across the DHA enterprise and assigning responsibility for compliance，＂ Sean Parnell， chief Pentagon spokesman， said in a statement on the new guidelines．
＂By proactively identifying and treating suboptimal hormone levels， the Department continues to invest in the health of its warfighters， strengthen their performance， and maximize force readiness，＂ Parnell＇s statement added．
Under the clinical practice guidelines， all male service members over age 30 will be screened with a ＂structured symptom and risk assessment．＂ Service members under age 30 may be screened upon request．
Service members will have testosterone levels measured on two separate days in the morning while they are fasting．
The repeat draw will include an LH／FSH blood test panel， which measures the luteinizing hormone and the follicle-stimulating hormone， two key reproductive hormones produced by the pituitary gland．
Additionally， when total testosterone levels are in range， levels of free testosterone will be tested． Total testosterone is the entire amount of testosterone circulating in the body， both bound and unbound to proteins and isbiologically active， while free testosterone refers only to the hormone not bound to proteins and is biologically active．
The new guidelines posted on Thursday said guidance for female service members are ＂being reviewed and will be posted upon approval．＂
Earlier this year， Hegsethannouncedthat troops would be tested annually for testosterone levels， a significant shift on a health issue that has gained momentum in recent years．
Low testosterone levels have been a concern in the military， particularly in the special operations community， where high stress and extreme physical labor， paired with not getting enough calories， could negatively impact testosterone levels -- though research is still ongoing．
As of 2023， between 4．0 million and 13．8 million men in the U．S． have testosterone deficiency， according to theAmerican Urological Association（AUA）， though the full scope of the issue is unclear， and there are different thresholds used to measure whether someone has a deficiency．
Testosterone issues are most common among older men， and those with diabetes or obesity．
Some doctors are concerned that the online popularity of ＂low-T＂ as a medical problem creates a false impression that this is a bigger problem than it really is．
Testosterone testing and prescribing have tripled in recent years． However， some studies suggest that up to 25% of men who receive testosterone therapy do not have their levels properly tested， according to theAUA．
The AUA estimates up to a third of men who are put on testosterone therapy do not meet the criteria for a medical diagnosis， previously telling ABC News in a statement ＂a testosterone deficiency diagnosis requires both symptoms and／or signs of low testosterone and at least two separate early-morning total testosterone measurements demonstrating low testosterone levels．＂
Meanwhile， up to one-third of men who are put on testosterone therapy do not meet the criteria for a medical diagnosis．
Service members have long had access to testosterone testing and replacement therapy through Tricare， the health insurance program for military personnel and their families． But the screenings have never been part of the military＇s annual health assessments， which have traditionally focused on vaccinations， vision and hearing tests， and other routine medical evaluations．
It＇s unclear what testosterone levels the Pentagon would find acceptable． It＇s also unclear whether troops with lower levels could face professional consequences．
