美国国防部长皮特・赫格塞思于周三宣布新规：所有 30 岁及以上军人每年必须接受睾酮检测。这一政策引发诸多疑问，包括检测流程，以及睾酮指标偏低人群是否需要接受睾酮替代治疗。
赫格塞思在公告中表示，这项新增强制睾酮筛查(睾酮是男性主要性激素)，将纳入军人年度常规健康体检;未满 30 岁的军人也可主动申请在体检中加做睾酮检测。
赫格塞思就任国防部长以来，美军已推出多项体能相关改革，本次激素筛查是又一新举措，此前军方已调整体能考核标准与体成分测算方式。
结合国防部长发布的新规，以下为关于睾酮检测的完整科普： 睾酮偏低会出现哪些症状?
美国泌尿协会数据显示，全美约 2% 男性存在睾酮水平低下问题。 美国国家医学图书馆旗下医学数据库 StatPearls 介绍，睾酮缺乏典型表现有：性欲减退、勃起功能下降、情绪低落、思维迟钝、空间感知能力变差、疲惫乏力、抑郁、易怒;同时容易体脂上涨、肌肉量与力量下降、体毛稀疏、骨密度降低，进而诱发骨质疏松、骨骼脆弱。
临床研究证实，睾酮治疗能够缓解上述不适，显著改善性欲、贫血、骨密度、肌肉含量、抑郁状态及勃起功能。 如何检测睾酮是否偏低?
美国国家医学图书馆健康平台 MedlinePlus 介绍，确诊睾酮缺乏只需抽血检测总睾酮，包含结合型睾酮与游离睾酮两类指标。 结合型睾酮：与血液中蛋白质结合，人体难以吸收利用; 游离睾酮：未和蛋白结合，可直接参与骨骼、肌肉合成，更易被身体利用。
平台补充说明：人体大部分睾酮与蛋白结合是一种自我保护机制，避免激素过量作用损伤身体。
美国泌尿协会强调，采血时间与检测稳定性直接影响结果准确性。睾酮水平在清晨达到峰值，且会随睡眠、压力每日波动。临床标准要求：至少分两次抽血，且采血时段均为早上 7 点至 10 点，才能最终确诊真性睾酮缺乏。
印第安纳大学男性生殖医学主任、泌尿学副教授海伦・伯尼博士(未供职美军)接受美国广播公司采访时表示：“获取自身睾酮基准数值十分关键。” 她称，睾酮是反映男性整体健康的核心生物标志物，一旦确诊睾酮缺乏，会直接影响精力状态，基准数据能帮助医生排查多种相关健康问题。
女性体内同样会分泌睾酮，但分泌量远低于男性。MedlinePlus 指出，女性睾酮偏低，往往提示肾上腺、垂体或卵巢存在病变。 什么是睾酮替代治疗?
StatPearls 定义：睾酮替代治疗(简称 TRT)属于处方药治疗手段，专门针对确诊睾酮缺乏人群，安全将激素调回健康正常区间。
治疗方案因人而异，常见给药方式有每日外用凝胶、定期注射、皮下缓释埋植颗粒。治疗核心目的是改善持续疲惫、情绪异常、肌肉流失、性欲低下等临床症状。
伯尼特别提醒：单次检测睾酮数值偏低，不等于需要立刻开展替代治疗。 “激素数值偏低只是完整评估的起点，医生还要结合个人症状、可逆转诱因综合判断。治疗目标是把激素恢复至人体正常生理水平、缓解不适，而非单纯拉高化验单数字。” 补充睾酮能否延长寿命?
目前没有充足可靠的医学证据证明，人为提升睾酮能够延年益寿。
美国内分泌学会表示：对于睾酮处于同龄正常水平的男性，美国食品药品监督管理局并未批准通过补充睾酮增强体能、提升运动表现。
医生普遍认为，睾酮并非越高越好。本身不缺乏睾酮的人群额外补充，会引发多种健康风险，StatPearls 列举并发症如下：痤疮等皮肤问题、睡眠呼吸暂停、外用贴片 / 凝胶引发皮肤过敏、情绪暴躁易怒、男性乳房组织增生。
除此之外，睾酮治疗会促进红细胞增殖，让血液黏稠度上升，提升血栓、中风、心梗发病风险;同时会抑制精子生成，影响生育能力。 普通人有必要检测睾酮吗?
伯尼认为，所有人都建议检测一次睾酮，留存个人基础参考值。 “每个人至少要清楚自己的睾酮基准水平，这是衡量男性全身健康的重要指标。”
她补充，几类人群建议定期筛查：糖尿病患者、接受过化疗 / 放疗人群、长期服用麻醉类药物人群;只要出现睾酮偏低相关不适症状，都应主动检测。 军人查出睾酮偏低会怎样?
军方这套筛查细则尚未完全落地。赫格塞思在视频中提到，检测显示睾酮偏低的军人，可以自主选择接受睾酮替代治疗。
目前五角大楼尚未划定睾酮合格参考标准，也未明确激素指标偏低是否会对军人岗位、晋升造成影响。
What to know about testosterone after Defense Secretary Pete Hegseth directs screening for troops over 30
Defense Secretary Pete Hegseth's announcement Wednesday that military members 30 and up must undergo annualtestosterone screeningshas raised questions about the testing process and potential testosterone replacement therapy for those with lower levels of the hormone.
Hegsethsaid in his announcement that the new required screenings for testosterone -- the primary male sex hormone -- would occur during service members' annual Periodic Health Assessments, and that troops under 30 will be able to request a testosterone screening as part of their assessment.
The new policy follows several other fitness-related changes made within the military services during Hegseth's tenure as secretary, which have so far included adjustments to physical fitness tests and how the military measures body composition.
Below, read what you should know about testosterone testing in light of Hegseth's announcement.
What are the symptoms of low testosterone?
Some 2% of men in the United States have low testosterone, according to theAmerican Urological Association.
Symptoms of low testosterone include decreased sexual desire, decreased erections, low mood, decreased intellectual activity and spatial orientation, fatigue, depression, and anger. It can also cause increased body fat with associated decreases in muscle volume and strength, decreased body hair, and decreased bone density resulting in osteoporosis or weakening of bones, according toStatPearls, an online medical resource published by the National Library of Medicine.
Testosterone therapy may help reduce these symptoms and has been found in clinical trials to help significantly improve libido, anemia, bone density, lean body mass, depression, and erectile function, StatPearls states.
How do you test for low testosterone?
Diagnosing low testosterone relies on a straightforward blood test measuring total testosterone -- both "bound" and "free" (or "unbound") -- according toMedlinePlus, an online health resource run by the National Library of Medicine.
"Bound" testosterone is testosterone that is bound to proteins in the blood, while "free" testosterone is not; the latter is "more available for your body to use when building bones and muscles," MedlinePlus states, while bound testosterone is harder for the body to use.
"This is necessary for your health. Having most of your testosterone bound to proteins makes sure your body doesn't use too much," it notes.
Both the timing and consistency of a testosterone screening are critical for an accurate result, according to theAmerican Urological Association.
Because testosterone levels naturally peak in the early morning and fluctuate daily based on factors like sleep and stress, clinical standards require at least two separate blood draws, both performed between 7 and 10 a.m., to officially confirm a true deficiency,according to MedlinePlus.
"I think it's really important to get a baseline level," Helen L. Bernie, DO, MPH, director of male sexual and reproductive medicine at Indiana University and an associate professor of urology, told ABC News.
Bernie, who is not associated with the U.S. military, said knowing that baseline could make patients aware of a wide variety of health issues stemming from low testosterone levels.
"We know testosterone is an important biomarker for a man's overall health. So, if a man truly has low testosterone, or what we call testosterone deficiency, it can affect their energy levels" she said.
Females also produce testosterone, but at a much lower level than men. Low testosterone levels in females can be a sign of adrenal and pituitary gland disorders or an ovary disorder, according to MedlinePlus.
What is testosterone replacement therapy?
Testosterone replacement therapy, or TRT, is a prescription medical treatment aimed at safely restoring hormone levels back to a normal, healthy range, for those diagnosed with a testosterone deficiency, according toStatPearls.
It is highly customized to the patient and typically delivered via daily topical gels, regular injections, or slow-release subcutaneous pellets, with the ultimate goal of reversing clinical symptoms like persistent fatigue, mood changes, muscle loss, and low libido, according to StatPearls.
Bernie stressed that low levels during a testosterone screening do not automatically indicate a need for testosterone replacement therapy.
"Really, just a low testosterone result should be the beginning of an evaluation," she said, noting other factors to consider include symptoms and any reversible causes that may be responsible for the low levels.
"The goal is to restore someone's testosterone to a normal physiologic range and improve symptoms. It's not simply just to raise the laboratory value," she added.
Is increased testosterone good for longevity?
There is no robust data to suggest boosting testosterone can help as a longevity tool.
Among men with age-appropriate testosterone levels, boosting testosterone is also not approved by the Food and Drug Administration as a way to improve strength or athletic performance, according to theEndocrine Society.
Doctors say that more testosterone is not necessarily better. In fact, using testosterone when you do not have a testosterone deficiency can lead to health problems. Complications can include acne and similar skin problems, sleep apnea, skin reactions to patches or gels, steroid rage and emotional disorders, and enlarged breast tissue, according to StatPearls.
In addition, testosterone therapy increases red blood cell production, making the blood thicker, and potentially increases the risk of blood clot, stroke and heart attack. It can also affect fertility as it can decrease sperm production.
Does the average person need to test for testosterone?
According to Bernie, it can be helpful for anyone to test testosterone levels in order to achieve understanding of their baseline level.
"I think it's safe to say that everyone should at least know what their baseline number is," she said. "Testosterone is a really important biomarker of a man's overall health."
Bernie said added that some patient populations, including those with a history of diabetes, chemotherapy, radiation, narcotic use, and more, should be screened routinely. Any patients with signs or symptoms of low testosterone should test for it as well.
What happens if troops are diagnosed with low testosterone?
Although the military's new screening policy has not yet been fully defined, Hegseth indicated in his video that service members whose tests show low testosterone levels will have the option to undergo testosterone replacement therapy.
It's unclear what testosterone levels the Pentagon would find acceptable. It's also unclear whether troops with lower levels could face professional consequences.
