How do I install the Ata Male Testosterone Replacement Indications skill?

Run npx skillmds@latest add dromlakhani/ata-male-testosterone-replacement-indications in your terminal (requires Node.js), paste this page's agent-chat prompt into Claude, Cursor, or any MCP-connected agent, or download the SKILL.md file and copy it into your agent's skills directory.

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Is Ata Male Testosterone Replacement Indications free to use?

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Who published Ata Male Testosterone Replacement Indications?

dromlakhani (@dromlakhani) published this skill. Their other Agent Skills are listed on their SkillMD profile.

Ata Male Testosterone Replacement Indications by dromlakhani

Name: Ata Male Testosterone Replacement Indications
Rating: 4.2 (5 reviews)
Author: dromlakhani

Ata Male Testosterone Replacement Indications

Recommends testosterone replacement for adult males with central hypogonadism and no contraindications to prevent anemia related to T deficiency; reduce fat mass; and improve BMD, libido, sexual function, energy levels, sense of well-being, and muscle mass and strength. Triggers include consideration of testosterone replacement in males with central hypogonadism (e.g., low serum testosterone with symptoms of deficiency).

dromlakhani Updated Sep 8, 2026 10 repo stars

File contents

Indicate testosterone replacement for adult males with central hypogonadism

STEP 1 — Gather Information

Collect morning total testosterone (before 10 AM after overnight fast), LH, FSH, and prolactin to confirm central hypogonadism (low testosterone with low/normal LH/FSH). Assess for contraindications: prostate or breast cancer, severe untreated sleep apnea, hematocrit >54%, PSA >4 ng/mL (or age-specific), and desire for fertility without discussing alternatives.

STEP 2 — Rule In / Rule Out

If total testosterone is below the laboratory lower limit with LH/FSH low or normal (indicating central hypogonadism) AND no contraindications are present → Rule in as eligible for testosterone replacement; otherwise → Rule out (do not initiate replacement).

STEP 3 — Classify or Stratify

Stratify by symptom burden: presence of anemia (Hb <13 g/dL), low BMD (T-score <-1.5), low libido, low energy, decreased muscle mass, or increased fat mass. If any of these are present → high priority for replacement; if none are present → still consider replacement for preventive benefit per guideline.

STEP 4 — Decide

Offer testosterone replacement (e.g., transdermal gel 50 mg daily or intramuscular ester 75–100 mg every 1–2 weeks) targeting physiologic total testosterone levels (approximately 300–1000 ng/dL). Schedule follow‑up labs (testosterone, hematocrit, PSA) and symptom review at 3–6 months.

Clinical Guardrails / Mimics / Pitfalls

Do not treat if prostate or breast cancer is present, severe untreated sleep apnea, hematocrit >54%, or if the patient desires fertility without discussing alternatives (e.g., gonadotropins). Avoid in uncontrolled heart failure or recent myocardial infarction/stroke. Monitor for erythrocytosis and worsening sleep apnea.

Concrete Clinical Example

A 45‑year‑old male post‑resection of a pituitary macroadenoma has morning testosterone 200 ng/dL, LH 1.5 IU/L, FSH 2.0 IU/L, normal prolactin, hemoglobin 12.8 g/dL (mild anemia), lumbar spine T‑score –2.0, reports low libido and fatigue. No contraindications identified. Initiate testosterone gel 50 mg daily, re‑check testosterone and hematocrit in 3 months, assess symptoms and adjust dose as needed.

Source: Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2016, doi:10.1210/jc.2016-2118

---name: ata-male-testosterone-replacement-indicationsdescription: Recommends testosterone replacement for adult males with central hypogonadism and no contraindications to prevent anemia related to T deficiency; reduce fat mass; and improve BMD, libido, sexual function, energy levels, sense of well-being, and muscle mass and strength. Triggers include consideration of testosterone replacement in males with central hypogonadism (e.g., low serum testosterone with symptoms of deficiency).---# Indicate testosterone replacement for adult males with central hypogonadism## STEP 1 — Gather InformationCollect morning total testosterone (before 10 AM after overnight fast), LH, FSH, and prolactin to confirm central hypogonadism (low testosterone with low/normal LH/FSH). Assess for contraindications: prostate or breast cancer, severe untreated sleep apnea, hematocrit >54%, PSA >4 ng/mL (or age-specific), and desire for fertility without discussing alternatives.## STEP 2 — Rule In / Rule OutIf total testosterone is below the laboratory lower limit with LH/FSH low or normal (indicating central hypogonadism) AND no contraindications are present → Rule in as eligible for testosterone replacement; otherwise → Rule out (do not initiate replacement).## STEP 3 — Classify or StratifyStratify by symptom burden: presence of anemia (Hb <13 g/dL), low BMD (T-score <-1.5), low libido, low energy, decreased muscle mass, or increased fat mass. If any of these are present → high priority for replacement; if none are present → still consider replacement for preventive benefit per guideline.## STEP 4 — DecideOffer testosterone replacement (e.g., transdermal gel 50 mg daily or intramuscular ester 75–100 mg every 1–2 weeks) targeting physiologic total testosterone levels (approximately 300–1000 ng/dL). Schedule follow‑up labs (testosterone, hematocrit, PSA) and symptom review at 3–6 months.## Clinical Guardrails / Mimics / PitfallsDo not treat if prostate or breast cancer is present, severe untreated sleep apnea, hematocrit >54%, or if the patient desires fertility without discussing alternatives (e.g., gonadotropins). Avoid in uncontrolled heart failure or recent myocardial infarction/stroke. Monitor for erythrocytosis and worsening sleep apnea.## Concrete Clinical ExampleA 45‑year‑old male post‑resection of a pituitary macroadenoma has morning testosterone 200 ng/dL, LH 1.5 IU/L, FSH 2.0 IU/L, normal prolactin, hemoglobin 12.8 g/dL (mild anemia), lumbar spine T‑score –2.0, reports low libido and fatigue. No contraindications identified. Initiate testosterone gel 50 mg daily, re‑check testosterone and hematocrit in 3 months, assess symptoms and adjust dose as needed.**Source:** Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2016, doi:10.1210/jc.2016-2118

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