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

Endo T Monitoring Early And 6mo by dromlakhani

Name: Endo T Monitoring Early And 6mo
Rating: 4.2 (5 reviews)
Author: dromlakhani

Endo T Monitoring Early And 6mo

This skill recommends monitoring serum testosterone levels 3–6 weeks after initiating therapy and every 6 months thereafter to detect overuse or signs of androgen excess. It is triggered when a clinician manages a woman on testosterone therapy requiring early safety assessment and ongoing surveillance for adverse effects.

dromlakhani Updated Sep 8, 2026 10 repo stars

File contents

Suggest testosterone monitoring at 3–6 weeks and every 6 months thereafter

STEP 1 — Gather Information

Collect the date of testosterone therapy initiation, baseline testosterone level (if obtained), and any clinical signs of androgen excess such as acne, hirsutism, voice deepening, or clitoromegaly.

STEP 2 — Rule In / Rule Out

Is the patient within 3–6 weeks of testosterone therapy initiation? If yes, proceed to early safety check; if no, proceed to routine 6‑month surveillance.

STEP 3 — Classify or Stratify

Classify the measured testosterone level: elevated above the upper limit of the normal female range (suggesting overuse/androgen excess), within the normal range, or below the normal range (possible underdosing).

STEP 4 — Decide

If testosterone is elevated, consider dose reduction or temporary discontinuation and re‑check in 3–6 weeks; if normal, continue current dose and repeat testing in 6 months; if low, evaluate for dose increase after assessing for lack of efficacy.

Clinical Guardrails / Mimics / Pitfalls

Do not rely on symptoms alone for dose adjustment; avoid using immunoassays known to be inaccurate in women; do not continue therapy beyond 6 months without reassessment if there is no clinical response; do not use oral testosterone formulations formulated for men due to safety concerns in women.

Concrete Clinical Example

A 52‑year‑woman with HSDD begins transdermal testosterone 300 µg/d. Baseline T is 12 ng/dL. At 5 weeks, T measures 48 ng/dL (above normal). The clinician reduces the dose to 150 µg/d and schedules a repeat level in 4 weeks.

Source: Androgen Therapy in Women: A Reappraisal: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2014, DOI:10.1210/jc.2014-2260

---name: endo-t-monitoring-early-and-6modescription: This skill recommends monitoring serum testosterone levels 3–6 weeks after initiating therapy and every 6 months thereafter to detect overuse or signs of androgen excess. It is triggered when a clinician manages a woman on testosterone therapy requiring early safety assessment and ongoing surveillance for adverse effects.---# Suggest testosterone monitoring at 3–6 weeks and every 6 months thereafter## STEP 1 — Gather InformationCollect the date of testosterone therapy initiation, baseline testosterone level (if obtained), and any clinical signs of androgen excess such as acne, hirsutism, voice deepening, or clitoromegaly.## STEP 2 — Rule In / Rule OutIs the patient within 3–6 weeks of testosterone therapy initiation? If yes, proceed to early safety check; if no, proceed to routine 6‑month surveillance.## STEP 3 — Classify or StratifyClassify the measured testosterone level: elevated above the upper limit of the normal female range (suggesting overuse/androgen excess), within the normal range, or below the normal range (possible underdosing).## STEP 4 — DecideIf testosterone is elevated, consider dose reduction or temporary discontinuation and re‑check in 3–6 weeks; if normal, continue current dose and repeat testing in 6 months; if low, evaluate for dose increase after assessing for lack of efficacy.## Clinical Guardrails / Mimics / PitfallsDo not rely on symptoms alone for dose adjustment; avoid using immunoassays known to be inaccurate in women; do not continue therapy beyond 6 months without reassessment if there is no clinical response; do not use oral testosterone formulations formulated for men due to safety concerns in women.## Concrete Clinical ExampleA 52‑year‑woman with HSDD begins transdermal testosterone 300 µg/d. Baseline T is 12 ng/dL. At 5 weeks, T measures 48 ng/dL (above normal). The clinician reduces the dose to 150 µg/d and schedules a repeat level in 4 weeks.**Source:** Androgen Therapy in Women: A Reappraisal: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2014, DOI:10.1210/jc.2014-2260

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