How do I install the Icsm Avoid Tt In Eugonadal skill?

Run npx skillmds@latest add dromlakhani/icsm-avoid-tt-in-eugonadal 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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This skill has not completed SkillMD's automated safety review yet. Independent scanners report: SkillSpector: PASS, Skill Scanner: PASS. Capability flags: makes network calls. SkillMD never runs a skill's scripts for you; review the SKILL.md before installing.

Which AI agents work with Icsm Avoid Tt In Eugonadal?

This skill is tagged as working with Claude Code, Claude.ai, OpenAI Codex. SKILL.md is an open format, so most agents that read a skills directory can load it too.

Is Icsm Avoid Tt In Eugonadal free to use?

Yes. Installing skills from SkillMD is free, and the skill stays under its author's original license.

Who published Icsm Avoid Tt In Eugonadal?

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

Icsm Avoid Tt In Eugonadal by dromlakhani

Name: Icsm Avoid Tt In Eugonadal
Rating: 4.5 (4 reviews)
Author: dromlakhani

Icsm Avoid Tt In Eugonadal

This skill advises against initiating testosterone therapy in eugonadal men with normal serum testosterone and no symptoms of deficiency. It is triggered when a clinician questions whether to prescribe testosterone for a patient with normal labs and no hypogonadal symptoms, such as asking 'should I give testosterone to someone with normal T?' or 'is treatment appropriate for eugonadal men?'

dromlakhani Updated Sep 8, 2026 10 repo stars

File contents

Do not treat eugonadal men with testosterone therapy

STEP 1 — Gather Information

Obtain morning fasting total testosterone level and assess for symptoms of testosterone deficiency (low libido, erectile dysfunction, decreased morning erections, fatigue, depressed mood). Document level and symptom presence.

STEP 2 — Rule In / Rule Out

If total testosterone ≥12 nmol/L (≥350 ng/dL) AND patient reports no symptoms of hypogonadism, rule out testosterone therapy and proceed to Step 3; otherwise, proceed to Step 3 to evaluate for treatment.

STEP 3 — Classify or Stratify

Classify the patient as either "Eugonadal asymptomatic" (no treatment) or "Symptomatic hypogonadism" (candidate for testosterone therapy) based on the data gathered.

STEP 4 — Decide

For "Eugonadal asymptomatic", withhold testosterone therapy; for "Symptomatic hypogonadism", consider initiating testosterone therapy after shared decision‑making.

Clinical Guardrails / Mimics / Pitfalls

Do not treat based solely on low‑normal testosterone without symptoms; avoid using testosterone for non‑specific complaints like fatigue or depressed mood without confirmed deficiency; if therapy is inadvertently started, monitor hematocrit to prevent polycythemia.

Concrete Clinical Example

A 52‑year‑old man presents for a wellness visit; his morning total testosterone is 14 nmol/L (403 ng/dL) and he denies low libido, erectile dysfunction, or fatigue. He asks whether a testosterone booster would help his energy. According to the skill, testosterone therapy is not indicated.

Source: Male hypogonadism: recommendations from the Fifth International Consultation on Sexual Medicine (ICSM 2024), International Society for Sexual Medicine, 2025, https://doi.org/10.1093/sxmrev/qeaf036

---name: icsm-avoid-tt-in-eugonadaldescription: This skill advises against initiating testosterone therapy in eugonadal men with normal serum testosterone and no symptoms of deficiency. It is triggered when a clinician questions whether to prescribe testosterone for a patient with normal labs and no hypogonadal symptoms, such as asking 'should I give testosterone to someone with normal T?' or 'is treatment appropriate for eugonadal men?'---# Do not treat eugonadal men with testosterone therapy## STEP 1 — Gather InformationObtain morning fasting total testosterone level and assess for symptoms of testosterone deficiency (low libido, erectile dysfunction, decreased morning erections, fatigue, depressed mood). Document level and symptom presence.## STEP 2 — Rule In / Rule OutIf total testosterone ≥12 nmol/L (≥350 ng/dL) AND patient reports no symptoms of hypogonadism, rule out testosterone therapy and proceed to Step 3; otherwise, proceed to Step 3 to evaluate for treatment.## STEP 3 — Classify or StratifyClassify the patient as either "Eugonadal asymptomatic" (no treatment) or "Symptomatic hypogonadism" (candidate for testosterone therapy) based on the data gathered.## STEP 4 — DecideFor "Eugonadal asymptomatic", withhold testosterone therapy; for "Symptomatic hypogonadism", consider initiating testosterone therapy after shared decision‑making.## Clinical Guardrails / Mimics / PitfallsDo not treat based solely on low‑normal testosterone without symptoms; avoid using testosterone for non‑specific complaints like fatigue or depressed mood without confirmed deficiency; if therapy is inadvertently started, monitor hematocrit to prevent polycythemia.## Concrete Clinical ExampleA 52‑year‑old man presents for a wellness visit; his morning total testosterone is 14 nmol/L (403 ng/dL) and he denies low libido, erectile dysfunction, or fatigue. He asks whether a testosterone booster would help his energy. According to the skill, testosterone therapy is not indicated.**Source:** Male hypogonadism: recommendations from the Fifth International Consultation on Sexual Medicine (ICSM 2024), International Society for Sexual Medicine, 2025, https://doi.org/10.1093/sxmrev/qeaf036

Frequently asked questions