How do I install the Icsm Estimate Tt Increase From Bariatric Surgery skill?

Run npx skillmds@latest add dromlakhani/icsm-estimate-tt-increase-from-bariatric-surgery 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.

Is Icsm Estimate Tt Increase From Bariatric Surgery safe to use?

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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 Estimate Tt Increase From Bariatric Surgery free to use?

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Who published Icsm Estimate Tt Increase From Bariatric Surgery?

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

Icsm Estimate Tt Increase From Bariatric Surgery by dromlakhani

Name: Icsm Estimate Tt Increase From Bariatric Surgery
Rating: 4.666666666666667 (3 reviews)
Author: dromlakhani

Icsm Estimate Tt Increase From Bariatric Surgery

Estimates that bariatric surgery can raise serum testosterone by approximately 10 nmol/L in obese hypogonadal patients. Triggered when a clinician considers surgical weight loss for a hypogonadal obese patient and wonders how much testosterone might rise after surgery or what T change to anticipate from bariatric procedures.

dromlakhani Updated Sep 8, 2026 10 repo stars

File contents

Estimate testosterone increase from bariatric surgery

STEP 1 — Gather Information

Collect patient’s BMI, waist circumference, presence of obesity-related comorbidities (T2DM, hypertension, dyslipidemia), confirm hypogonadism with morning total testosterone <12 nmol/L on two occasions and associated symptoms (low libido, ED, fatigue), and assess motivation for bariatric surgery (weight loss vs testosterone increase alone).

STEP 2 — Rule In / Rule Out

Rule out bariatric surgery if the primary motivation is testosterone increase alone or if BMI <35 without comorbidities; rule in if patient meets surgical criteria (BMI ≥40 or BMI ≥35 with obesity-related comorbidity) and has confirmed hypogonadism secondary to obesity.

STEP 3 — Classify or Stratify

Estimate expected testosterone rise: approximately 10 nmol/L increase from baseline; e.g., baseline 8 nmol/L → anticipated post‑surgery ~18 nmol/L, but interpret within age‑adjusted normal range and note variability.

STEP 4 — Decide

If bariatric surgery is indicated for weight loss, counsel that testosterone may rise by ~10 nmol/L as a beneficial side effect, but do not pursue surgery solely for hypogonadism; optimize medical management first and monitor testosterone postoperatively.

Clinical Guardrails / Mimics / Pitfalls

Bariatric surgery is not appropriate for the majority of patients seeking hypogonadism treatment alone; weight‑loss surgery carries surgical risks; testosterone response is variable and not guaranteed; ensure other causes of low T are excluded; postoperative nutritional deficiencies can affect hormone levels.

Concrete Clinical Example

A 48‑year‑old man with BMI 41, total testosterone 9 nmol/L, low libido and fatigue, meets criteria for Roux‑en‑Y gastric bypass; anticipates testosterone increase of ~10 nmol/L (to ~19 nmol/L) after surgery, but surgery is pursued for weight loss, not testosterone therapy alone.

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

TODO: consider adding scripts/calc.py for the icsm-estimate-tt-increase-from-bariatric-surgery calculator

---name: icsm-estimate-tt-increase-from-bariatric-surgerydescription: Estimates that bariatric surgery can raise serum testosterone by approximately 10 nmol/L in obese hypogonadal patients. Triggered when a clinician considers surgical weight loss for a hypogonadal obese patient and wonders how much testosterone might rise after surgery or what T change to anticipate from bariatric procedures.---# Estimate testosterone increase from bariatric surgery## STEP 1 — Gather InformationCollect patient’s BMI, waist circumference, presence of obesity-related comorbidities (T2DM, hypertension, dyslipidemia), confirm hypogonadism with morning total testosterone <12 nmol/L on two occasions and associated symptoms (low libido, ED, fatigue), and assess motivation for bariatric surgery (weight loss vs testosterone increase alone).## STEP 2 — Rule In / Rule OutRule out bariatric surgery if the primary motivation is testosterone increase alone or if BMI <35 without comorbidities; rule in if patient meets surgical criteria (BMI ≥40 or BMI ≥35 with obesity-related comorbidity) and has confirmed hypogonadism secondary to obesity.## STEP 3 — Classify or StratifyEstimate expected testosterone rise: approximately 10 nmol/L increase from baseline; e.g., baseline 8 nmol/L → anticipated post‑surgery ~18 nmol/L, but interpret within age‑adjusted normal range and note variability.## STEP 4 — DecideIf bariatric surgery is indicated for weight loss, counsel that testosterone may rise by ~10 nmol/L as a beneficial side effect, but do not pursue surgery solely for hypogonadism; optimize medical management first and monitor testosterone postoperatively.## Clinical Guardrails / Mimics / PitfallsBariatric surgery is not appropriate for the majority of patients seeking hypogonadism treatment alone; weight‑loss surgery carries surgical risks; testosterone response is variable and not guaranteed; ensure other causes of low T are excluded; postoperative nutritional deficiencies can affect hormone levels.## Concrete Clinical ExampleA 48‑year‑old man with BMI 41, total testosterone 9 nmol/L, low libido and fatigue, meets criteria for Roux‑en‑Y gastric bypass; anticipates testosterone increase of ~10 nmol/L (to ~19 nmol/L) after surgery, but surgery is pursued for weight loss, not testosterone therapy alone.**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> **TODO:** consider adding scripts/calc.py for the icsm-estimate-tt-increase-from-bariatric-surgery calculator

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