How do I install the Icsm Repeat Testosterone Low skill?

Run npx skillmds@latest add dromlakhani/icsm-repeat-testosterone-low 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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Which AI agents work with Icsm Repeat Testosterone Low?

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Is Icsm Repeat Testosterone Low free to use?

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Who published Icsm Repeat Testosterone Low?

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

Icsm Repeat Testosterone Low by dromlakhani

Name: Icsm Repeat Testosterone Low
Rating: 4.2 (5 reviews)
Author: dromlakhani

Icsm Repeat Testosterone Low

Recommends repeating total testosterone measurement on at least two separate occasions when the initial result is below 12 nmol/L before starting testosterone therapy. Triggered when a clinician finds a low total testosterone (<12 nmol/L) and questions whether confirmation is needed prior to treatment.

dromlakhani Updated Sep 8, 2026 10 repo stars

File contents

Repeat testosterone measurement if low before therapy

STEP 1 — Gather Information

Collect a morning (07:00–11:00) fasting total testosterone level using a reliable assay, and document symptoms suggestive of hypogonadism (e.g., low libido, erectile dysfunction, fatigue). Ensure the sample was not drawn during acute illness.

STEP 2 — Rule In / Rule Out

Is the initial total testosterone <12 nmol/L?

Yes → Proceed to repeat testing.
No → Consider other diagnoses; no repeat needed for testosterone deficiency confirmation.

STEP 3 — Classify or Stratify

Are both repeat total testosterone measurements (taken on separate days) <12 nmol/L?

Yes → Confirm biochemical hypogonadism.
No → Consider functional causes, assay variability, or transient suppression; repeat testing may be deferred.

STEP 4 — Decide

If hypogonadism is confirmed (≥2 low results), discuss testosterone therapy initiation after shared decision‑making.
If not confirmed, evaluate for reversible factors (obesity, opioids, illness) and consider lifestyle optimization before retesting.

Clinical Guardrails / Mimics / Pitfalls

Do not base therapy on a single low testosterone; avoid testing during acute illness or non‑fasting states; recognize that obesity, opioids, glucocorticoids, and acute illness can cause transient low total testosterone; ensure assay reliability and proper timing.

Concrete Clinical Example

A 48‑year‑man presents with decreased libido and morning fatigue. Initial fasting total testosterone is 10 nmol/L. Repeat measurements on two separate mornings yield 9 nmol/L and 11 nmol/L. Biochemical hypogonadism is confirmed, and testosterone therapy is discussed after evaluating symptoms and preferences.

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-repeat-testosterone-lowdescription: Recommends repeating total testosterone measurement on at least two separate occasions when the initial result is below 12 nmol/L before starting testosterone therapy. Triggered when a clinician finds a low total testosterone (<12 nmol/L) and questions whether confirmation is needed prior to treatment.---# Repeat testosterone measurement if low before therapy## STEP 1 — Gather InformationCollect a morning (07:00–11:00) fasting total testosterone level using a reliable assay, and document symptoms suggestive of hypogonadism (e.g., low libido, erectile dysfunction, fatigue). Ensure the sample was not drawn during acute illness.## STEP 2 — Rule In / Rule OutIs the initial total testosterone <12 nmol/L? - Yes → Proceed to repeat testing. - No → Consider other diagnoses; no repeat needed for testosterone deficiency confirmation.## STEP 3 — Classify or StratifyAre both repeat total testosterone measurements (taken on separate days) <12 nmol/L? - Yes → Confirm biochemical hypogonadism. - No → Consider functional causes, assay variability, or transient suppression; repeat testing may be deferred.## STEP 4 — DecideIf hypogonadism is confirmed (≥2 low results), discuss testosterone therapy initiation after shared decision‑making. If not confirmed, evaluate for reversible factors (obesity, opioids, illness) and consider lifestyle optimization before retesting.## Clinical Guardrails / Mimics / PitfallsDo not base therapy on a single low testosterone; avoid testing during acute illness or non‑fasting states; recognize that obesity, opioids, glucocorticoids, and acute illness can cause transient low total testosterone; ensure assay reliability and proper timing.## Concrete Clinical ExampleA 48‑year‑man presents with decreased libido and morning fatigue. Initial fasting total testosterone is 10 nmol/L. Repeat measurements on two separate mornings yield 9 nmol/L and 11 nmol/L. Biochemical hypogonadism is confirmed, and testosterone therapy is discussed after evaluating symptoms and preferences.**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

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