How do I install the Icsm Treat Symptomatic Low Tt skill?

Run npx skillmds@latest add dromlakhani/icsm-treat-symptomatic-low-tt 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 Treat Symptomatic Low Tt safe to use?

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 Treat Symptomatic Low Tt?

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 Treat Symptomatic Low Tt free to use?

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

Who published Icsm Treat Symptomatic Low Tt?

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

Icsm Treat Symptomatic Low Tt by dromlakhani

Name: Icsm Treat Symptomatic Low Tt
Rating: 4.2 (5 reviews)
Author: dromlakhani

Icsm Treat Symptomatic Low Tt

Recommends initiating testosterone therapy in symptomatic men with total testosterone less than 12 nmol/L (350 ng/dL). Triggers when patients present with low libido, erectile dysfunction, fatigue, or decreased vigor and have confirmed low T levels.

dromlakhani Updated Sep 8, 2026 10 repo stars

File contents

Treat symptomatic men with low testosterone

STEP 1 — Gather Information

Collect symptom history (low libido, erectile dysfunction, fatigue, diminished physical vigor, depressed mood, sleep disturbances) and obtain morning total testosterone (between 07:00-11:00 fasting) using a reliable assay on at least two separate occasions; exclude acute illness; assess hematocrit, PSA, and perform DRE to rule out prostate abnormalities before therapy.

STEP 2 — Rule In / Rule Out

Rule in if the patient reports at least one hypogonadal symptom AND has total testosterone <12 nmol/L (350 ng/dL) on two separate morning samples; rule out if testosterone ≥12 nmol/L or the patient is asymptomatic.

STEP 3 — Classify or Stratify

Classify as a candidate for testosterone therapy if symptomatic and biochemically hypogonadal, then screen for contraindications: desire for fertility, baseline hematocrit ≥54%, known prostate cancer, or untreated severe lower urinary tract symptoms.

STEP 4 — Decide

If candidate and no contraindications, initiate testosterone therapy using shared decision‑making to select formulation (gel, injectable, etc.) and target correction of serum total testosterone to the mid‑normal reference range (approximately 12‑25 nmol/L).

Clinical Guardrails / Mimics / Pitfalls

Do not treat eugonadal men; avoid monotherapy for moderate/severe erectile dysfunction without PDE5 inhibitor; monitor hematocrit (hold if ≥54%); PSA and DRE per prostate cancer screening guidelines; testosterone therapy is contraindicated in men seeking fertility.

Concrete Clinical Example

A 48‑year‑old man presents with low libido, erectile dysfunction, and fatigue; morning total testosterone is 10.5 nmol/L on two occasions, hematocrit 48%, PSA 1.2 ng/mL, DRE benign; after discussing risks/benefits, transdermal gel is started aiming for mid‑normal testosterone.

Source: Box2 Recommendation 2, International Consultation on Sexual Medicine (ICSM) 2024, 2025, https://doi.org/10.1093/sxmrev/qeaf036

TODO: consider adding scripts/calc.py for the icsm-treat-symptomatic-low-tt calculator

---name: icsm-treat-symptomatic-low-ttdescription: Recommends initiating testosterone therapy in symptomatic men with total testosterone less than 12 nmol/L (350 ng/dL). Triggers when patients present with low libido, erectile dysfunction, fatigue, or decreased vigor and have confirmed low T levels.---# Treat symptomatic men with low testosterone## STEP 1 — Gather InformationCollect symptom history (low libido, erectile dysfunction, fatigue, diminished physical vigor, depressed mood, sleep disturbances) and obtain morning total testosterone (between 07:00-11:00 fasting) using a reliable assay on at least two separate occasions; exclude acute illness; assess hematocrit, PSA, and perform DRE to rule out prostate abnormalities before therapy.## STEP 2 — Rule In / Rule OutRule in if the patient reports at least one hypogonadal symptom AND has total testosterone <12 nmol/L (350 ng/dL) on two separate morning samples; rule out if testosterone ≥12 nmol/L or the patient is asymptomatic.## STEP 3 — Classify or StratifyClassify as a candidate for testosterone therapy if symptomatic and biochemically hypogonadal, then screen for contraindications: desire for fertility, baseline hematocrit ≥54%, known prostate cancer, or untreated severe lower urinary tract symptoms.## STEP 4 — DecideIf candidate and no contraindications, initiate testosterone therapy using shared decision‑making to select formulation (gel, injectable, etc.) and target correction of serum total testosterone to the mid‑normal reference range (approximately 12‑25 nmol/L).## Clinical Guardrails / Mimics / PitfallsDo not treat eugonadal men; avoid monotherapy for moderate/severe erectile dysfunction without PDE5 inhibitor; monitor hematocrit (hold if ≥54%); PSA and DRE per prostate cancer screening guidelines; testosterone therapy is contraindicated in men seeking fertility.## Concrete Clinical ExampleA 48‑year‑old man presents with low libido, erectile dysfunction, and fatigue; morning total testosterone is 10.5 nmol/L on two occasions, hematocrit 48%, PSA 1.2 ng/mL, DRE benign; after discussing risks/benefits, transdermal gel is started aiming for mid‑normal testosterone.**Source:** Box2 Recommendation 2, International Consultation on Sexual Medicine (ICSM) 2024, 2025, https://doi.org/10.1093/sxmrev/qeaf036> **TODO:** consider adding scripts/calc.py for the icsm-treat-symptomatic-low-tt calculator

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