Sexual Performance & Prostate Health

Sexual performance is a barometer of vascular, hormonal, and psychological health.
If it’s not working right, it’s not just about libido—it’s about nitric oxide signaling, endothelial integrity, androgen balance, and neurologic drive. We don’t mask the symptom; we find the system failure and rebuild it.

Why Men Come to Us

  • Erectile dysfunction (ED) that’s partial, inconsistent, or unresponsive to oral PDE5 inhibitors (Viagra/Cialis).

  • Low libido or “mental disconnect” between desire and performance.

  • Rapid or delayed ejaculation, reduced sensitivity, or lack of satisfaction.

  • Prostate issues: frequent urination, weak stream, post-void dribble, or elevated PSA without malignancy.

  • Post-TRT sexual fatigue: men optimized hormonally but still underperforming due to vascular or neurochemical issues.

Evaluation Protocol

We use a layered diagnostic model—not just “try Cialis and see.”

Baseline labs

  • Total & free testosterone, estradiol, SHBG

  • LH, FSH, prolactin, DHT (as indicated)

  • CMP, fasting glucose, lipid panel, apoB (if indicated)

  • PSA

  • Other Possible Diagnostics Might Include: Sleep Study, ADMA.SDMA, Uric Acid, ESR, CRP, Homocysteine, Thyroid panel (TSH, FT4, FT3), Vitamin D, B12, iron studies, ferritin

Additional assessments when indicated:

  • Penile Doppler ultrasound (for vascular insufficiency)

  • HRV and BP variability (for sympathetic overdrive)

  • Psychological screen for anxiety/depression-related inhibition

Treatment Framework

1. Restore the Physiology

We address vascular, endocrine, and neurochemical roots—before prescribing anything for performance.

  • Optimize testosterone/estradiol ratio. Stable androgen balance = improved nitric oxide signaling.

  • Correct insulin resistance and inflammation. Hyperinsulinemia and high CRP blunt endothelial response.

  • Normalize sleep architecture and cortisol rhythm. Sleep apnea and cortisol dysregulation sabotage erection quality.

2. Enhance Performance

When the system is stable, we build function—not dependence.

  • PDE5 inhibitors (sildenafil, tadalafil, vardenafil) used strategically, not chronically.

  • Apomorphine, Tri/Quad Mix, Oxytocin, or PT-141 for arousal and central dopaminergic drive.

  • Nitric Oxide precursors (L-citrulline, beet-derived nitrates) and endothelial support compounds.

  • Targeted peptide therapy when repair and sensitivity restoration are goals.

3. Support the Prostate

Benign prostatic hypertrophy (BPH) doesn’t mean benign symptoms.

  • Lifestyle: reduce nocturnal fluid intake, caffeine, and alcohol; timed voiding strategies.

  • Supplements: saw palmetto, pygeum, beta-sitosterol, zinc, pumpkin seed extract.

  • Pharmaceuticals: tamsulosin or finasteride only when conservative measures fail or obstruction verified.

  • Inflammatory causes: address prostatitis, infections, and hormonal triggers.

What Sets Us Apart

  • We never prescribe “sex pills” as a reflex.

  • We correlate sexual performance with metabolic and cardiovascular function.

  • We track outcomes, not anecdotes.

  • We respect patient privacy and autonomy—no judgment, no embarrassment, no gimmicks.

What to Expect

  1. Virtual intake (Texas only): detailed history and symptom inventory.

  2. Targeted labs: vascular, hormonal, and metabolic assessment.

  3. Review & plan: individualized protocol with short-term and long-term goals.

  4. Follow-up: 3 months initially, then every 6 months once stable.

  5. Ongoing access: secure messaging for dose adjustments and questions.

Safety & Boundaries

  • All prescriptions require evaluation and monitoring.

  • We do not dispense controlled substances or compounded blends without medical justification.

  • Sexual performance issues can signal cardiovascular disease—we will refer as needed.

  • Virtual care is provided under Texas telemedicine regulations.

Pricing

Transparent membership pricing listed on our Pricing page.

FAQs

Can I use ED medications while on testosterone therapy?
Yes, and in many cases they work synergistically when testosterone is optimized and estradiol balanced.

Are injectables like Trimix offered?
Yes, we partner with compounding pharmacies for intracavernosal therapies if oral and peptide options fail, but only after full assessment.

Can performance issues be psychological?
Absolutely. Anxiety, depression, and relationship stress alter dopamine and prolactin balance. We address physiology and refer for counseling when appropriate.

Will TRT make prostate issues worse?
No current evidence supports that in monitored patients. In fact, low testosterone often worsens BPH symptoms due to estrogen dominance.

Call To Action

Your sexual performance tells the truth about your overall health.
We help you decode it, fix what’s broken, and rebuild confidence—with science, not shortcuts.

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