Sexual Wellness · Performance & Libido
Sexual performance and libido for men.Physician-led testosterone optimization and PT-141.
Reduced libido and changes in sexual performance are clinical signals. The Genesis approach is physician-led testosterone optimization (TRT or enclomiphene) plus PT-141 where indicated. PDE5 inhibitors remain the first-line option for vascular causes and are coordinated with your primary care physician.
Important: changes in sexual function can be a cardiovascular signal
New-onset changes in erectile function are associated with future cardiovascular events and can precede a cardiac diagnosis by years. We treat the hormonal and metabolic dimension and we recommend appropriate cardiovascular evaluation in coordination with your primary care physician.
A note on care
Discreet, dignified, evidence-graded.
Common contributors include low free testosterone, elevated SHBG, thyroid disease, insulin resistance, sleep apnea, and chronic stress. Many patients have more than one contributor at once.
Our workup begins with a directed history and clinical evaluation. Therapy follows the clinical picture: TRT or enclomiphene for hormonal contributions, and PT-141 where desire is the limiting factor. PDE5 inhibitors for vascular causes remain first-line and are coordinated with your primary care physician.
How it works
What Genesis offers, and what we do not.
Inside this clinic, we offer physician-led testosterone optimization (TRT or enclomiphene) and PT-141. PDE5 inhibitors (sildenafil, tadalafil) are effective, well-tolerated, and remain the first-line option for vascular causes; we do not substitute peptides for them, and we coordinate prescribing with your primary care physician where appropriate.
We do not offer Trimix, intracavernosal injections, P-Shot, shockwave, or GAINSWave at Genesis Longevity. New-onset erectile changes in a man over 40 with cardiovascular risk factors warrant cardiology referral, not just a prescription.
In context
Where this fits among other options.
Hormonal: TRT
When clinical evaluation identifies low testosterone. Physician-led dosing, not symptom-only prescribing. See the TRT therapy page for protocol detail.
Hormonal: Enclomiphene
Fertility-preserving alternative to TRT for men with secondary hypogonadism. Off-label.
Adjunct: PT-141
Off-label use in men. Useful when desire is the limiting factor. CNS mechanism, distinct from PDE5 inhibitors.
Candidacy
Who this is appropriate for.
- Men with low libido alongside symptoms of low testosterone
- Men with clinically-confirmed low free or total testosterone
- Men whose changes in sexual function have not been worked up hormonally or metabolically
Safety considerations
What we screen for.
- Cardiovascular risk factors (we coordinate cardiac evaluation)
- Current nitrate medications (PDE5 contraindicated, prescribed by PCP)
- Diabetes, sleep apnea, and metabolic syndrome (often contributors)
- Medications with sexual side effects (some SSRIs, beta blockers)
Frequently asked
Frequently asked questions.
No. Genesis Longevity offers physician-led testosterone optimization (TRT or enclomiphene) and PT-141. We do not offer P-Shot, GAINSWave, low-intensity shockwave, intracavernosal injections, or Trimix.
A directed history and clinical evaluation of the hormonal and metabolic picture. Where indicated, we coordinate cardiovascular evaluation with your primary care physician.
PDE5 inhibitors remain the first-line option for vascular causes. They are typically prescribed by your primary care physician. Genesis coordinates the hormonal dimension alongside that.
PT-141 acts in the central nervous system on the melanocortin pathway, distinct from PDE5 inhibitors. It can be useful when desire is the limiting factor or PDE5 response is partial. Off-label in men. See the PT-141 therapy page for detail.
Next step
Schedule a private consultation.
Your conversation is confidential. Provider-led, evidence-graded, no pressure.