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Sexual Wellness · Regenerative Medicine · Ann Arbor, Michigan

Your Intimate Health Deserves the Same Clinical Excellence as the Rest of You.

"This is the part of your health most people never discuss with a clinician. That silence is why so many people suffer longer than they should."
Arbour Longevity offers the most comprehensive sexual wellness program in Southeast Michigan, P-Shot®, O-Shot®, low-intensity shockwave therapy, male enhancement with PRP and Botox, and peptide support with PT-141 and kisspeptin. All assessed within a whole-person clinical framework that no medspa in the region can replicate: hormonal, psychiatric, metabolic, and functional medicine, under one clinician.

94%

P-Shot® Worth It Rating · RealSelf

8.2

Average IIEF Improvement · PRP + LiSWT

86%

O-Shot® Worth It Rating · RealSelf

Board Certified · FNP · PMHNP · Anti-Aging Medicine

Your consultation is private. Your records stay between you and your clinician

Before You Read Anything Else

Is This Right For You?

You're in the right place if:

You've noticed changes in sexual desire, performance, or satisfaction, and you've been reluctant to bring it to a clinician.
ED has been affecting your confidence, your relationship, or your sense of self, and you want a treatment that addresses the root cause, not just the symptom.
Your body has changed, after childbirth, menopause, or aging, and intimacy doesn't feel the way it used to.
You've tried PDE5 inhibitors and want something that addresses the vascular and neurological mechanisms, not just the immediate effect
You have Peyronie's disease, painful curvature, or scar tissue that's affecting function, and want a non-surgical approach with published evidence.
You want to feel like yourself again, in your body, in your relationship, in your life.

Not sure where to start?

ED, reduced erectile quality, or want performance enhancement?
P-Shot® + LiSWT Male PRP Program: the highest-evidence combination available
Peyronie's disease or painful curvature?
P-Shot® specifically: published evidence for curvature reduction and pain relief
Reduced arousal, orgasm difficulty, or vaginal dryness?
O-Shot®: PRP-based tissue regeneration for the clitoris and anterior vaginal wall
On a GLP-1 program and want to address the skin?
PT-141 + Kisspeptin: neurological activation of desire, not just blood flow
Sexual wellness concerns are among the most underreported issues in medicine, often because patients fear being dismissed, rushed, or made to feel exposed. At Arbour Longevity, your consultation is fully private and unhurried. Your clinician has heard every concern before, approaches each one without judgment, and treats every conversation with the clinical seriousness it deserves. Nothing leaves the room without your explicit consent.

The Arbour Longevity Difference: What No Other Practice in SE Michigan Offers

Sexual Wellness Is Not a Menu Item. It's a Clinical Program.

Most medspas offer P-Shot and O-Shot as line items alongside Botox and facials. At Arbour Longevity, sexual wellness is assessed as what it actually is: a complex intersection of hormonal, vascular, neurological, and psychological factors. Gandhi Bhattarai is the only clinician in SE Michigan who addresses all four dimensions simultaneously.

Four dimensions most providers miss

Hormonal: Testosterone drives libido, erectile tissue health, and vaginal tissue vitality. Estrogen governs lubrication, tissue elasticity, and clitoral sensitivity. A patient with suboptimal hormones who receives a P-Shot or O-Shot without hormonal correction gets a fraction of the outcome they could achieve. Arbour Longevity assesses and addresses both simultaneously.
Vascular: ED is often the first sign of cardiovascular disease, manifesting 3–5 years before a cardiac event. LiSWT addresses the underlying endothelial dysfunction and neovascularization deficit that PDE5 inhibitors only mask. Gandhi's Anti-Aging certification means this vascular context is always assessed.
Neurological: PT-141 activates melanocortin receptors in the central nervous system, addressing desire at the level of the brain, not just the body. This is the dimension that purely vascular treatments miss, and where Gandhi's PMHNP-BC certification becomes uniquely valuable.
Psychological: Sexual dysfunction has a psychological component in the majority of cases. No other sexual wellness provider in SE Michigan holds a psychiatric certification. The PMHNP-BC means Gandhi can assess and address the psychological drivers of dysfunction as part of the same clinical relationship.

What this means for your outcome

A patient who receives a P-Shot at Arbour Longevity has had their testosterone, estrogen, thyroid, metabolic markers, and vascular health assessed in context. The PRP treatment doesn't happen in a clinical vacuum, it happens as part of a coordinated regenerative program.
A patient who receives an O-Shot at Arbour Longevity has had their hormonal status assessed, particularly estrogen, which directly governs the tissue health and receptor sensitivity that determines how dramatically PRP can stimulate regeneration. Low estrogen and O-Shot produces modest results. Optimized estrogen and O-Shot produces transformation.
The combination of LiSWT + PRP for ED shows a published IIEF improvement of 8.2, more than double either treatment alone. At Arbour Longevity, this combination is sequenced correctly within the hormonal context, producing outcomes that simply aren't achievable at a medspa that doesn't practice functional medicine.
"Sexual health is downstream of everything. When you treat the whole person, hormones, vascular health, nervous system, emotional context, the outcomes are different." Gandhi Bhattarai, FNP-BC, PMHNP-BC, Anti-Aging
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The Complete Arbour Longevity Sexual Wellness Program

Five Programs. One Clinical Philosophy.

Each program is assessed individually at consultation. Most patients benefit from a coordinated approach across multiple programs, your clinician designs the sequence based on your specific anatomy, lab results, and goals.

P-Shot® · CMA Licensed

Male PRP Program

PRP + LiSWT + Botox + Fillers · Coordinated Sequence

The most clinically comprehensive male sexual wellness program available in SE Michigan. PRP regenerates erectile tissue. LiSWT restores vascular function. The combination produces IIEF improvement of 8.2, published evidence. Available as standalone P-Shot or full four-step program.

Series of up to 3 sessions · Annual maintenance · Hormone Foundation Assessment

O-Shot® · CMA Licensed

Women's Sexual Wellness

PRP · Clitoral + Anterior Vaginal Wall

PRP-based tissue regeneration for improved arousal, orgasmic function, lubrication, and stress urinary incontinence. Assessed within the hormonal context, estrogen optimization dramatically amplifies outcomes. 86% Worth It Rating on RealSelf from published patient reviews.

Hormone assessment included · Series of up to 3 · Annual maintenance

Peptide Support

PT-141 + Kisspeptin

Neurological Desire Activation · Men & Women

PT-141 activates melanocortin receptors in the brain, addressing desire at the neurological level. Kisspeptin stimulates the hypothalamic-pituitary-gonadal axis, amplifying endogenous testosterone and LH production. Together, the most comprehensive libido support available without pharmaceutical intervention.

Questions Patients Ask: Answered Honestly

Nothing Here is Embarrassing.

Is this confidential? Will anyone know I was here?
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Completely. Your records are held with the same legal protections as any medical record under HIPAA. The consultation, the treatment, and the follow-up are private. No employer, no family member, no insurer receives this information without your explicit written consent. Many of Arbour Longevity sexual wellness patients are professionals, executives, and public figures who cannot have this information disclosed, and it never is.

What's the difference between the P-Shot and Viagra/Cialis?
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PDE5 inhibitors like Viagra and Cialis temporarily increase blood flow to the penis by inhibiting the enzyme that degrades cGMP. They work acutely but do nothing to address the underlying endothelial dysfunction, neurological deficit, or vascular compromise that causes ED in the first place. The P-Shot delivers concentrated platelet-derived growth factors, VEGF, PDGF, TGF-β, directly into erectile tissue, stimulating new blood vessel formation, nerve regeneration, and tissue remodeling. The goal is restoration of physiological function, not temporary pharmacological augmentation. LiSWT amplifies this by mechanically stimulating neovascularization. The combination produces durable improvement, not a pill you need to take before every encounter.

Is the O-Shot actually effective? I've read mixed things.
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The honest answer: the evidence for the O-Shot is promising but still emerging. A 2023 systematic review concluded the evidence base needs more randomized controlled trials. Existing studies, including a Brazil pilot study of 68 women with 94% reporting satisfaction, and published case series show meaningful improvements in lubrication, arousal, orgasmic function, and stress urinary incontinence. A 2021 study reported orgasm scores more than doubled after treatment. At Arbour Longevity, the O-Shot is offered with clinical honesty about what the evidence shows, it is not presented as a guarantee, but as a well-tolerated regenerative intervention with meaningful patient-reported outcomes in the existing literature. The key variable that most O-Shot providers miss: hormonal optimization. Estrogen-replete tissue responds dramatically differently to PRP than atrophied, estrogen-deficient tissue. Arbour Longevity assesses this before every O-Shot.

Is PT-141 the same as Vyleesi?
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PT-141 (bremelanotide) is the same compound as Vyleesi, which is FDA-approved for hypoactive sexual desire disorder (HSDD) in premenopausal women. At Arbour Longevity, PT-141 is dispensed as a compounded peptide, which is significantly more cost-effective than the brand-name Vyleesi, pricing discussed at consultation. Its use in men for low libido and ED is off-label, this is disclosed and discussed at consultation. PT-141 works differently from any other sexual wellness treatment: it acts on melanocortin receptors in the brain, stimulating desire neurologically rather than through blood flow. It can be used by both men and women, takes effect in 30–45 minutes, and effects last up to 72 hours.

Does the P-Shot or O-Shot hurt?
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Both procedures use topical numbing cream applied 30–45 minutes before treatment, and a local anesthetic block for the P-Shot specifically. Most patients describe the sensation as significantly less than they expected. The blood draw is the same as any lab draw. The injection itself is brief. Post-procedure, mild soreness lasting 1–3 days is common for the P-Shot. The O-Shot typically involves minimal post-procedure discomfort. ProNox (nitrous oxide) is available for patients with significant procedural anxiety.

Why do I need my hormones assessed before a sexual wellness treatment?
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Because the outcome of your PRP treatment depends substantially on the hormonal environment of the tissue being treated. Testosterone directly influences the density and responsiveness of erectile tissue. Estrogen governs vaginal tissue thickness, receptor sensitivity, and lubrication capacity. A P-Shot delivered into testosterone-deficient tissue generates a fraction of the growth factor response of the same treatment in hormonally optimized tissue. The same is true for the O-Shot. At Arbour Longevity, this is not an upsell, it's a clinical imperative. Most sexual wellness patients benefit meaningfully from addressing the hormonal foundation before or alongside their regenerative treatments.

In Their Own Words

★★★★★

"I've been dealing with ED for years. I tried every medication. The P-Shot at Arbour Longevity, combined with addressing my testosterone and doing the shockwave protocol, was the first thing that actually addressed the problem instead of just masking it."

P-Shot® + LiSWT Patient · Male PRP Program · Ann Arbor

★★★★★

"After my second child, intimacy was just different. Less sensation, less desire, and I'd accepted that as the new normal. The O-Shot, and getting my hormones sorted at the same time, brought me back. I wish I'd done this years ago."

O-Shot® Patient · Women's Sexual Wellness Program ·Ann Arbor

★★★★★

"Gandhi was the first clinician who treated this as a complete medical concern, not just a shot and a goodbye. Gandhi looked at my testosterone, my stress levels, everything. The PT-141 and hormonal support together changed things meaningfully."

PT-141 + Hormone Patient · Arbour Longevity · Ann Arbor
Sexual Wellness · Ann Arbor · Completely Confidential

The Consultation is the First Step.

Sexual wellness concerns are among the most common and most underaddressed health issues in medicine. The consultation at Arbour Longevity is private, unhurried, and clinical, not a sales conversation. Your clinician will listen to your concern, review your history, and tell you honestly what program makes sense for your specific situation. No commitment required beyond the conversation.

Thursday-Monday, 10am-7pm. Closed Tuesday and Wednesday. · By Appointment Only · 2217 Packard St #15, Ann Arbor, MI 48104