Your Intimate Health Deserves the Same Clinical Excellence as the Rest of You.
Before You Read Anything Else
Is This Right For You?
You're in the right place if:
Not sure where to start?
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
What this means for your outcome
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.
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.
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.
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.
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.
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.
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.
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.
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.
★★★★★
"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."
★★★★★
"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."
★★★★★
"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."
The Consultation is the First Step.
Thursday-Monday, 10am-7pm. Closed Tuesday and Wednesday. · By Appointment Only · 2217 Packard St #15, Ann Arbor, MI 48104





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