Sexual wellness · Orlando
Erectile dysfunction and sexual wellness: evaluation first
Erectile dysfunction is common and treatable, and it can be an early sign of heart disease, diabetes or a hormone problem. Kenny Chantasi, DO, evaluates the cause first, discusses FDA-approved treatments, and is candid about which newer injections are still investigational.
Scheduling opens securely in Prospyr · the first visit is an evaluation, not a procedure
In one paragraph
How does PrimeCell approach erectile dysfunction?
Short answer
PrimeCell approaches erectile dysfunction (ED) as a medical symptom first. Dr. Kenny Chantasi reviews your health, medications and risk factors, checks labs including a morning testosterone level, and then discusses FDA-approved treatments. PRP, stem cell and exosome injections for ED are investigational and are offered only in selected cases, after evaluation and written informed consent.
ED is not only a quality-of-life problem. The blood vessels that supply an erection are small, so they can show the effects of narrowed arteries, high blood sugar or high blood pressure earlier than the heart does. The American Urological Association (AUA) advises that men be counseled that ED is a risk marker for cardiovascular disease and other conditions that may need evaluation.1,2
That is why the first visit is a medical evaluation, not a treatment session.
Evaluation first
What the evaluation looks for
The AUA recommends a medical, sexual and psychosocial history, a physical examination and selective laboratory testing for every man with ED.1
- 01
Heart and blood vessels
Blood pressure, cholesterol, smoking, family history and exercise tolerance. If your risk looks high, you are referred for cardiac evaluation before treatment for ED is started.2
- 02
Blood sugar and metabolism
Diabetes and prediabetes are common, often silent causes. Labs may include blood sugar or A1c and lipids.
- 03
Hormones
The AUA recommends measuring a morning total testosterone level in men with ED.1 Low testosterone has its own evaluation and treatment: see hormone therapy and low testosterone evaluation.
- 04
Medications, sleep and mood
Some blood pressure medications, antidepressants and other drugs affect erections, as do poor sleep, stress, depression and relationship strain. These are discussed openly and without judgment.
- 05
When to involve a urologist
Curvature, pain, a history of pelvic surgery or radiation, or a poor response to first-line treatment may need a urologist’s specialized testing. PrimeCell coordinates that referral.
Options, by FDA status
FDA-approved treatments come first
Effective, FDA-approved treatments for ED exist. PrimeCell may prescribe them where appropriate, or coordinate care with your primary care physician or a urologist.
- FDA-approved / cleared
Approved or cleared by the FDA for erectile dysfunction.
- Investigational
Not FDA-approved for ED. Evidence in people is limited to small studies.
| Option | What it is | U.S. status | At PrimeCell |
|---|---|---|---|
| PDE5 inhibitor tablets | Sildenafil, tadalafil and related medicines, the usual first-line treatment. They must not be taken with nitrate medicines for chest pain.1 | FDA-approved | May be prescribed after evaluation |
| Alprostadil | A medicine given as a small injection into the penis or as an intraurethral pellet. | FDA-approved | Discussed; may be coordinated with a urologist |
| Vacuum erection devices | A cylinder and pump that draw blood into the penis, with a band to maintain the erection. | FDA-cleared devices | Discussed; not sold here |
| Penile implant surgery | A surgical option for men in whom other treatments have not worked. | FDA-approved devices | Referral to a urologist |
| PRP injections | A concentrate of your own platelets, injected into the penis. | Investigational · not FDA-approved for ED | Selected cases, written informed consent |
| Stem cell and exosome injections | Products derived from donated tissue or cultured cells, injected into the penis. | Investigational · not FDA-approved | Selected cases, written informed consent |
Lifestyle changes, including more physical activity, better sleep, stopping smoking and managing weight, can improve overall health and may improve erectile function; the AUA recommends discussing them with every man with ED.1 If weight is part of the picture, PrimeCell’s medical weight management is managed by the same physician.
Investigational options
PRP, stem cell and exosome injections for ED
These injections are marketed widely. The evidence behind them is much thinner than the marketing suggests.
Short answer
PRP, stem cell and exosome injections are not FDA-approved for erectile dysfunction, and published studies are small. The AUA guideline classifies stem cell therapy for ED as investigational and PRP as experimental.1 PrimeCell offers these injections only in selected cases, after a full evaluation and written informed consent, and never in place of a medical workup.
What professional societies say
The Sexual Medicine Society of North America reviewed these “restorative” therapies in 2021. It concluded that stem cell therapies are investigational, that PRP is experimental, and that both should be offered only under research protocols with institutional review board approval.3 PrimeCell offers them outside a research study in selected cases. You should know that before deciding, and it is part of the written consent discussion.
The FDA has also warned the public about unapproved stem cell and exosome products.4,5
What written informed consent covers
The type of product and its source, its regulatory status, the limited evidence, the risks (including pain, bruising, infection and scarring that can cause curvature), the FDA-approved alternatives and the cost, all in writing before any injection. You can decide not to proceed at any point.
No treatment for ED comes with a guaranteed result, and investigational injections are not a substitute for treating a heart, blood-sugar or hormone problem.
This page is not a substitute for urgent care
Call 911 for chest pain, shortness of breath or fainting, including during sexual activity. Go to an emergency department for an erection that lasts more than four hours (priapism), which can permanently damage tissue. Do not take a PDE5 inhibitor if you use nitroglycerin or another nitrate medicine.
Privacy & discretion
What the visit is like
A private, one-on-one conversation with Dr. Chantasi. Your records are protected health information, and nothing about your visit is shared without your permission.
History
Your health, medications, heart and metabolic risk factors, sleep, mood and what has already been tried.
Examination & labs
A focused physical examination and blood work, including a morning testosterone level.
Options in writing
FDA-approved treatments first, with their risks, alternatives and a written estimate. Referral where needed.
Follow-up
A check on how treatment is working and whether any underlying condition needs more attention.
Candidacy
Who is, and is not, a candidate for investigational injections
May be considered after evaluation
- Men who have completed a medical evaluation for the cause of ED
- Men who have discussed or tried FDA-approved treatments
- Men who understand the limited evidence and accept that there may be no benefit
Not a candidate, or not yet
- Symptoms of heart disease that have not been evaluated
- Uncontrolled diabetes or blood pressure
- A bleeding disorder or blood thinners that cannot be paused
- Active infection, or active cancer
- Anyone looking for a guaranteed result
Cost
Self-pay, with a written estimate
PrimeCell is a self-pay practice and does not bill insurance. Cost depends on the evaluation, labs and the option you choose. You receive a written estimate before any procedure. Investigational injections are generally not covered by insurance anywhere.
Questions
Erectile dysfunction FAQ
Does PrimeCell offer erectile dysfunction care?
Yes, starting with a medical evaluation of the cause, including heart, blood-sugar and hormone risk factors. Dr. Chantasi may prescribe FDA-approved treatments where appropriate, coordinate care with a urologist, or, in selected cases, offer investigational injections with written informed consent.
Are PRP or stem cell injections for ED FDA-approved?
No. No PRP, stem cell or exosome product is FDA-approved for erectile dysfunction. The AUA guideline classifies stem cell therapy for ED as investigational and PRP as experimental, and published studies are small.
Why check my heart for erectile dysfunction?
ED is a risk marker for cardiovascular disease and can appear before heart symptoms do. Checking blood pressure, cholesterol, blood sugar and other risk factors is part of a proper evaluation.
Should my testosterone be checked?
The AUA recommends measuring a morning total testosterone level in men with ED. If it is low, PrimeCell’s hormone therapy evaluation covers the next steps.
Is my visit private?
Yes. Visits are one-on-one with Dr. Chantasi, and your records are protected health information that is not shared without your permission.
Are results guaranteed?
No. Responses to every ED treatment vary, and investigational injections may produce no benefit. The plan and its limitations are explained in writing before treatment.
A private conversation, and a proper workup.
An evaluation with Dr. Chantasi looks for the cause, checks what matters for your heart and hormones, and explains every option with its FDA status, in writing.
References
- Burnett AL, Nehra A, Breau RH, et al. Erectile dysfunction: AUA guideline. J Urol. 2018;200(3):633–641. doi:10.1016/j.juro.2018.05.004 · auanet.org
- Nehra A, Jackson G, Miner M, et al. The Princeton III consensus recommendations for the management of erectile dysfunction and cardiovascular disease. Mayo Clin Proc. 2012;87(8):766–778. doi:10.1016/j.mayocp.2012.06.015
- Liu JL, Chu KY, Gabrielson AT, et al. Restorative therapies for erectile dysfunction: position statement from the Sexual Medicine Society of North America (SMSNA). Sex Med. 2021;9(3):100343. doi:10.1016/j.esxm.2021.100343
- U.S. Food and Drug Administration. Public safety notification on exosome products. fda.gov
- U.S. Food and Drug Administration. Consumer alert on regenerative medicine products including stem cells and exosomes. fda.gov
Medically reviewed by Kenny Chantasi, DO, on September 23, 2026. General education only; not medical advice. Candidacy is determined at an individual evaluation. PRP, stem cell and exosome injections are investigational and not FDA-approved for erectile dysfunction. Results vary and are not guaranteed. In an emergency, call 911.