Sexual Dysfunction Therapy, Charleston

Reviewed by Ashley Harwyn, PA-C, ABAAHP | A4M Board Certified | Updated October 2, 2026

Sexual dysfunction is a symptom, not a diagnosis. Here is what actually causes it, which treatments are proven, and why finding the cause comes before any procedure.

Most pages selling sexual dysfunction therapy push a single product, often a shot or a device, as the answer. The honest version is more useful: sexual dysfunction is an umbrella term, not a diagnosis, and it usually has a specific, treatable cause worth finding before you pay for any procedure.[1] The most heavily advertised options, PRP shots and energy devices, are not FDA-approved for sexual function, and the major urology and sexual-medicine societies call them experimental.[1][4] Meanwhile the proven treatments, which actually address the common causes, are well studied and often inexpensive.

That is the approach here. We offer a range of options at Solcara, including hormone therapy, the O-Shot, and the P-Shot, and for every one of them you will hear how strong the evidence really is. The goal is not to talk you into a procedure. It is to find what is actually driving your symptoms and to begin with the treatment best supported for that cause.

Key takeaways

Sexual dysfunction is a symptom with many causes: hormonal (low testosterone, menopause), vascular, medication side effects, pelvic floor problems, and stress or relationship strain. The first step is an evaluation, not a procedure.[1]
For men, erectile dysfunction is often an early warning of cardiovascular disease, so an evaluation that checks heart and metabolic risk can matter more than any single treatment.[1]
The proven first-line treatments work for most people: FDA-approved pills helped men succeed in 76 percent of attempts versus 50 percent on placebo in a randomized trial, and women have effective, guideline-backed options for menopausal changes.[2][3]
PRP shots (the O-Shot and P-Shot) and energy devices are not FDA-approved for sexual function, and the AUA and SMSNA classify them as experimental.[1][4]
A placebo-controlled trial of PRP for erectile dysfunction found it worked no better than a saline injection, which is why the marketed shots should be discussed honestly, not sold as cures.[5]
Treating the real cause, with proven options, beats treating the marketing category.

Section 01 / What it means

What sexual dysfunction therapy actually means

Here is the thing to understand before comparing any treatment: sexual dysfunction is a broad category, not a single condition. It covers low desire, difficulty with arousal or orgasm, erectile dysfunction, pain with sex, and changes that come with menopause or aging, and those are different problems with different answers.[1] Lumping them under one marketed therapy is how people end up paying for a procedure that does not address what is actually wrong.

The single most useful step is a real evaluation that separates a treatable medical cause from an elective goal. A good clinic examines you, reviews your history and medications, checks the relevant hormones and risk factors, and only then talks about treatment. That is not a delay. It is how the problem that actually matters, sometimes one with consequences well beyond sexual function, gets caught and treated.

Section 02 / Hear from Ashley

Why the cause comes first

Ashley Harwyn, PA-C talks through why sexual problems so often have a medical cause, and why finding that cause comes before choosing a treatment.

Ashley Harwyn, PA-C on how we approach sexual health. Under a minute.

Section 03 / The causes

What actually causes sexual dysfunction

Most sexual dysfunction traces back to one or more identifiable causes, and naming yours is what makes treatment work. Hormonal shifts are common: low testosterone in men and the hormonal changes of menopause in women both affect desire and function, and both have established treatments. Vascular and metabolic problems matter too. In men, erectile dysfunction is frequently an early sign of cardiovascular disease, high blood pressure, or diabetes, which is exactly why a proper evaluation looks beyond the symptom.[1]

Medications are an underappreciated cause, from blood-pressure drugs to antidepressants, and a simple review can identify a culprit. Pelvic floor dysfunction, pain conditions, and the vaginal changes of menopause each have their own proven treatments. And stress, mood, and relationship strain are genuine contributors that no injection will fix. The point is not to overwhelm you with possibilities. It is to show why a careful evaluation, with the right laboratory work, comes before any procedure.

What proven treatment addresses

Low testosterone, menopausal changes, medication effects, vascular and metabolic risk, pelvic floor problems, and stress or relationship strain, each of which has a real, evidence-based treatment.

What the marketed shots have behind them

PRP shots (the O-Shot and P-Shot) and energy devices are heavily advertised for sexual dysfunction but are not FDA-approved for it, and the AUA and SMSNA classify them as experimental.

Section 04 / The treatments

The treatments, and how proven each is

With the causes in view, the treatments line up on what matters most: whether they are proven and FDA-approved, or experimental. The table below compares them honestly, so you can see what you would actually be choosing.

A proven treatment, shown against placebo. The marketed shots cannot show the same.

Option	Evidence and approval	Honest role
Proven pills, hormones, pelvic floor therapy, counseling	Strong evidence, FDA-approved or guideline-backed	First-line, cause-directed treatment
PRP shots (O-Shot, P-Shot)	Mixed or negative trials; not FDA-approved; AUA and SMSNA call them experimental	Unproven; realistic expectations only
Energy-based devices (lasers, radiofrequency)	Not FDA-cleared for sexual function; a sham trial was negative	Unproven for this use

Which part of the picture is yours?

Six common contributors

Check the ones that sound familiar. Several of these are treatable causes in their own right, so the more you check, the more an evaluation should come before any elective procedure.

Two things stand out. The options with the strongest evidence, and usually the lowest cost, are the ones aimed at the cause, not the shots. For men, the FDA-approved pills are a clear example: in a randomized trial, intercourse succeeded in 76 percent of attempts on sildenafil against 50 percent on placebo, and women have effective, guideline-backed treatments for menopausal symptoms.[2][3] Second, the heavily marketed procedures are the least proven, which is the opposite of how they are usually sold.

Section 05 / Treat the cause

Treating the real cause first

A clinic built around one procedure rarely leads with this. The symptoms that send people looking for sexual dysfunction therapy are usually driven by a specific cause that has a proven treatment, and finding it is the whole game. If low testosterone is the issue, testosterone therapy is the evidence-based answer. If menopausal changes are driving it, hormone therapy and local treatments are well studied. If the problem is vascular, the proven pills work for most men, and the evaluation that reveals this often catches cardiovascular risk worth treating in its own right.[1]

For women, menopausal dryness and pain often respond to low-dose vaginal estrogen, which is well studied and guideline-recommended, with over-the-counter moisturizers and lubricants as a reasonable first step for milder symptoms.[3] If leaking or pelvic pain is part of the picture, pelvic floor physical therapy has a stronger evidence base than any injection for those specific problems, and it costs less. And where mood, stress, or relationship strain is driving things, counseling and a medication review often do more than any procedure, because they address the actual mechanism rather than working around it.

Where an elective option like the O-Shot or P-Shot is genuinely what you want, we will present it as what it is, an experimental option with uncertain benefit, and never as a cure. But it comes after the evaluation, not instead of it.

Not sure what is behind your symptoms? That is the question to answer before any procedure. Call 843-981-0870 and we will look at the common causes, including the ones that matter for your overall health, and begin with the best-supported treatment.

Section 06 / Our approach

Sexual health visits in Mount Pleasant and Charleston

With so many options marketed, the useful first step is an evaluation, not a procedure. That means an exam, a look at hormones, medications, blood vessels, and stress or relationship factors, the proven treatment if one fits, and only then a conversation about elective options and their evidence.

This is how visits run at Solcara. Both men and women are seen, and it helps to bring a list of current medications, since several common ones affect sexual function. Visits take place in private exam rooms at both of our offices, in Mount Pleasant and downtown at The Longevity Club. Ashley Harwyn, PA-C will be direct about where the evidence is thin. When a proven treatment fits, that is where we begin, and an elective option is offered only with its limits clearly explained.

Testosterone Therapy

For low-testosterone causes in men. Read Testosterone Therapy.

Bioidentical Hormone Therapy

For hormonal causes, including menopause. Read Bioidentical Hormone Therapy.

Full Panel Lab Testing

Where an honest evaluation actually starts. Read Full Panel Lab Testing.

If erectile changes started recently

Read why erectile dysfunction is often a heart health signal.

Ask Ashley

Ashley Harwyn, PA-C PA-C, ABAAHP · Founder, Solcara Health Online

Tap a question to ask

What actually works for sexual dysfunction? It depends entirely on the cause, which is why an evaluation comes first. For erectile dysfunction, FDA-approved pills are the proven first-line treatment and help most men, succeeding in about 76 percent of attempts against 50 percent on placebo in a randomized trial. For low testosterone, testosterone therapy is evidence-based. For menopausal changes in women, local estrogen and hormone therapy are well studied and guideline-backed. Pelvic floor physical therapy, medication review, and counseling each address specific causes. The common thread is that proven treatments target the actual problem, which is why naming the cause matters more than picking a procedure.

Do the O-Shot and P-Shot work? The honest answer is that they are unproven. Both are platelet-rich plasma injections, and neither is FDA-approved for sexual function. The best placebo-controlled trial of PRP for erectile dysfunction found it worked no better than a saline injection, and the American Urological Association and the Sexual Medicine Society of North America both classify PRP as experimental, to be used only in research settings. The shots may help some people, and the short-term safety record is reasonable, but they should be offered honestly as experimental options, not sold as reliable cures. We offer them with exactly that framing.

Is erectile dysfunction a sign of something more serious? It can be, and that is one of the most important reasons to be evaluated rather than just buy a treatment online. In men, erectile dysfunction is frequently an early warning of cardiovascular disease, and it is also commonly linked to low testosterone, diabetes, high blood pressure, and medication side effects. A proper evaluation checks these, which can catch a health problem that matters far beyond sexual function. Treating the cause often improves both your overall health and your symptoms at the same time.

Should I treat the cause or just get a procedure? Treat the cause. Most sexual dysfunction is driven by something specific, hormonal, vascular, medication-related, pelvic floor, or psychological, and each has a proven treatment that works better than an unproven injection. A clinic that reaches for a shot or a device before diagnosing what is actually going on has the order backwards. The evaluation is not an upsell. It is how you avoid paying for a procedure that does not address your problem and how you find the treatment that does.

Is sexual dysfunction therapy safe? That depends on the specific treatment, and safety is not the same as effectiveness. The proven options, from pills to hormone therapy to pelvic floor physical therapy, have well-established safety profiles when prescribed and monitored appropriately. The elective procedures carry their own considerations: PRP injections are generally well tolerated in short studies but unproven, and energy devices have been flagged by the FDA for reports of burns and pain when used for genital cosmetic purposes. We walk you through the specific risks of whatever is actually being considered, so you choose with full information.

Be taken seriously, and told the truth

Book an evaluation at The Longevity Club, 163 Rutledge Avenue downtown, or our Mount Pleasant office.

BOOK A CONSULTATION →

Or call 843-981-0870

About the author

Ashley Harwyn, PA-C, founder of Solcara Health in Charleston, South Carolina.

Ashley Harwyn, PA-C, ABAAHP

Founder, Solcara Health · Diplomate, American Board of Anti-Aging Health Practitioners (ABAAHP)

Ashley has practiced medicine for more than fifteen years. Her path into it began at home, with a family member born with a congenital heart defect and a childhood spent watching how much the quality of a clinician's attention could change the shape of a life. She has since practiced across a range of settings, including medical mission work in Uganda, before founding Solcara to build the kind of practice she kept wishing existed, one that treats patients as whole people and tells them the truth about what the evidence does and does not support.

Full bio →

Medical Disclaimer: This page is for educational and informational purposes only and does not constitute medical advice, and reading it does not create a patient-provider relationship. It describes general medical information and categories of care, not a recommendation that any individual start, stop, or change any test, treatment, or medication. Any diagnosis or treatment decision requires evaluation by a qualified, licensed clinician who knows your personal and family history. Consult a qualified healthcare provider before making medical decisions. Information reflects sources available as of October 2, 2026.

Ashley Harwyn, PA-C, ABAAHP, is a Diplomate of the American Board of Anti-Aging Health Practitioners (ABAAHP) through A4M and the founder of Solcara Health. Solcara serves South Carolina from Downtown Charleston (163 Rutledge Ave, Ste 202, The Longevity Club) and Mt. Pleasant (496 Bramson Ct, Ste 120).

visit our ZO store

Shop ALASTIN Skincare^®