ED Has a Root Cause.
Most Clinics Miss It.
Low testosterone is one of the most common — and most undertreated — contributors to erectile dysfunction. At Body Balance Medical, Mia LoPreiato, NP evaluates the hormonal picture before reaching for a prescription pad.
Apply for Your Hormone Optimization Assessment
Testosterone and ED: The Link Most Providers Never Check
Erectile dysfunction isn't a single condition — it's a symptom. And in men over 40, testosterone deficiency is one of the most clinically significant contributing factors that routinely goes unexamined.
When testosterone levels decline, vascular function is affected, nitric oxide production decreases, and the entire hormonal environment that supports sexual function shifts out of balance. A prescription alone addresses none of that. It manages the symptom while the underlying cause continues unchecked.
Most telehealth ED services are built around a short questionnaire and a monthly refill. Body Balance Medical starts with a comprehensive hormone panel. Because Mia LoPreiato, NP wants to understand what's actually driving the problem — not just treat the presenting complaint.
If you've been experiencing changes in sexual function alongside other symptoms — lower energy, shifts in mood, reduced drive, or difficulty maintaining muscle — these may all be part of a connected hormonal picture.
In February 2025, the FDA removed the cardiovascular black box warning from testosterone products following the landmark TRAVERSE trial — the largest cardiovascular outcomes study on testosterone therapy to date. This is a clinically significant development that changes how hormone therapy can be discussed with patients.
Read the Cleveland Clinic summary of the TRAVERSE findings →
of men between 40 and 70 experience some degree of erectile dysfunction — with severity increasing alongside declining testosterone levels as men age.
per decade: prevalence rises from roughly 40% of men in their 40s to 50% in their 50s and 60% in their 60s — a progression that closely tracks the natural decline in testosterone over time.
men with clinically low testosterone identify ED as a primary symptom — yet most are never offered a hormone evaluation as part of their workup.
A Protocol Built Around the Cause
Body Balance Medical offers a range of evidence-informed treatment options — from platelet-rich plasma therapy to full hormone optimization — depending on what Mia's evaluation reveals about the underlying physiology.
Platelet-Rich Plasma Therapy
Often called the P-Shot, PRP therapy uses your own platelet-rich plasma — derived from a simple blood draw and processed in-office — to support blood flow, tissue quality, and nerve sensitivity. A non-pharmaceutical option that can be used independently or alongside other treatment modalities.
Prescription Sildenafil & PDE5 Inhibitors
Sildenafil (Viagra) and related medications are clinically appropriate for many men and may be prescribed as part of a comprehensive evaluation where indicated. The difference from a telehealth refill: at BBM, any prescription is informed by your hormone panel, cardiovascular history, and a real clinical evaluation — not a questionnaire alone.
Topical Testosterone Therapy
Testosterone creams and topical preparations address androgen deficiency directly and are a practical, non-injectable delivery method. Mia evaluates each patient's hormonal baseline to determine whether topical therapy is appropriate, at what dose, and how it fits alongside other treatment elements.
Testosterone therapy at BBM →Hormone Optimization & TRT
For men whose testosterone deficiency is the primary driver, a full hormone optimization protocol — including Biote pellet therapy or injectable TRT — addresses the root cause rather than managing downstream symptoms. This is the approach most telehealth providers are not equipped to offer.
Biote hormone pellet therapy →A Clinic, Not an Algorithm
The telehealth ED industry is built for volume. A brief questionnaire, a quick approval, a monthly shipment. What that model cannot do is identify why you're experiencing ED — whether the cause is hormonal, vascular, metabolic, or some combination of all three.
That level of clinical evaluation requires a physical clinic, a credentialed provider, and a lab workup. Those are not barriers — they are what make the difference between a prescription and a plan.
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Physical Clinic · Summerlin, Las Vegas
7975 W Sahara Ave #101. A real exam room, a real provider, and a clinical evaluation that requires you to be present. That's not a limitation — that's what a medical evaluation looks like. Learn about our hormone optimization program →
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LegitScript Certified
Body Balance Medical is LegitScript certified — a third-party standard that confirms legal, ethical, and safe practices. Most telehealth ED platforms operating at scale do not hold this certification.
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Mia LoPreiato, NP — Named Provider
Mia is a Biote-certified hormone specialist with clinical depth in men's hormone health, testosterone therapy, and the interconnected symptoms of androgen deficiency. You are not evaluated by a rotating pool of remote clinicians. You work with Mia.
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The Hormone-First Evaluation
Every new patient evaluation begins with a comprehensive hormone panel — not a questionnaire. Your labs inform your protocol, which means the treatment you receive is calibrated to your actual physiology rather than a statistical average. Explore our hormone and metabolic health program →
A Clinically Significant Shift: The TRAVERSE Trial
For years, a cardiovascular black box warning on testosterone products made many clinicians hesitant to prescribe hormone therapy for men with cardiac history. In February 2025, following the FDA's review of the TRAVERSE trial, that warning was removed. The study — the most comprehensive cardiovascular outcomes trial on testosterone therapy to date — found no increased risk of major cardiovascular events in appropriately indicated men receiving testosterone therapy versus placebo.
Mia references this evidence in every evaluation involving cardiovascular considerations.
Cleveland Clinic: TRAVERSE Study & Testosterone Cardiovascular Safety →
Mia LoPreiato, NP
Biote-Certified Hormone & Longevity Specialist
Mia's clinical focus is hormone optimization in men and women — with particular depth in testosterone therapy, metabolic health, and the interrelated symptoms that make patients feel like something is off long before a lab value crosses a reference range threshold.
Every men's evaluation with Mia begins not with a prescription but with a question: what is actually happening, and why? That clinical orientation — evaluation before intervention — is what differentiates an in-person assessment from a telehealth questionnaire.
Mia holds Biote certification, meaning her hormone training extends beyond general NP education to include pellet therapy protocols, advanced hormone panel interpretation, and the evidence-based clinical frameworks that Biote's platform supports.
Mia LoPreiato, NP is Biote-certified — a training designation specific to hormone pellet therapy, advanced panel interpretation, and individualized hormone protocols.
An Evaluation, Not an Appointment
Mia's hormone evaluations are structured to understand the full hormonal picture before any treatment is discussed. The process takes time by design.
Apply for Your Assessment
Complete the brief intake to confirm candidacy. Mia's evaluations are limited by her availability — the intake process ensures the appointment is the right fit before you arrive.
Hormone Optimization Assessment
A comprehensive evaluation: detailed health history, symptom review, and a full hormone panel that Mia interprets in the context of your individual physiology — not just against population reference ranges.
Your Protocol, Calibrated to You
Based on your labs and clinical history, Mia develops a personalized protocol that may include hormone therapy, PRP, prescription medication, or a combination. Follow-up is built in — this is a clinical program, not a one-time transaction.
Medically Supervised. LegitScript Certified.
Body Balance Medical holds LegitScript certification — one of the most stringent third-party verification standards for medical clinics. LegitScript confirms that we operate within legal, ethical, and safety guidelines for prescribing and patient care. When the treatment involves prescription medications or compounded therapies, credentials are not optional.
The Right Evaluation
Changes Everything
Mia's Hormone Optimization Assessment is a clinical deep-dive — not a 10-minute visit. If you've been managing symptoms without understanding them, this is where that changes.
Apply for Your Hormone Optimization AssessmentCommon Questions About ED Treatment
Is erectile dysfunction always caused by low testosterone?
No — ED has multiple contributing causes, including vascular health, blood sugar regulation, medications, psychological factors, and hormonal imbalance. Testosterone deficiency is one of the most common and most undertreated contributors in men over 40, but it's rarely the only factor. That's why Mia's evaluation examines the full picture rather than starting with a single diagnosis. Learn more about the signs of low testosterone →
What is PRP therapy for erectile dysfunction, and how does it work?
Platelet-rich plasma therapy (also called the P-Shot) involves drawing a small amount of blood, processing it to concentrate the platelet-rich plasma, and delivering it to the treatment area via injection. Platelets contain growth factors associated with tissue repair, improved blood flow, and nerve function. It's a non-pharmaceutical clinical option that can be used independently or alongside other elements of a hormone protocol.
Can I get a prescription for sildenafil (Viagra) at Body Balance Medical?
Yes, where medically appropriate. Sildenafil (Viagra) and related medications are legitimate clinical options that Mia may include as part of a comprehensive protocol. The distinction from a telehealth refill is that at BBM, any prescription is informed by your hormone panel, cardiovascular history, and a full clinical evaluation — not a questionnaire alone.
How do I know if my testosterone is low?
Common indicators include reduced libido, fatigue, difficulty maintaining muscle mass, mood changes, disrupted sleep, and changes in sexual function — though not all of these need to be present. The only way to confirm testosterone deficiency is through a comprehensive lab panel. Many men have levels that fall within population "normal" ranges but are low for their individual baseline. Mia interprets labs in context, not just against statistical averages. See the full list of low testosterone symptoms →
Is testosterone therapy safe if I have a history of cardiovascular issues?
This is a clinical question that Mia discusses directly during your evaluation. In February 2025, the FDA removed the cardiovascular black box warning from testosterone products following review of the TRAVERSE trial — the most comprehensive cardiovascular outcomes study on testosterone therapy conducted to date. The trial found no statistically significant increase in major cardiovascular events in appropriately indicated men receiving testosterone therapy versus placebo. Cardiovascular history does not automatically exclude someone from consideration, but it is reviewed carefully and discussed transparently during the assessment. Review the Cleveland Clinic TRAVERSE summary →
Beyond cardiovascular history, TRT in general requires ongoing monitoring — hematocrit, prostate markers where appropriate, and for men with fertility considerations, a transparent conversation about how hormone therapy affects sperm production. That level of clinical oversight is exactly what Mia's follow-up protocol is built around — and what a monthly telehealth refill cannot provide.
What is the difference between BBM and an online ED service?
Telehealth ED services are optimized to approve and prescribe quickly. Body Balance Medical is structured to understand the underlying cause. That means a comprehensive hormone evaluation, a named provider who evaluates you in person, and a protocol that may include hormone therapy, PRP, prescription medication, or a combination — calibrated to your labs. BBM is also LegitScript certified, a compliance standard most telehealth platforms do not hold. If the goal is to understand what's driving symptoms and address it properly, that requires a clinical setting.
Does Body Balance Medical accept insurance for ED treatment?
Body Balance Medical operates on an out-of-pocket investment model. Hormone optimization, PRP therapy, and related services are not typically covered by insurance. Financing is available through Cherry Financing and CareCredit for patients who prefer to spread the investment over time. The cost includes Mia's evaluation, lab interpretation, protocol design, and follow-up care — not just the procedure.
How long before testosterone therapy affects sexual function?
Individual response timelines depend on baseline testosterone levels, the delivery method, dosage, and overall metabolic health. Some men notice changes in energy and mood within weeks; improvements in libido and sexual function generally develop over a longer course of therapy. Hormone optimization is a sustained clinical program — regular follow-ups and dose adjustments are part of how Mia structures every protocol. Learn more about what TRT involves in Las Vegas →
Summerlin · Las Vegas
7975 W Sahara Ave #101
Las Vegas, NV 89117
Summerlin · Las Vegas · Henderson, NV