What We Treat › Sexual Wellness
Physician-Directed Hormonal Optimization · Scottsdale AZ

Sexual Health Is
Hormonal Health.

Reduced libido, sexual dysfunction, and intimacy changes are among the most common — and least discussed — consequences of hormonal imbalance. For men, low testosterone is the primary driver. For women, it's a complex interplay of estrogen, progesterone, and testosterone. In both cases, the root cause is physiological, not psychological — and physician-directed hormonal optimization produces real, measurable improvements when the underlying imbalance is correctly identified and treated.

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43%Of women and 31% of men report sexual dysfunction — most never seek treatment
HormoneRoot cause in the majority of libido and function changes after age 35
TreatableMost cases improve significantly with correct hormonal diagnosis and treatment
Sexual wellness concern checklist:
  • Reduced libido or interest in sex
  • Erectile or arousal difficulties
  • Vaginal dryness or discomfort with intercourse
  • Difficulty reaching orgasm or reduced sensation
  • Loss of spontaneous sexual interest
  • Changes coinciding with a hormonal transition
  • Low energy, mood changes alongside sexual symptoms
Testosterone Evaluation Hormone Panel TRT Program Women's Hormones
Understanding the Problem

The Hormonal Basis of Sexual Health

Sexual function is a hormonal phenomenon. The key hormones involved differ by sex but the principle is the same: when levels are optimal, sexual interest and function are intact. When they decline, the symptoms are predictable and addressable.

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Men: Testosterone and libidoTestosterone is the primary driver of male libido. As testosterone declines — naturally after age 30 at ~1% per year, or more rapidly due to stress, obesity, or illness — sexual interest follows. Low testosterone also contributes to erectile dysfunction through its effects on nitric oxide-mediated vascular response and psychological energy for sexual engagement.
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Women: The estrogen-testosterone-progesterone triadFemale libido depends on a functional balance of all three major sex hormones. Estrogen maintains vaginal tissue health, lubrication, and sensitivity. Testosterone (in smaller amounts) drives desire and arousal. Progesterone affects mood and cycle-related libido changes. Any disruption — perimenopause, post-pill, post-partum, or chronic stress — alters this balance and produces predictable sexual function changes.
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Nutrient cofactors for sexual functionZinc is required for testosterone synthesis in both sexes. B vitamins support dopamine and nitric oxide pathways essential for arousal. NAD+ maintains cellular energy in the tissues responsible for sexual response. IV nutrient therapy addressing these cofactors provides meaningful support alongside hormonal optimization.
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The psychological layerHormonal changes produce real psychological effects — reduced self-confidence, relationship strain, mood decline — that compound the physiological disruption. Addressing the hormonal root cause often produces rapid mood and confidence improvements that are as important as the direct libido effects. This is not a psychological issue that happens to have hormonal correlates — it is a hormonal issue that has psychological consequences.
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Energy and physical vitalitySexual wellness is not separate from overall vitality. The same hormonal and nutritional factors driving fatigue, poor sleep, and reduced motivation also drive sexual interest decline. Patients who optimize their overall hormonal and nutritional status consistently report improvements across all dimensions of vitality — including sexual interest — as interconnected outcomes of the same interventions.
Treatment Options

Viva Sexual Wellness Programs

All consultations are confidential. Dr. Cordova evaluates the physiological basis of your symptoms and presents evidence-based treatment options without judgment or pressure.

Men's Program
TRT Program
From $199/mo

Physician-directed testosterone optimization for men with low testosterone-related libido and function changes. Full hormone panel, physician consultation, protocol design, and ongoing monitoring. Libido improvements typically emerge at 4–6 weeks.

  • Full hormone panel (total T, free T, E2, SHBG)
  • Physician-designed TRT protocol
  • Wellness ($199/mo) to Elite ($599/mo)
  • Libido improvements at 4–6 weeks
View TRT Program →
Women's Program
Women's Hormone Program
Custom

Comprehensive hormonal evaluation for women — estrogen, progesterone, testosterone, SHBG, DHEA. Physician-directed bioidentical hormone options and supportive therapies addressing the full spectrum of female sexual wellness concerns.

  • Full female hormone panel
  • Addresses libido, dryness, sensation
  • Bioidentical options available
  • Physician-directed personalized protocol
View Women's Hormones →
Cellular Energy
NAD+ IV Therapy
From $200

NAD+ supports the mitochondrial energy production that underlies overall vitality — including sexual energy. Many patients report improvements in energy, drive, and overall vitality alongside hormonal optimization, creating synergistic outcomes greater than either intervention alone.

  • Supports overall energy and vitality
  • Synergistic with hormonal optimization
  • Nitric oxide pathway support
  • 250mg ($200) to 1000mg ($700)
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Comprehensive
Optimization Program
Custom

For patients who want a complete picture before starting any specific program. Full bloodwork covering hormones, metabolic markers, thyroid, nutrients — with physician review and a complete treatment plan addressing all contributing factors to sexual wellness.

  • Comprehensive diagnostic panel
  • Rules out all contributing factors
  • Physician-designed integrated protocol
  • Addresses hormonal and nutritional basis
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Dr. Jerome Cordova MD
Medical Director & Founder
Dr. Jerome Cordova, MD
Critical Care Physician · Biomedical Engineer · Founded Viva IV Therapy 2017 · Old Town Scottsdale

"Sexual health is an indicator of overall health, not a separate category. When someone's libido declines, it's usually a signal that something hormonal, nutritional, or metabolic is off — not that they've simply aged out of sexual interest. These are treatable physiological conditions. The reluctance people have to discuss them means they go undertreated for years, affecting relationships and quality of life unnecessarily. My job is to identify what's driving the change and address it directly."

Common Questions

Sexual Wellness FAQ

Completely. All consultations at Viva are confidential and protected by standard medical privacy law. Sexual health concerns are discussed in the same professional context as any other medical condition — without judgment, and with complete discretion. Dr. Cordova has these conversations regularly and approaches them with straightforward medical professionalism.
For men on TRT, libido improvements typically begin at 4–6 weeks and continue to improve over 3–6 months as testosterone levels stabilize and body composition improves. For women, hormonal effects on libido and tissue health vary — some improvements are felt within weeks while vaginal tissue changes take longer. Dr. Cordova sets realistic timelines at your consultation so you have accurate expectations.
Standard lab reference ranges are extremely wide and don't account for where within the normal range you function optimally. A testosterone level of 320 ng/dL is technically "normal" but is associated with significant symptoms in many men. We take a symptom-informed approach: if your symptoms are consistent with hormonal imbalance and your labs show low-normal levels, a therapeutic evaluation is often the most clinically useful next step.
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Address the Root Cause. Confidentially.

Physician-directed evaluation of hormonal and nutritional contributors to sexual wellness. No judgment — just clinical medicine.

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(480) 508-8482

Open Daily · 10:00 AM – 7:00 PM · 7320 E. 6th Ave, Old Town Scottsdale