MELTS.LA β€” INTAKE CLINICAL DECISION ALGORITHM
AI-Guided Multi-Stack Routing Protocol for Erectile Dysfunction & Sexual Wellness
VERSION 1.0
DATE 2026-03-17
REF KG_MASTER_v3.2
STACKS S1-S8, W1-W3, C1-C4
KEY:
Hard Gate (πŸ”΄ block)
Soft Gate (🟑 caution)
Product Outcome
Clinical Decision
Assessment Step
Output / Handoff
PATIENT PRESENTS TO MELTS.LA INTAKE
STEP 1: INTAKE MODE SELECTION
Solo or Couples? β†’ Sets flow routing + bundle eligibility
PHASE I β€” SAFETY SCREENING (MANDATORY, NON-BYPASSABLE)
STEP 2: COMPOUND SAFETY SCREEN
Evaluate 6 gates sequentially. Any HARD gate = route restriction or exit.
G1: NITRATE
USE?
YES
πŸ”΄ BLOCK ALL PDE5i STACKS
S1, S2, S3, S5, S6, S7, S8 excluded.
Route to S4 SPARK ONLY (no PDE5i).
S4
SPARK
PT-141 + OT (no PDE5i)
Safe with nitrates
NO
G2: CARDIAC
EVENT <6mo?
YES
πŸ”΄ HARD STOP β€” EXIT
Refer to cardiologist. Cannot proceed
with any MELTS product until cleared.
NO β†’ Continue
SOFT GATES: G3 (Ξ±-Blockers) Β· G4 (Hepatic/Renal) Β· G5 (Unstable BP)
If ANY soft gate = YES β†’ flag for provider review, cap max tier at LITE, exclude Quantum
G3: Ξ±-BLOCKER
β†’ LITE cap
G4: HEPATIC/RENAL
β†’ LITE cap + labs
G5: UNSTABLE BP
β†’ LITE cap, no S8
All safety gates passed or flagged β†’ Proceed to clinical assessment
PHASE II β€” CLINICAL SIGNAL CAPTURE
STEP 3: ASSESS ERECTILE FUNCTION
"When the moment comes, does your body show up the way you want?"
PERFORMANCE
IMPAIRED?
YES (hit/miss or struggling)
SITUATIONAL
OR GENERAL?
SITUATIONAL
Psychogenic Frame
Lower dose needed
S3 Connection candidate
GENERAL PATTERN
Organic Frame
Higher-tier PDE5i
Vascular workup flag
NO (performance OK)
Performance INTACT
Screen other dimensions:
desire, hormonal, lifestyle
STEP 4: ASSESS DESIRE / LIBIDO
"How's your drive been lately?"
DESIRE
DIMINISHED?
YES (fading / barely there)
GRADUAL
OR SUDDEN?
GRADUAL
Hormonal Flag
Low T etiology likely
β†’ S6 Vitality+ path
Labs recommended
SUDDEN / STRESS
Psychogenic
Stress-related
β†’ S4 Spark or S3
NO (desire intact)
Desire INTACT
Likely performance-primary
β†’ S1 Edge pathway
STEP 5: VASCULAR DISCRIMINATOR
"Do you notice morning erections?"
MORNING
ERECTIONS
PRESENT?
YES (vascular intact)
Psychogenic Etiology Likely
Lower PDE5i dose sufficient
Consider: S3 Connection, S4 Spark
NO (vascular impairment)
Organic/Vascular Etiology
Higher PDE5i tier indicated
Consider: S1 PRO/MAX, S6, S8
PHASE III β€” TREATMENT HISTORY & GOAL ALIGNMENT
STEP 6: PRIOR TREATMENT RESPONSE
"Have you tried anything before?"
PRIOR
PDE5i USE?
TREATMENT-NAÏVE
Start Conservative
LITE tier default
Education-forward
PDE5i RESPONSIVE
Match Prior Dose
PRO tier
Known responder
PDE5i FAILED
Non-Responder Flag
β†’ S8 Quantum pathway
(AI soft gate)
STEP 7: PRIMARY TREATMENT GOAL
"What matters most to you?"
PHASE IV β€” ALGORITHMIC PRODUCT SELECTION
6-DIMENSION ALGORITHM SCORING
Performance + Desire + Psychology + Vascular + Hormonal + Lifestyle
Weighted by: safety flags Β· treatment history Β· goal preference Β· couples mode
PRIMARY
DIMENSION?
S1 β€” PHASE 1
THE EDGE
Vard + Tad (dual PDE5i)
5/5mg 10/10mg 15/10mg
IF: Perf=LOW, Desire=HIGH
S2 β€” PHASE 1
VELOCITY
Vard + Tad + PT-141
5/5/.75 10/10/1.5 15/10/2.0
IF: Perf=LOW, Desire=LOW
S3 β€” PHASE 2
CONNECTION
Vard + Tad + Oxytocin
5/5/25IU 10/10/50IU 15/10/100IU
IF: Psych=HIGH, Connection goal
S4 β€” PHASE 1
SPARK
PT-141 + OT (NO PDE5i)
.75/50IU 1.5/75IU 2.0/100IU
IF: Nitrate block OR desire-only
S5 β€” PHASE 1
DAILY
Tadalafil 5mg QD
5mg daily
IF: Always-ready goal, no timing
S6 β€” PHASE 1
VITALITY+
Enclomiphene 12.5mg + Tad 5mg QD
12.5/5mg daily
IF: Hormonal FLAG, energy LOW
S8 QUANTUM β€” PHASE 3 (RESCUE)
QUANTUM V / QUANTUM+
Q1: Vard 10 + Tad 10 + Apo 3mg (AI-gated)
Q2: Vard 15 + Tad 10 + Apo 3 + OT 50IU (clinician-only)
Q1: ADVERTISED (soft gate) Q2: CLINICIAN ESCALATION
IF: Prior PDE5i failure, non-responder flag
COUPLES
MODE?
YES β†’ Add Bundle
C1 Together: His S1 + Her W1 Bloom
C2 Desire Duo: His S2 + Her S4 Spark
C3 Connection+: His S3 + Her W1 + W3
C4 Spark Pack: His S4 + Her S4
NO β†’ Solo Rx
PHASE V β€” TIER CALIBRATION & HANDOFF
TIER SELECTION ALGORITHM
LITE: Treatment-naΓ―ve Β· Safety flag (G3/G4/G5) Β· Safety-anxious barrier Β· First-time
PRO: Prior PDE5i responder Β· Standard clinical profile Β· No safety flags
MAX: Documented partial response Β· Refractory profile Β· Aggressive-goal patient
GENERATE PROVIDER SUMMARY PACKET
1. Safety Dashboard (6 gates: βœ…/❌)
2. 6-Dimension Radar Chart (Perf/Desire/Psych/Vasc/Horm/Life)
3. Recommended Stack + Tier + Dosing + Clinical Rationale
4. Risk Flags (drug interactions, comorbidities)
5. Behavioral Micro-Signals (response time, answer edits)
6. Evidence Citation (mechanism, grade, 503A compounding reference)
PROVIDER
APPROVES?
APPROVE
Rx ISSUED β†’ PHARMACY β†’ PATIENT
MODIFY / REJECT
Provider Override
Adjust stack/tier/dosing
or reject with reason