Month: May 2018

What to expect after the O-Shot® [Orgasm Shot®] procedure from the Inventor of the Procedure-Charles Runels, MD

Reporters may reach Dr. Runels at support@CellularMedicineAssociation.org

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Charles Runels:

This recording is to help you understand what to expect after the O-Shot® (also called the Orgasm Shot®) procedure.

Hello, my name is Charles Runels and I'm honored to talk with you about the procedure. During this recording, we'll discuss interstitial cystitis, chronic mesh pain, the appearance of the labia majora, lichen sclerosus, lichen planus, dyspareunia, incontinence, both stress and urge, orgasm and difficulty with orgasm, both with masturbation and with penis and vagina sex. That's a lot, so let's get started.

First of all, my thanks to the amazing people in our group. The Cellular Medicine Association governs the quality of provider, helps curate the information that's provided, and the observations that are seen by the members of our group. The Cellular Medicine Association helps finance research, and much of what I'm giving to you now has been gleaned from the amazing physicians and nurse practitioners in that group.

Blood is not governed by the FDA. The Food and Drug Administration governs food and drugs and devices. They don't govern blood, but the members of our group have agreed to use a device that is approved by the FDA to prepare the plasma that's used in the O-Shot or the Orgasm Shot. You should have had the procedure done by someone in our group. This is not just a shot to be done any way that might occur to someone. The structures around the urethra are very intricately and amazingly put together. The results can vary tremendously based on where the injection is placed, both in not only the results, but also the comfort can be completely pain-free or it could be excruciatingly painful depending on the skillset of the person doing it and their understanding of what it is we do. Be sure that that is done, and if you have a not so good experience, that you report your experience, good or bad, to the Cellular Medicine Association.

There is a blog on the O-Shot website, and there's also a survey that can be done for free, to help us understand what happens with people who have the procedure done. Request that your provider enroll you in that survey, which is done in a very private way using two HIPAA compliant, double password protected and very, very secure servers that never ask you for your name. That's not obligated. You're not obligated to participate, but we hope that you will, and all the members in our group have that capability to help us understand what's going on and how to further develop this.

There's been over 9,000 papers published in PubMed about platelet-rich plasma, and thus far, none of those research papers have demonstrated any severe infections or damage done from platelet-rich plasma, which is what you would expect since platelet-rich plasma is what the body uses to heal tissue. On the other hand, that doesn't mean that everything works out perfectly and that there are no side effects, so we should talk about that.

A review of some of the research (transcript continues below)...

First of all, in general, the plasma will go away after about nine days. The platelet-rich plasma contains platelets, which act like suitcases to carry growth factors and cytokines, over 20 of them, that then recruit stem cells from the bone marrow that come to the area and heal new tissue. Research has shown that platelet-rich plasma can help heal scars, help fight infection, down regulate the autoimmune response, help regrow new nerve. That's been demonstrated in multiple studies, like I said, over 9,000 studies in wounds healing, in dentistry and surgery over the past 15 years. We are applying that research in the area of the genitourinary space.

In general, and what we have seen in this procedure is that the plasma goes away at about three days. This is not a pharmacological effect, like if you take a pain medicine or if you take ... For example, if you have anesthesia, you immediately go to sleep, or if you take an IV shot of morphine, you immediately feel the effects. Because this involves growth of stem cells, then it takes time for that to grow. The beginnings of those effects from the actual growth usually start at about three weeks. Full effect is two to three months. In orthopedics, when using stem cells to help with tendon and bone, which grows much more slowly, full effect is six months to a year. Now, that doesn't mean there won't be effects the day of the procedure. Just like if you scrape your knee or if you have surgery and there's a laceration that's been sutured together, you can have symptoms of throbbing, you can have increased sensitivity, you can have decreased sensitivity, as with when you have a bruise it can feel boggy and decrease less sensitive. Then, when the healing comes, then things grow back.

That's exactly what happens with the O-Shot. In the beginning, people can have decreased sensation that can happen, last from a few days to a few weeks. They can have increased sensation with hypersexuality and almost inability to get relief with multiple strong orgasms. This is more rare, but it happens. They could have increased libido. They can have urgency when they, like the urge to urinate. They can have frequency. They can have sexual arousal with urination, almost any sensation you can imagine, burning, itching, all sorts of things, but what's usually observed by almost all women is nothing. Most women have a little spotting from the injection. There's a lot of blood flow down there so they have some spotting and may wear a pantyliner for the day. Just like if you had a shot, you might need a band-aid to keep it from bleeding a few drops on your clothing. In the same way, there might be a few drops of blood. That's about it. Most women, therefore, experience almost nothing for the first three weeks.

Then, things start to kick in. If they had pain, it starts to decrease and we'll get into more specifics of what happens during that time when we get to discussing each problem that is treated with the O-Shot, but most of the effects, the beneficial effects start to happen at three weeks and the symptoms that might be more a nuisance, like decreased sensation or hypersexuality, start to go away by that time.

Let's talk about the various problems that are treated with the O-Shot and how each might respond. Let's start with decreased libido. Decreased libido can be from so many things. It can be emotional, it can be endocrine or from hormones. It can be because of a relationship problem with a partner. It can be past history, say, if the person was abused or something of that nature. Libido involves a lot of things. It can also be a positive or a negative spiral. For example, if a woman starts to have sex and then she has pain, then she starts to associate sex with pain and then she develops decreased sex drive or libido. If she has a good experience, then she starts to associate sex with something wonderful and so her sex drive may go up.

It is very true that there's a very complicated system involving orgasm. The orgasm system is not the same as the reproductive system. A woman could have pregnancy without any sexual arousal at all, but it's because there's this complicated system, it doesn't mean ... Let me say that a different way. Anything in that system can affect it negative or positively. For example, we could give you the O-Shot, and you could have the healthiest vagina and clitoris on the planet, but if you're emotionally bothered by a really poor relationship or emotional trauma from when you were a child, then the O-Shot is not going to make you have an amazing sex life. If you have an extremely low testosterone level where it seems impossible to have a libido, could be the same thing.

On the other hand, you could have the most amazing relationship and perfectly balanced hormones, but if you have genitalia that are scarred and causing you pain or with lichen sclerosus or decreased sensation from nerve damage from riding a bicycle or decreased blood flow for whatever problem, diabetes, all the things that could affect the genitalia, then all the emotions in the world may not be sufficient to make things as good as they could be, so we do not claim that the O-Shot fixes everybody's sexual problems, but we do claim that healthy genitalia and the tissue of the genitalia is extremely important as part of the sexual or the orgasm system.

Back to libido. We have seen an extremely beneficial effect from the O-Shot, but all of those other things should be considered, endocrine relationship and emotional, especially testosterone levels should be ... The free testosterone levels should be in the upper level, normal for the woman, and she should have her prolactin level checked to make sure it's not too high.

What if the woman's trying to have an orgasm and she's never had an orgasm in her life? This is a very difficult problem and a very frustrating problem and affects about 10% of women. This is one of the less effective problems that the O-Shot helps, although we do have amazing results when it works. Women who've gone for many years and never had an orgasm in their life then start to have orgasm. We think what happens is that some women have less sensitivity in the area, and the O-Shot helps bring new blood flow and new nerve tissue to the area, allowing them to have a vaginal or clitoral orgasm, but, again, this one is more difficult because the problem can be so multifactorial. It's like saying shortness of breath, if I give you bronchodilators, which would help someone with asthma for shortness of breath, but the reason you're short of breath is you have carbon monoxide poisoning or you're profoundly anemic and don't have enough red cells to carry your oxygen, then the bronchodilators are not going to help, but it does not mean bronchodilators will not help the person who has bronchospasm from asthma, or maybe someone might have anemia or bronchospasm.

In the same way, our O-Shot does not make everyone well, say, for example, in the woman where everything is perfect with the labia and vagina and clitoris, but she's suffering from extreme problems emotionally because of abuse, the O-Shot may not help her.

On the other hand, it could be that the abuse was physical, as I have seen in the past, and the woman has scarring from extreme physical abuse, and then the culmination of the O-Shot, which helped the pain from the scarring so that she's now able to feel good and function again, gave her the confidence and to go out and seek a new relationship, so the physical helped the emotional healing. Listen to that again. A woman abused in the genitalia, scarring, extreme dyspareunia or pain with sexual intercourse, you could give her therapy all day long, every day, which she had for six, almost seven years before I treated her, but without effect, still leaving alone, and then after my O-Shot, the pain improved, her genitalia functioned more normally, she was able to have an orgasm more easily, sought a relationship. Her whole life was changed.

Again, with decreased libido, with decreased orgasm, it can be helpful, but it's not total story.

We estimate, from our surveys, that if the woman has never had an orgasm in her life and everything else has been optimized as much as possible, the O-Shot is going to help her have an orgasm for the first time in her life in 30-40% of the time. If the woman has had an orgasms and continues to have orgasms, but they're not as potent or as strong or as satisfying as they once were, this is a different matter. In this case, our O-Shot seems to help around 80% of the time.

Here again, the full effect appears to be around 8-12 weeks, so if you're not feeling much at two weeks, it's really too soon for the new nerve or the new blood flow or the new collagen to have even grown, so it does not mean that you will not have a satisfying result. Also, the procedure seems to be cumulative, just like it is with hair growth and treating the scar tissue in the face, which has been shown to help with acne scarring. Then, in those cases, the treatment is usually two to three treatments, about 6-12 weeks apart. Again, with our procedures, it also seems to be cumulative with the O-Shot for the various causes.

I recommend that you give the procedure at least eight weeks before you have it repeated, maybe even twelve depending on the severity and the strain on the relationship, etc., that might make you want to go sooner.

Here, it's worth mentioning the various devices that are used in concert with the O-Shot. If you have radiofrequency or laser or electromagnetic therapy used along with your O-Shot, I recommend that you have those procedures done first with the O-Shot following. It can be done immediately following on the same day, but it should be the energy first and then the O-Shot. The growth factors are small amino acid peptide chains, so just like insulin, the amino acids are strung together in a way that act like a code that talk to the cell tissue. Growth hormone is another one. These amino acid chains, if they're heated up, it denatures the protein, just like when you fry an egg, it changes the protein, and so they no longer code for the message. Therefore, if you gave an O-Shot on the same day, immediately after the O-Shot, if you did a laser treatment or radiofrequency, then you would undo what you had just accomplished with the laser or the radiofrequency.

The purpose of the laser or the radiofrequency is to incite damage that which then stimulates growth factors. We are injecting growth factors when we do the O-Shot, so it would enhance the effects of the laser or the radiofrequency, but if you do the O-Shot first, then you do the laser or the radiofrequency, you're going to fry the growth factors that you just injected and, therefore, denature them so that they don't work so well.

In the same way, if you do electromagnetic treatments to strengthen the pelvic floor, it's been shown that PRP can help recover muscle, as well. As a matter of fact, for a while, it was banned by the Olympic committee, although they don't ban it any longer, because PRP helps athletes recover. PRP's now commonly used by athletes of many different forms, Olympic athletes, football players, even very expensive racehorses. Having muscle stimulation with electromagnetic therapy and then using platelet-rich plasma in the area can be a dramatic, like a pro-football, Olympic treatment for the pelvic floor.

Let's talk about some of the other problems. Chronic interstitial cystitis, we are not sure why platelet-rich plasma helps, but it seems to help in a large percentage of the time, over half the time. It helps dramatically in women who have suffered for many years. We think this is because it both down regulates the autoimmune response and decreases inflammation with healing. In the short run, there can be an increase in inflammation. That's part of the healing process, but in the long run, it gets much better.

We have women, as I said, have suffered for many years, and we're not sure why. The whole idea of chronic interstitial cystitis is a difficult and painful problem. The O-Shot can be done in the normal manner. It doesn't have to be injected into the bladder. It's done in a normal manner around the paraurethral space, but we're using a volume enough that is going to coat the bladder and the urethra.

In women who have chronic mesh pain, we also see amazing results, again, because we think it's healing and decreasing some of the chronic inflammatory process that can go on with mesh. Some autopsy studies have shown that mesh wraps around the pudendal nerve, so if your doctor treats you for chronic mesh pain, you'll do the procedure in the same way, but there also may be some injections around the distribution of pudendal nerve.

With mesh pain, it doesn't usually go completely away, but we see a wonderful attenuation of that pain from say 10 to 2 or 8 down to 2 or 1, almost immediately, with full effect again being around two to three months out, but for some reason, platelet-rich plasma has an immediate attenuation in many women in this instance.

For lichen sclerosus, the usual protocol is that you're injected, and then whatever places are still itching or look sclerotic or cracking, bleeding, etc., can be retreated at six weeks out, and then, oftentimes, the women has no symptoms, even without steroids for up to a year afterwards.

Lichen planus has a similar effect. This can be a painful procedure. It's more painful than the others. With a regular O-Shot, some topical numbing cream and ice, a little local lidocaine block seems to be all that's required for most women, but lichen sclerosus, either oral agent or some nitrous may be necessary to help attenuate some of the pain during the procedure.

When treating women who suffer with pain, as dyspareunia from various causes, the symptoms will vary depending on the cause. For example, if a woman has pelvic floor tenderness, she can put her finger or the physician can put his or her finger on the pelvic floor, and we produce the pain. That's often treated with [inaudible 00:21:38] injection. We have found treating with platelet-rich plasma can lead to a better result, and the good thing about platelet-rich plasma, both in pelvic floor pain and with lichen sclerosus, is we're doing something that enhances the immune system versus cortisone, which decreases the immune system. We do not know what long-term use of low-dose steroids do to the risk for various viral causes of cancer. In theory, it might make a woman more susceptible, although we don't know that. However, platelet-rich plasma enhances the immune system and we would hope, my hope, decrease her chances of the viral illnesses that might cause cancer to wreak their havoc.

Also, a woman with lichen sclerosus has a 10% chance of squamous cell carcinoma, and we are hoping that the true antiinflammatory effects of lichen sclerosus as it attenuates, or of platelet-rich plasma in lichen sclerosus as it attenuates the autoimmune response might help decrease. We have to do the studies to find out, but we think it could help decrease the incidence of squamous cell carcinoma in lichen sclerosus.

Back to dyspareunia, if the woman has an episiotomy that causes pain, which they don't always do, if she has an episiotomy scar that's bleeding and cracking and causing pain, the O-Shot is absolutely the bomb, works amazingly well in this condition.

If she has really thin tissue in that area, she may need to be injected more than once, maybe two or three times with 8-12 weeks between treatments, but amazing, amazing results here.

If she's got pain from fibroids, she needs surgery. If she has pain from big ovarian cysts, that's not something the O-Shot's going to help.

Before the O-Shot is used for pain, there should be understanding of what's causing the pain, although not all pain is completely well understood and, oftentimes, the woman is left with an unsatisfying diagnosis, but if there is a surgical cause for the pain, then the O-Shot is not the treatment. If she needs a hysterectomy, she needs a hysterectomy, or if she needs treatment for ovarian cysts, that should be done, not an O-Shot.

If a woman has pain because of a small introitus, the usual treatment is gradually increasing dilators. In this case, you would do the same, only add to that treatment, an O-Shot prior to the dilator use.

The wonderful thing about platelet-rich plasma, again, after over 9,000 papers published in PubMed, there's never been an incidence of a serious side effect, as in a serous infection, never been a documented causing cancer, there's never been a documentation of any serious granuloma, none of those things, unlike, say, for example, midurethral slings, which we know can interfere with the nerves of sexual pleasure. Midurethral slings are a good procedure when they work, and I'm not saying they shouldn't be done, but it's perfectly reasonable to try a nonsurgical option first, especially when we know that the symptoms and side effects when a sling goes wrong are much more severe than what's ever been documented with platelet-rich plasma.

For stress incontinence, what can happen is that when that platelet-rich plasma turns to a fibrin matrix, sometimes, the woman can experience relief of her stress incontinence that day, but then the matrix gets replaced by normal tissue, and it could be that her incontinence starts to come back over the next week or two, and then, as the new tissue grows from three weeks to three months, it improves again. If it's not completely relieved, she should consider having it repeated at eight to twelve weeks. There does seem to be some synergy with stress incontinence if she has radiofrequency or laser treatment or a electromagnetic pelvic floor treatment prior to the O-Shot.

Urge incontinence surprisingly also works very well with the O-Shot. That most likely is from the nerves growing, and there are multiple papers showing that PRP causes new nerves to generate, so this can happen, but nerves grow very slowly, so if you're treated mixed incontinence, where's there a component of urge incontinence, then plan on at least eight to twelve weeks before you see the effects of it, and you most likely will want to have a repeat treatment done and then decide after the second treatment whether it was effective or not.

Thank you for listening. I hope this helps clear up some of the general ideas relating to this procedure. We have over 1,000 physicians in over 50 countries we've done. We're approaching now 100,000 procedures. This is an extremely revolutionary procedure, and I'm honored to be cooperating with all the amazing providers in our group, and I encourage you to see the provider that took care of you, whether your results was wonderful or if it was not so wonderful, so that we can better take care of you and better learn about how to choose the best candidate for the procedure and how to develop the procedure so that it might work better.

I'm honored to speak with you, and I hope that you'll let me know how you do. Remember, our survey is extremely important, and sharing your data could help us plan future research and help many thousands of women in the future. Thank you.

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Sexless Marriage

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Maureen McGrath: It's been said if you never want to have sex again, get married. Sex is one of the most contentious issues in marriage today, second only to finances. There are many married couples that have not had sex for months, even years, and that's okay as long as they're okay with it and happily married. The problem arises when one person in the relationship wants sex and the other doesn't. According to a national newspaper survey of approximately 10,000 respondents, mostly married men, 75% were satisfied in their relationship but more than 50% were dissatisfied with their sex lives. We're having sex, don't get me wrong, we're just having sex at the wrong time and with the wrong people, I'll get to that later.

We're having sex before we get married, 10 years on average, so we are effectively in a long term relationship and potentially quite sexually bored before we even mess up the marital bed. That has its consequences. Most brides today do not have sex on their wedding nights, and 50% of men would not have married their spouse had they known their marriage was going to be sexless. So, everybody wants to know, just how much sex are married people having, whether they are in heterosexual relationships or same sex unions, you all want to know what's going on at the Jones'? Well not much.

Only about 7% of married couples set the sheets ablaze. Most married couples have sex a little more than once a week for the first decade of their marriage, it decreases after that. So they have sex about 58 times a year, and 20% of marriages meet the criteria as a sexless marriage. That, defined by the experts, is sex less than 10 times a year. So why aren't we having sex in our marriages? Well, there's a little known chemical in the brain conveniently called PEA, or PEA. It's responsible for the elation, the excitement and the euphoria that you feel when you meet somebody that you are sexually interested in.

It's a fantastic feeling, this chemical is scourging through your blood vessels, you are so happy, that's how powerful this little chemical is. What happens after two years, that chemical diminishes as does sexual frequency. That's just about the time you might get married or might have conflict in your relationship and that is why communication is key to great sex. There's another reason we're not having sex in our relationships, that has to do with the sex education that we provide. I'd like to share a story about myself, when I was a teenager my mother came racing into my bedroom and she said, “Maureen, please tell me you have not allowed a boy to french kiss you!” She was feeling terrible that this sex education came a bit late, I was feeling horrifically guilty as an Irish catholic girl that I'd french kissed a number of boys by that stage.

We teach girls and women that sex is dirty and sex is bad or it's overrated. We say, you're just going to get a sexually transmitted infection anyway, or you might get pregnant! This whole fear based thing frightens women from enjoying sex and we never talk about pleasure with girls and women, or orgasm. In fact, some women say orgasm is not important and that the journey is just as good as the destination. I disagree. Of course. I'm the one who french kissed all the boys as an Irish catholic girl. It's like getting on a train with your lover, and you are going to the most pleasurable place on the planet. You are so excited, you're getting lubed up with all the free drinks they're giving you, this is amazing. Just before you reach your destination, he gets off and you don't. You get my point.

Now, the sex education we have for boys and men, that's entirely different. It's a global program, it's free, it's accessible to everybody and it's known as internet pornography. Fantastic. It does nothing to teach men and boys about intimacy which is really important to men and boys, or how to make love to anybody, also we have a paucity of information about sexual health for our LGBTQI community and we need to add to that. Now marriage can rapidly go from holy matrimony to holy hell with the finances, the kids, the houses, the illness. You may have signed up for sickness and health but that was long before you'd ever witnessed a man cold, and how about that richer or poorer thing? Ladies we're going to have to start going for richer.

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Most women today are working inside and outside of the home. We're doing the lion share of the housework because according to research, men don't feel they're that good at it. We're bridging the gap between growing children and aging parents. We're exhausted doing it all and never doing it, and when we are doing it, we're checking our smartphones. 10% of people check their smartphones during sex. 35%immediately afterward. We are connected to the internet. We are connected to the internet and disconnected from our would be lovers. Maybe this is the reason that the most common sex position for married couples is doggy style. No, no, no. It's not what you're thinking. Get your minds out of the gutter.

This is the one where he's on all fours and begs and she plays dead. I have a clinical practice where I see patients that have sexual disfunction and there are two questions that I ask everybody. The first one is, are you sexually active? That's obvious. When I ask women they never say yes or no. Well, they never say yes. But they never say yes or no. They say; sometimes, sort of, I'm not sure, he is or they say “I'm married.” I say well that means no to me. They say yes you're right, it is no. Most men complain that women never initiate sex. The reason for this is because once again the sex education we provide to women, women falsely believe that female sexual interest, desire, precedes sexual activity when in actuality, it is sexual activity that prompts sexual interest and desire. Sexual arousal emerges as a result of sexual activity.

So, you guys I know, intimacy is important to you. The most important question that reflects this that I receive from you is, “How much masturbation is too much masturbation?” So I just say as long as you can go to work, you should be fine. Then I realize, that that's perhaps all that you're doing at work. So I know intimacy is important, you want to come home and you want to make love to your wife if you're in a heterosexual relationship, so after a long and quite possibly very hard day, you come home to a bit of chaos perhaps, you've just got sex on the mind and she says, “Did you remember the milk?” You're like darn, the milk! I forgot the milk. Don't beat yourselves up about it, if not for the milk we have Facebook, hormones, I'm feeling a little tired tonight, my stomachs sticking out I'm feeling kind of fat, can't do it tonight, didn't we have sex last month? You're like, that was actually last year. You don't get it. Literally, you don't get it.

You're like she's amazing, she works in and outside of the home, she does a great job with the kids, she volunteers, she even has time for girls nights out. So, I brought a friend home after one such girls night out. As we approached her house, drove up she looked up to her bedroom window, saw that the lights were on and she said, “Donny's waiting up for me, do me a favor, drive around the block a few times until the light goes out” I said listen, “You get in there and make love to your husband before somebody else does” Because that is one thing that will increase a woman's sexual desire, when someone else wants her man. Still unconvinced she said, “I decided to extol the health and beauty benefits that sex has for a woman, a youthful glow, better sleep, wrinkle free skin. Keep driving” She said.

There is a device that will increase anybody's sexual desire and that happens to be the Mercedes Benz 4MATIC convertible SL and it comes in 64 colors. If that doesn't do it, the desire to have a baby will rev up any woman's sex drive. The problem is, having that baby is likely to kill it along with any marital eroticism a couple may have had. A lot of people believe that motherhood and being sexual is incongruousness. John, John followed me on LinkedIn for two years before he mustered up the courage to make an appointment about his sexless marriage. He'd been married for seven years and they had never consummated the relationship. Their parents were pressuring them to have parents because they wanted grandchildren. When they came into my clinical practice, the second question that I ask everybody that enters my clinical practice most unfortunately is, “Have you ever experienced sexual abuse or unwanted sexual advances as a child?”

This was the first time this gentle man had learned that his wife had experienced sexual abuse as a six year old at the hands of her best friend's father. She thought sex was dirty, she hated sex, we need a worldwide moratorium on ending sexual violence on our children, boys and girls, because it happens to both. Healing from sexual abuse takes a lifetime. Ella had lived a lifetime. A widow, she said she wasn't sexually active but she hoped to be. I thought, fantastic! Somebody is going to have sex here, but she said, “The problem Maureen is that these old guys can't get it up anymore” I said well Ella, you might have to go for a younger guy. She said, “What's younger when you're 84? 70?” Yes some of you are saying.

The hard truth is that men in their 30s and 40s may experience erectile dysfunction. Ella is going to have to go for a millennial. So you're all probably thinking, “What's the big deal, why treat my erectile dysfunction?” Well I liken the penis to a plane, if a pilot can't get the plane up in the air, and keep the plane in the air for the entire trip, there's probably a problem with the engine. So if you can't get your penis up and keep it up for the entire sexual experience, there's likely a problem with your engine. That's your heart. Erectile dysfunction is the canary in the coal mine and it may signify cardiovascular disease. It may also indicate diabetes. These two medical conditions in addition to low testosterone, stress, substance use and abuse, excessive alcohol consumption, unresolved conflict, financial issues, all of those may contribute to low sexual desire and you may end up in a sexless marriage.

George presented to my clinical practice at age 40, he decided to settle down. He was marrying a beautiful and accomplished woman in a few months. There's only one problem, George was gay. George could not bear to tell his family that he was gay because he felt it would have shamed the entire family. I said, “George, you're going to end up in a sexless marriage!” He said, “Tell me something I don't know!” George said to me his plan was this, “Well, when my parents die I'm then going to divorce this woman and I'm going to marry the man that I love” And I said, “George, you are not thinking straight.” Sex is the barometer of the state of affairs in a marriage. People who live in sexless marriages report feeling frustrated, unloved, undesirable, unattractive and the worst of all, lonely.

Loneliness has been shown to increase vascular resistance and elevate blood pressure and lead to an early death. You're more likely to die from loneliness than you are from obesity or excessive alcohol consumption. When I educate women and I say, “If you're not having sex with your husband, someone else may” They get upset and they say that I'm blaming women for men's bad behavior when in actuality I'm doing a community service. You see, men in sexless marriages cheat to remain in that marriage in general. Women cheat to leave a sexless marriage. Women cheat too, nobody ever thinks we do but we're just sneakier about it, we just don't get caught or socialize very differently, this is one thing we have on you guys. Women cheat with other men and women cheat with other women.

Technology has made cheating accessible for everybody, from the politician to the stay at home parent, that quick swipe right can lead to an online passionate love affair. From texting to sexting to secret phone conversations. The more two people communicate online, the more likely an in-person encounter will occur, but you can always blame your genes. The gene DN4N has been isolated in cheaters and the sexless marriage, just the environment to turn on that gene. It's based on a system of pleasure and reward. The stakes are high, the rewards substantial. It is the perfect cocktail to turn that love drug back on, PEA and the cycle begins again. Historically, marriage was not based on mutual love but rather it was an institution to acquire of all things in laws, property and physical labor. At the turn of the 20th century, in America, egalitarian ideals and the emerging Hollywood movie industry burdened marriages with promising romantic love forever.

Now we're living forever, fantastic, congratulations, you get to have sex with the same person for the rest of your life. The second most common question that I hear from patients is, "When does sex end?" Well a 44 year old asked me, he said, " When does sex end Maureen, 65?" I answered him this way, a 22 year old asked me, "When does sex end Maureen, 35?" Everybody's older until you get there. I'm here to tell you that sex never ends. If you're healthy, you can have a great sex life well into your 80s and 90s. Sex is good for you, sex is healthy, yet sex is shrouded in shame. In the ancient aristocracies, the wealthy men had courtesans for pleasure and concubines for quick sex. The way we're going, computers will be our concubines, internet pornography our mistress of the day. Technology is fast replacing human connection at high speed.

So how do you rev up the sexless marriage?

  • Sex is about blood flow, sexercise. Every day you want to have a daily workout. It increases your agility, your stamina, women will experience more sexual sensation when blood is flowing to the genitalia. It also helps to treat erectile dysfunction.
  • Also get help for any of the sexual dysfunctions you may have [& for men],  vaginal dryness, it's an issue that happens to women who are on the oral contraceptive pill, who are breastfeeding, perimenopausal, postmenopausal and there are treatments for you.
  • Pay more attention to your spouse than you do your smartphone.
  • Spend more time in your bedrooms than you do your boardrooms or your bedrooms are going to become bored rooms.
  • Deal with your marital issues.
  • Go to sleep in the same bed at the same time and don't bring anything or anyone into your marriage except for a great sex toy and a darn good sex therapist.
  • You must establish guidelines that govern those moments when you are struck by someone's attractiveness outside of your marriage, but don't think for a second that you have to have sex with the same person for the rest of your life. That's not what I mean. In your mind, that is. Fantasy is key. Your brain is your largest sex organ, and one more thing.
  • I would like to leave you all off with a bang. Settle all marital arguments in the bedroom, naked.

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