PRP in a Gynecology Setting

Here's a beautiful research summary about the O-Shot® and variations that may be done to help with a variety of problems (click to read)<--

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Reviving Ovaries to Improve Life



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You might've seen this episode of the Housewives of Orange County that came out this month. A lot of press has been out and discussing what happened with Shannon Storms, and why she got the shot and what might be possible with it. I think might be helpful to actually go to the medical research and look at this paper that came out this year about actually seeing what happens with the behavior, and the sex drive and, the whole life of people who have platelet rich plasma injected into actually the ovaries.

So what this study did was they injected ovaries with PRP, which is just a ... It's the concentrate of the growth factors in the platelets of someone's blood. And then they documented that the ovary started to create new hormones and creating a younger mindset within the woman's body. Obviously your ovaries do more than make eggs.

They have to do with metabolism and how you think, and how things work. So they documented an improvement you see and clarity of thinking. Lots of things happened by waking up the ovaries. There's also been recent studies showing that you can use platelet rich plasma to help a post-menopausal woman sometimes produce fertile eggs again.

But now what we do with our O-Shot®, what Shannon had, was instead of using it in the ovary, or instead of using in the face like with our vampire facelift, we're using it in the genital tissue to restore blood flow and nerve function, and improve the sexuality and the urinary continence of women who might have problems with those things.

If you think this might be of help to you, I will put a link to the research below the video and also there's a link to find one of our providers who would be happy to talk with you about it. I hope you found this helpful and you'll send it to someone whom you think might be helped by it.

O-Shot® Procedure Helps Woman Conceive?

Hey, so I thought you might be interested in this article where this woman got an O-shot and not only did it make her sex better but somehow helped her to conceive. So, you can believe it or not believe it, but I think it's a pretty simple concept to think that maybe if someone wants to have sex more they might be more likely to get pregnant. But more interesting, and it doesn't cover that in this article, but some of the people in our O-shot group have demonstrated that you can actually inject the ovaries and a postmenopausal woman be able to become fertile again.

Some Italian doctors published that study about a year ago, but people in our group have been doing it now for several years. So really interesting, but it might be fun to actually go look at some of the research about it. If you go over to PubMed and you look at this article, it's written by a Brazilian doctor Dr. [Nato 00:01:01] down in Brazil who sees so many patients as a gynecologist down there and documented the improvement in incontinence and in sexual function, which makes sense, PRP's been around so long.

So if you go Google, if you just look at platelet-rich plasma in PubMed, there's so much about it. I'll just show you right now. If you just Google platelet-rich plasma on PubMed where all the good research lives, you'll see there's 11,000 papers. It's been researched for the past 20 years, and if you think about what we're doing, if you just look at the anatomy of the vagina, I'll just pull it up here for you, and look at images here, what we're doing is we're coming in and rebuilding the tissue that's right here between the vagina and the urethra, and this tissue correlates on ultrasound studies with the ability to have an orgasm. It correlates with continence. It becomes thin with menopause. We've known for 20 years, the orthopedic surgeons, the wound care doctors, that PRP helps rebuild healthy tissue with fibroblast and new blood vessels and new nerve.

But we're just now beginning to explore this with research about how rebuilding tissue here using the same protocols can help with sex and can help with continence. So if you're interested, you should call one of our doctors listed on the directory and have somebody check it out for you.

Research about the O-Shot for urological conditions<--

Woman pregnant after O-Shot® procedure<--

Research demonstrating help with incontinence<--

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Ultimate Intimacy

Cindy Barshop: Hey ladies, we're here at The VSPOT, which is a women's intimate health spa. And my name is Cindy Barshop and we're here with renowned Dr. Carolyn Delucia, world renowned gynecologist. And we're here to tell you the truth about women's intimate health and vaginal rejuvenation. So first of all, vaginal rejuvenation is not saying, "I want a cute vagina." It's saying that we want more intimacy. We don't want to suffer in silence with what? Let me just think of a few of the things, dryness, inability to orgasm, difficulty to orgasm, after you have a baby, some looseness, yes, that's possible. It doesn't pop back.

Carolyn Delucia: And losing urine.

Cindy Barshop: That was my big problem was the losing urine. So those are just a few of the things that we're going to address. But why are we talking about it now? Because it's super, super important to get the word out. We're trying to educate people. And the most unbelievable way to educate people is the way Carolyn did it, is she put out a book, a simple, unbelievable, the greatest book about everything. Even your child should know. Well, not child, let's say mid age, like after menstruation, to really find out. So just please Carolyn, tell us a little bit about it.

Carolyn Delucia: Thank you, Cindy. The book I wrote is called Ultimate Intimacy: The Revolutionary Science of Female Sexual Health. It's available on amazon.com right now on an ebook. And the reason I wrote the book, as Cindy has mentioned, is that we have all been suffering. Women suffer every day. You may be suffering from not having comfortable intercourse with your partner and stopping from even being intimate because of pain, because of lack of pleasure. Why are we going through this when women have a solution? And there-

Cindy Barshop: Because there's not enough information out there. That is the facts.

Carolyn Delucia: That's right.

Cindy Barshop: And that's why Carolyn came out with the book. Honestly, Carolyn, I even read through the book super quick and I was like, "Whoa, finally people have the truth. They have the options." You know, what do I do for looseness?

Carolyn Delucia: Yeah, exactly. So in the whole book, we'll go through what traditionally has been done, what the problem is, what solutions we have now, and what is to come in the future. There's so much promising information out there for women and these conditions. Never having to go through those lonely times, when you're sitting there wondering, "Do I even like my partner anymore? Is it me? Is something different?" And you torture and torment yourself.

Cindy Barshop: Is it in my head? I hate that. It always goes to women, it's in your head. It's horrible. It's not.

Carolyn Delucia: It's not. And there are ways to treat this. So the book goes through all of those topics. And my goal was to really educate women that there are solutions to everything we're experiencing, and we provide them here at The VSPOT. But there are many other physicians, as well, and I give resources to that in the book.

Cindy Barshop: Let's stop suffering in silence, ladies.

Carolyn Delucia: Yes.

Cindy Barshop: Excuse me. Let's let our friends know that there are solutions out there and join together. It's like the year of the woman. Yay.

Carolyn Delucia: Yay.


Research<--

V-Spot™ <--

Sex after Breast Cancer–New Research

Transcript

Hello, I'm Charles Runels. I'm a physician who's been taking care of women, thousands of women for the past 20 years, and I'd like to talk with you about a really serious problem, which is how to have comfortable, enjoyable sexual relations as a woman who has survived breast cancer.

They say around one in eight women will struggle with breast cancer. It's personal to me because I have women in my family who have fought breast cancer and I've taken care of a hundreds of women who have suffered with the problem. And imagine what happens in the heartache from having survived the cancer, and now having pain when you try to have sexual relations with your husband.

Research from this video<--

Research about O-Shot® for dryness after breast cancer<--

More research--summary of other options<--

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Well, the things that have been tried for that are legion because it's a really disheartening thing. Unlike say, lack of desire or trouble with orgasm, pain will cause people to start to avoid each other. So, a woman can be deeply in love with her husband and start to avoid him because she loves him and doesn't want to say no to him. Yet, if she says yes, there's pain. And so, love becomes associated with pain.

What a horrible thing.

So what's been tried are things like lubricants and numbing medicine. But imagine that, you're going to have sex but you're going to put on lidocaine cream so you can't feel the sex. It's been a really difficult problem to solve. You can put the woman back on hormones, but now she has comfortable sex, but has to worry more about recurrence of her breast cancer.

So, I was looking at this research which pointed out some of the ... this is just out recently, and it points out that there are people now who are doing laser therapies, and they mentioned this warning, some of the laser companies about using this as a way to treat the problem. Actually to expand upon that, the warning was not having to do with the possibilities of it helping so much as it had to do with the laser companies making claims to try to sell the laser that were not approved by the FDA.

So physicians who are using these lasers are often getting great results. It's just that the person actually selling the laser or the companies were not following proper guidelines. So, that's a possibility that's fairly recent that could be used in place of some of the estrogen therapies.

Another possibility, which was published in Menopause, is the use of platelet rich plasma [as done with our O-Shot® procedure] as a way to help because it has a local effect that doesn't increase estrogen levels. What it does is just repair the tissue by recruiting growth factors to the area. Just like the professional football players have done for many years, over 10 years, and orthopedic surgeons and dentists to recruit growth factors to the area to repair tissue.

So, we're having a really wonderful result with this. Over 85% of our women are getting better with this after an O-Shot® placed in the anterior vaginal wall to wake up the Skene's glands (or the periurethral glands) and help that tissue become healthier and for more comfortable sex to happen without having to be on estrogen.

I recommend that you contact one of our O-Shot® providers and discuss, it may not be right for you. I'm obviously not your physician, but I want you to be aware of this as a possibility, and I hope that you find it helpful for you or someone you love. You'll find links to this research below this video.

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A “Triad” for Incontinence in Women

Transcript

Dr. Pelosi: Our next speaker is Dr. Oscar Aguirre from Colorado. If you don't know Oscar he is an urogynecologist who's been performing cosmetic vaginal procedures for a very long time ... surgical and non-surgical, and he's going to speak to us about his experience with the Viveve System, the radiofrequency with the active cooling.

Dr. Aguirre: Good morning. Thank you, Dr. Pelosi, for inviting me and wanted to talk about the Viveve System and how I incorporate that into my practice initially and some good work being done on showing its efficacy for stress incontinence. As [Marco 00:01:00] mentioned ... Which is my forward? So as he mentioned I am a urogynecologist. I'm in Denver, Colorado. This is the focus of my practice, I started first off as a urogynecologist but then added cosmetogynecology in 2007 as Dr. Pelosi mentioned, and then some body contouring.

Dr. Aguirre: So at first my practice is, I called it pelvic specialty care. I thought that was great as a urogynecologist concentrating on what you see here on the left side. As most urogynecologists, we concentrate on the pelvic floor, we're dealing with incontinence, pelvic relaxation, pelvic surgery, of course. In 2005, when the meshes came out, then doing Sacral Neuromodulation for voiding dysfunction, fecal incontinence, and adding Botox for that as well.

Dr. Aguirre: But during this seven-year period of my early career, patients were always asking other things, saying, "Well, while you're doing my bladder repair, can you do something about my tummy? Is everything okay down there? I want my vagina to be tighter. I want it nicer or a smaller labia." So all these things weren't things that we were taught in residency, let alone, pelvic surgery fellowship. So, and then what changed things even worse, or even further was the 2011 FDA statement, with regards to mesh. So the practices are changing quite a bit.

Dr. Aguirre: But then, in 2006 or so, the robots started coming out, and I made a point of not specializing in doing any robotic surgery but decided to do more cosmetic surgery. So I went and got trained with Dr. Matlock, I went with Dr. Alinsod to see how he does this in the office, then went with the Pelosis to learn liposculpture. So, that was the change in my practice. So from 2006, I changed the identity of my practice and it's more pelvic surgery, intimate aesthetics. I thought that was cool.

Dr. Aguirre: But then, so where do the lasers come in? Where do the non-surgical rejuvenation treatments come in? From 2007 to 2013, I felt my practice reached a ceiling. I was focused on surgical rejuvenation, where patients weren't always looking for surgery. There was a small percentage of women who had really a normal exam, who wanted better sex, and their only option at the time was a vaginoplasty. I kind of felt bad. They were really at the stage one relaxation, and I'm doing surgery on them. And a lot of those women didn't want surgery, so vaginoplasty is a great option for the right patient but most women just want sex to be better. They may be already having good sex.

Dr. Aguirre: So, I tell patients, it's hard to make, I can't make good sex better surgically. I don't want to stand a risk of their being a problem. If they're having terrible sex, great. Hands down, vaginoplasty is probably the best option. And the majority of women with incontinence, they don't want surgery, and they certainly don't want a sling anymore, the majority of them.

Dr. Aguirre: Then in 2013, I saw Dr. Bader who gave a talk on vaginal lasers for tightening. I thought, “That doesn't work. How can that work for looseness? It's just a laser.” So, Alma was good enough to let me borrow the laser for a couple months, and my first patient was a surgical tech who volunteered. She didn't have an issue or a medical problem, she didn't have prolapse. She was willing to do it because, in her life, sex was good. I thought, at first, “No, this isn't real. I'm looking for someone with a problem.” And then she kind of slaps me on the hand, says, “Sex can always be better, stupid.”

Dr. Aguirre: That was a paradigm shift in my thinking and how I approach patients because the majority of our patients that we treat are doing well. They just want to be better in a non-surgical way, certainly. So then, came the fractional CO2 to my practice. Then I trained with Dr. Runels, I did the O-Shot®, and that combination is beautiful. So we heard a nice talk this morning about combination therapy, so combining laser with PRP. So why would I need to add Viveve, which is a very quick frequency, because a lot of my patients were still wanting that introital tightened. They had better sensation inside. The laser worked well for many features. The O-Shot® was great but they still wanted more, so it's like, “Oh, maybe she needs surgery.”

Dr. Aguirre: So, that's where, when we think about by in 2017 also, when I purchased the Viveve System, there were many other, there's a lot of, as Dr. Pelosi said there's an overcrowded market, but actually the non-surgical applications of what we're doing is a bigger [inaudible 00:06:08]. It's a larger piece of the pie of patients that want non-surgical treatments.

Chapter 14 Covers the O-Shot® Procedure

Dr. Aguirre: So, now it's how, combining all these modalities into our patients, all for, think of vaginal rejuvenation. The patients look at it as vaginal rejuvenation by leading to individually thinking what aspect of their symptoms are we trying to improve by introducing collagen deposition, improving tissue remodeling, etc. All those treatments, the goal is to improve lubrication, sensation, and bladder control. And to them, it's vaginal rejuvenation. To me it's incontinence, atrophy, it's more medical.

Dr. Aguirre: So, the reason for the Viveve is when I first heard of the randomized sham study, well controlled study demonstrating efficacy at one year for improving sexual sensation, I thought, well that's what I needed to add to my complimentary services. And it's great because I don't have to do the treatment. I have three nonmedical doctors in my office doing treatments. We have two systems, so it's a way of moving along with our patients. So I thought of combining them with the other treatments.

Dr. Aguirre: So how does it work? Really quickly so, Dr. Pelosi mentioned the tip of the system cools the surface of the skin while the RF goes deeper into the tissues. It treats down into the lamina propria. So now, it's effect on incontinence. So was it beneficial? Also, these patients are choosing mainly the Viveve for improving introital laxity. Many of these patients have incontinence, of course, and those symptoms are improving. Now I'm going to show some information, some data here on some early work on the feasibility study that now led the way towards the two studies, one an international study that just finished enrollment, and then a US study that will start enrollment, and I would happy to be a part of it later this year.

Dr. Aguirre: But to be brief, so, this is showing, it's kind of a busy slide, but there's five parameters that we're looking at. So a one-hour pad weight test is the most impressive. So if you look at one year out, or at the baseline scores was 7.3 grams of one hour, reduced down to ... threw me off there ... so reduced down to 3.2 at 12 months. So what this essentially shows that in one year 72% of patients showed a marked reduction in their pad weight test. So that's a one-time treatment demonstrating results at six months and even up to a year.

Dr. Aguirre: So then, looking at it in one year also, 52% of patients or subjects at one year showed a greater than 50% reduction in their padway test. And also, if you look at the more moderate stress incontinent patients, they also showed improvement. They actually showed, 67% of them showed a greater than 50% reduction in their incontinence in their pad weight test. So this is taking even more, pretty incontinent patients, making them relatively dry. And actually, 50% of them showed to demonstrate a cure rate defined as less than one gram of leakage in a one-hour pad weight test compared to seven and a half grams.

Dr. Aguirre: Again this shows that at four months, six months, and 12 months, it shows a persistent efficacy of the one-time treatment. And also looking at questionnaires UDI-6, IIQ-7. So, and then some additional clinical updates. So that was just the [Pita 00:10:08] study. The international LIBERATE study, which is what it's called, just finished enrollment earlier this year. We should have that data in about six months. That's the study done in Canada, with over 100 patients. And that LIBERATE U.S. study will be started later this year, hopefully. Our goal is to enroll more than 50 patients.

Dr. Aguirre: Then the Viveve II. I purchased it based on the Viveve I data, which I mentioned earlier, the pre-poll. So that study showed that in one year, women had three times more improvement in their vaginal sensation aside from placebo. So now this Viveve II study has been going on. It should finish enrollment later this year. That's in the U.S.

Dr. Aguirre: So then, what's my approach? If you think of, as a urogynecologist, so I see women with vaginal relaxation, and I'm always asking questions about their sexual function, their urinary function, valve function. So think of the female sexual dysfunction. It could be orgasm issues, could be incontinence with sex, could be dyspareunia, it could be looseness, it could be vaginal dryness, stress incontinence. You look at that whole picture, ask all those questions, and then what are our current traditional treatments? Well, we always say do Kegels, doing biofeedback, vaginal [inaudible 00:11:36]. Do they need a psychiatric evaluation? Would they benefit from testosterone? Maybe it's a sling, or reconstructive and cosmetic vaginal surgery, so from non-surgical to surgical.

Dr. Aguirre: And of those new treatments, I will add, depending, and offer depending on what their complaints are. So the Viveve if they, if on exam day on introital laxity and they complain of it, and they wanted their to improve sensation and orgasm, and now they have incontinence. So a woman with those three symptoms, that's a great option for them. Now if she's 65 and post-menopausal entropic, then I'm gonna add fractional CO2 to it, to improve vaginal health, improve vaginal dryness and atrophy, and also probably prove helpful in incontinence.

Dr. Aguirre: If they wanna improve orgasm, then we'll add O-Shot®. So probably our most popular, common treatment in our office is doing this triad of treatments. So what works best is doing an O-Shot®, Viveve, and fractional CO2 at the first setting, and then having them come back two more times to finish their laser series.

Dr. Aguirre: But it all depends on what symptoms they're wanting to improve, and we as specialists in women's health think it's important for us to provide women with all their options for feminine rejuvenation and go beyond what's traditionally taught. We should listen to our patients, and it was mentioned earlier, hand a patient a mirror and have a discussion. Have them look at themselves and explain to them. It's a great time to educate them on, why are they feeling loose? Why are they incontinent? And then provide them with all the options, and then some realistic expectations, of course.

Dr. Aguirre: Thank you very much.

Research<--

Dr. Oscar Aguirre <--

ISCG (International Society of Cosmetogynecologists) <--

Find O-Shot® provider<--

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Dr. Oscar Aguirre discusses urinary incontinence

Transcript

Dr. Pelosi: Our next speaker is Dr. Oscar Aguirre from Colorado. If you don't know Oscar he is an urogynecologist who's been performing cosmetic vaginal procedures for a very long time ... surgical and non-surgical, and he's going to speak to us about his experience with the Viveve System, the radiofrequency with the active cooling.

Dr. Aguirre: Good morning. Thank you, Dr. Pelosi, for inviting me and wanted to talk about the Viveve System and how I incorporate that into my practice initially and some good work being done on showing its efficacy for stress incontinence. As [Marco 00:01:00] mentioned ... Which is my forward? So as he mentioned I am a urogynecologist. I'm in Denver, Colorado. This is the focus of my practice, I started first off as a urogynecologist but then added cosmetogynecology in 2007 as Dr. Pelosi mentioned, and then some body contouring.

Dr. Aguirre: So at first my practice is, I called it pelvic specialty care. I thought that was great as a urogynecologist concentrating on what you see here on the left side. As most urogynecologists, we concentrate on the pelvic floor, we're dealing with incontinence, pelvic relaxation, pelvic surgery, of course. In 2005, when the meshes came out, then doing Sacral Neuromodulation for voiding dysfunction, fecal incontinence, and adding Botox for that as well.

Dr. Aguirre: But during this seven-year period of my early career, patients were always asking other things, saying, "Well, while you're doing my bladder repair, can you do something about my tummy? Is everything okay down there? I want my vagina to be tighter. I want it nicer or a smaller labia." So all these things weren't things that we were taught in residency, let alone, pelvic surgery fellowship. So, and then what changed things even worse, or even further was the 2011 FDA statement, with regards to mesh. So the practices are changing quite a bit.

Dr. Aguirre: But then, in 2006 or so, the robots started coming out, and I made a point of not specializing in doing any robotic surgery but decided to do more cosmetic surgery. So I went and got trained with Dr. Matlock, I went with Dr. Alinsod to see how he does this in the office, then went with the Pelosis to learn liposculpture. So, that was the change in my practice. So from 2006, I changed the identity of my practice and it's more pelvic surgery, intimate aesthetics. I thought that was cool.

Dr. Aguirre: But then, so where do the lasers come in? Where do the non-surgical rejuvenation treatments come in? From 2007 to 2013, I felt my practice reached a ceiling. I was focused on surgical rejuvenation, where patients weren't always looking for surgery. There was a small percentage of women who had really a normal exam, who wanted better sex, and their only option at the time was a vaginoplasty. I kind of felt bad. They were really at the stage one relaxation, and I'm doing surgery on them. And a lot of those women didn't want surgery, so vaginoplasty is a great option for the right patient but most women just want sex to be better. They may be already having good sex.

Dr. Aguirre: So, I tell patients, it's hard to make, I can't make good sex better surgically. I don't want to stand a risk of their being a problem. If they're having terrible sex, great. Hands down, vaginoplasty is probably the best option. And the majority of women with incontinence, they don't want surgery, and they certainly don't want a sling anymore, the majority of them.

Dr. Aguirre: Then in 2013, I saw Dr. Bader who gave a talk on vaginal lasers for tightening. I thought, “That doesn't work. How can that work for looseness? It's just a laser.” So, Alma was good enough to let me borrow the laser for a couple months, and my first patient was a surgical tech who volunteered. She didn't have an issue or a medical problem, she didn't have prolapse. She was willing to do it because, in her life, sex was good. I thought, at first, “No, this isn't real. I'm looking for someone with a problem.” And then she kind of slaps me on the hand, says, “Sex can always be better, stupid.”

Dr. Aguirre: That was a paradigm shift in my thinking and how I approach patients because the majority of our patients that we treat are doing well. They just want to be better in a non-surgical way, certainly. So then, came the fractional CO2 to my practice. Then I trained with Dr. Runels, I did the O-Shot®, and that combination is beautiful. So we heard a nice talk this morning about combination therapy, so combining laser with PRP. So why would I need to add Viveve, which is a very quick frequency, because a lot of my patients were still wanting that introital tightened. They had better sensation inside. The laser worked well for many features. The O-Shot® was great but they still wanted more, so it's like, “Oh, maybe she needs surgery.”

Dr. Aguirre: So, that's where, when we think about by in 2017 also, when I purchased the Viveve System, there were many other, there's a lot of, as Dr. Pelosi said there's an overcrowded market, but actually the non-surgical applications of what we're doing is a bigger [inaudible 00:06:08]. It's a larger piece of the pie of patients that want non-surgical treatments.

Chapter 14 Covers the O-Shot® Procedure

Dr. Aguirre: So, now it's how, combining all these modalities into our patients, all for, think of vaginal rejuvenation. The patients look at it as vaginal rejuvenation by leading to individually thinking what aspect of their symptoms are we trying to improve by introducing collagen deposition, improving tissue remodeling, etc. All those treatments, the goal is to improve lubrication, sensation, and bladder control. And to them, it's vaginal rejuvenation. To me it's incontinence, atrophy, it's more medical.

Dr. Aguirre: So, the reason for the Viveve is when I first heard of the randomized sham study, well controlled study demonstrating efficacy at one year for improving sexual sensation, I thought, well that's what I needed to add to my complimentary services. And it's great because I don't have to do the treatment. I have three nonmedical doctors in my office doing treatments. We have two systems, so it's a way of moving along with our patients. So I thought of combining them with the other treatments.

Dr. Aguirre: So how does it work? Really quickly so, Dr. Pelosi mentioned the tip of the system cools the surface of the skin while the RF goes deeper into the tissues. It treats down into the lamina propria. So now, it's effect on incontinence. So was it beneficial? Also, these patients are choosing mainly the Viveve for improving introital laxity. Many of these patients have incontinence, of course, and those symptoms are improving. Now I'm going to show some information, some data here on some early work on the feasibility study that now led the way towards the two studies, one an international study that just finished enrollment, and then a US study that will start enrollment, and I would happy to be a part of it later this year.

Dr. Aguirre: But to be brief, so, this is showing, it's kind of a busy slide, but there's five parameters that we're looking at. So a one-hour pad weight test is the most impressive. So if you look at one year out, or at the baseline scores was 7.3 grams of one hour, reduced down to ... threw me off there ... so reduced down to 3.2 at 12 months. So what this essentially shows that in one year 72% of patients showed a marked reduction in their pad weight test. So that's a one-time treatment demonstrating results at six months and even up to a year.

Dr. Aguirre: So then, looking at it in one year also, 52% of patients or subjects at one year showed a greater than 50% reduction in their padway test. And also, if you look at the more moderate stress incontinent patients, they also showed improvement. They actually showed, 67% of them showed a greater than 50% reduction in their incontinence in their pad weight test. So this is taking even more, pretty incontinent patients, making them relatively dry. And actually, 50% of them showed to demonstrate a cure rate defined as less than one gram of leakage in a one-hour pad weight test compared to seven and a half grams.

Dr. Aguirre: Again this shows that at four months, six months, and 12 months, it shows a persistent efficacy of the one-time treatment. And also looking at questionnaires UDI-6, IIQ-7. So, and then some additional clinical updates. So that was just the [Pita 00:10:08] study. The international LIBERATE study, which is what it's called, just finished enrollment earlier this year. We should have that data in about six months. That's the study done in Canada, with over 100 patients. And that LIBERATE U.S. study will be started later this year, hopefully. Our goal is to enroll more than 50 patients.

Dr. Aguirre: Then the Viveve II. I purchased it based on the Viveve I data, which I mentioned earlier, the pre-poll. So that study showed that in one year, women had three times more improvement in their vaginal sensation aside from placebo. So now this Viveve II study has been going on. It should finish enrollment later this year. That's in the U.S.

Dr. Aguirre: So then, what's my approach? If you think of, as a urogynecologist, so I see women with vaginal relaxation, and I'm always asking questions about their sexual function, their urinary function, valve function. So think of the female sexual dysfunction. It could be orgasm issues, could be incontinence with sex, could be dyspareunia, it could be looseness, it could be vaginal dryness, stress incontinence. You look at that whole picture, ask all those questions, and then what are our current traditional treatments? Well, we always say do Kegels, doing biofeedback, vaginal [inaudible 00:11:36]. Do they need a psychiatric evaluation? Would they benefit from testosterone? Maybe it's a sling, or reconstructive and cosmetic vaginal surgery, so from non-surgical to surgical.

Dr. Aguirre: And of those new treatments, I will add, depending, and offer depending on what their complaints are. So the Viveve if they, if on exam day on introital laxity and they complain of it, and they wanted their  to improve sensation and orgasm, and now they have incontinence. So a woman with those three symptoms, that's a great option for them. Now if she's 65 and post-menopausal entropic, then I'm gonna add fractional CO2 to it, to improve vaginal health, improve vaginal dryness and atrophy, and also probably prove helpful in incontinence.

Dr. Aguirre: If they wanna improve orgasm, then we'll add O-Shot®. So probably our most popular, common treatment in our office is doing this triad of treatments. So what works best is doing an O-Shot®, Viveve, and fractional CO2 at the first setting, and then having them come back two more times to finish their laser series.

Dr. Aguirre: But it all depends on what symptoms they're wanting to improve, and we as specialists in women's health think it's important for us to provide women with all their options for feminine rejuvenation and go beyond what's traditionally taught. We should listen to our patients, and it was mentioned earlier, hand a patient a mirror and have a discussion. Have them look at themselves and explain to them. It's a great time to educate them on, why are they feeling loose? Why are they incontinent? And then provide them with all the options, and then some realistic expectations, of course.

Dr. Aguirre: Thank you very much.

Research<--

Dr. Oscar Aguirre <--

ISCG (International Society of Cosmetogynecologists) <--

Find O-Shot® provider<--

Apply for training as an O-Shot® provider<--

A Way to Calm the Pain of Vestibulodynia

Find nearest O-Shot® provider<--

Read the research<--

Charles Runels: So I thought you might want to share this research that came out this month. It's talking about using Botox to help with provoked vestibulodynia. In other words, it hurts when you touch the opening to the vagina, so the vestibule or the opening of the vagina, dynia or pain provoked by touch. This is a very severe problem, and although you may not suffer with it, I can tell you this right here really breaks up relationships, and if you know someone who's suffering with this, I'd really like you to forward this to them, because it just came out this February of this year.

What they did was they took women and they divided them into three groups, and one group got saline, and then one group got 50 units of Botox, and another group got 100 units of Botox. They found by injecting the Botox, the group that got the Botox at three months and again at six months, they had significant decreases in their pain. I also think it might be helpful because of the anti-inflammatory effects of it, of injecting PRP in this region. We're seeing that helps also with dyspareunia, especially with lichen sclerosis and with scarring. We're not sure exactly what caused provoked vestibulodynia in many patients, so that could be a combination therapy.

RESULTS WILL VARY

There is not a lot more I can say about this except that the downside of it should be not bad [...for most people, please see consent form, results will vary and no medical procedure is perfectly effective or perfectly predictable in either results or side effects]. The worst that's going to happen is if it doesn't work, and hopefully the good side is that if your body or your lover's body responds as they did in this trial, it could really be life changing.

Consent Form<--

I hope you'll give us a call if you think this might be something you want to try, so thank you very much.

FIND NEAREST O-SHOT® PROVIDER<--

Brave Reporter Undergoes the O-Shot® Procedure–Tells All in Cosmo

Sophie Blackman does very brave reporting about her quest to find better sexual relations. Thousands of women will benefit.

Sophie Blackman reports the details of her experience with the O-Shot® procedure in this eye-opening report. Not only will the last 3 paragraphs make you laugh--if you have a heart--you'll understand why sexual dysfunction can cause deep emotional hurt and why finding better ways to help women is so very very important.
Here's where to read the article (click)<--

Read the research<--

Find nearest provider<--

Physicians and physician extenders apply for training to be come an O-Shot® provider<--

O-Shot® Helps Treat Lichen Sclerosus (more research)

Here's--once again--more, new, research showing benefit from treating lichen scelrosus with the O-Shot® procedure...

**Platelet-rich plasma (PRP) for the treatment of vulvar lichen sclerosus in a premenopausal woman: A case report (this one with dramatic photos)<<click to read<---.

**Rejuvenation Using Platelet-rich Plasma and Lipofilling for Vaginal Atrophy and Lichen Sclerosus (click to read)<--

** The use of PRP(platelet-rich plasma) in patients affected by genital lichen sclerosus: clinical analysis and results. <--click to read<==

**The first study with biopsies showing benefit from PRP for lichen sclerosus (using the O-Shot® techniques). The dermatopathologists were blinded to the before and after treatments and benefit was shown...
click to read<---(scroll to the next to last abstract)

**More research about lichen sclerosus treatment with PRP
click to read<--

**Combining PRP with surgery for clitoral-hood phimosis from lichen sclerosus using O-Shot® techniques...
Click to read<-- (it's on page S14)

A video that shows more and gives some details...

Find provider who will consider treating lichen sclerosus with PRP (RESULTS WILL VARY)...
click<--(see the legend)

Apply for training as a member of the O-Shot® provider group
click<--(physicians and nurse practitioners)

Women suffering with lichen sclerosus--Apply to participate in our on-going research
click <--

Severe vaginal yeast treatment using combination of O-Shot® with antifungal

Story and photos courtesy of...
 João Brito Jaenisch Neto

João Brito Jaenisch Neto
Dr. João Brito Jaenisch Neto

42 years old with 2 vaginal childbirth. Came in to office complaining with vaginal itch, burning and white vaginal discharge.
Physical examination: I saw this issues and took pictures.

before treatment

 

 

 

 

 

 

 

I told her that her symptoms were from the acute and severe fungus , yeast, candidíase. I told her that I would like to treat her with PRP to repair the tissues damages and just oral cetoconazol for 5 days.


I never ever had such amazing tissues restore. I did PRP in all damage tissue area. She came back 7 days later and the outcome was the pictures.
NO VAGINAL CREAM.

 João Brito Jaenisch Neto (click to see his clinic)<--


Research by Dr. Neto<--

More O-Shot® research<--

Find Nearest O-Shot® (Orgasm Shot®) provider<--

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WARNING: Spa’s ‘Vampire Facial’ clients urged to get tested for HIV-How to stay safe

Questions Answered in the Video...

1. What is a Vampire Facial®?
2. How exactly does the process work?
3. What benefits does the procedure offer?
4. What are the health risks of undergoing the procedure?
5. Is there any data on how many people undergo this procedure in the U.S.?

6. How rare/common are incidents like the one that occurred in New Mexico?

7. Why did it occur?

Important Notice from the Cellular Medicine Association--the recent incident in New Mexico took place at a center illegally using our name (Vampire Facial®). Qualified medical professionals handle blood all day long without serious problems and this procedure is even safer since it's done with the patient's own blood. But done improperly--people can be killed by cross-contamination. The providers in this article were imposters.

This is the official website to find those who have been certified to do the procedure by the Cellular Medicine Association and where you can read the research--click to see our directory<-- Providers found there agreed to use devices approved by the FDA to both prepare the blood and to do the micro-needling. Anyone advertising the Vampire Facial® who is not listed there is stealing intellectual property and cannot be trusted. See PubMed & our website for more research

The Vampire Facial® name is owned by Charles Runels (see the website for the US Patent & Trademark office), although the name is currently under attack by those who would want free use of the name to sell devices and procedures without regard for our standards.

Someone using the name —as described in this article (click)—to trick people is exactly like someone making a fake Tylenol bottle and putting poison in it. Please—buyer beware! Only providers listed on our official website should be trusted to do the procedure.

We do our best to shut down the imposters. We list those we have found to be imposters/infringers at the website for the Cellular Medicine Association. But, the legal wheels turn slowly and expensively so people still use our good reputation to trick people.


Related Links

Woman dies in the office of a massage therapist advertising the Vampire Facelift® (if you read the article, you'll see the person actually died from a buttocks injection of something other than blood (probably something from the hardware store--NOT from a Vampire Facelift®). This woman would have never been accepted into our provider group and was using our name illegally.

Woman possibly contracts infectious disease from someone illegally using the Vampire Facial® name (again someone who never was part of our group, could never have been part of our group, and who was using our name-"Vampire Facial®" illegally).

CNN About the Vampire Facial®

Rolling Stone<--

Where to see the people actually licensed to use the name of those advertising the Vampire Facial®<--

Official Website for the Vampire Facial® procedure<--

Official Website for the Vampire Facelift®

Platelet Rich Plasma used to treat scars<---

Microneedling for scars<--

Research showing the use of platelet rich plasma combined with microneedling (what's done with the Vampire Facial® in a very specific way)<--

Platelet rich plasma used to help fight infection<--

Platelet rich plasma used to help with incontinence and with serious female genitalia issues (like lichen sclerosus)<--

Platelet rich plasma use to help with male genitalia problems (like Peyronie's disease and erectile dysfunction)<--

Blood tubes like what an infringer/imposter may use to look like they are doing the procedure<--

Mironeedling devices that are NOT FDA approved to use in a medical clinic that my be used by an imposter<--

Where to see infringers under notice or under litigation by the Cellular Medicine Association--those people who are using our names illegally or who have used our names illegally (these are those who are not to be trusted because are NOT certified to use our names but have been identified as illegally advertising)<--

US Patent & Trademark Office<--

What is the Cellular Medicine Association<--

Directory of teachers for the Cellular Medicine Association<--

Who is Charles Runels?<--

Research about the O-Shot® procedure<--

Research about micro-needling<--

More specific research about the Vampire Facial®<--

Contact the Cellular Medicine Association<--

 

Vaginal Dryness after Breast Cancer. Treatment with the O-Shot® Procedure

Full Transcript of Video & Link to Published Research Follows...

Charles Runels: Let's talk about something that I hate, I really hate, it's dyspareunia or pain with sexual intercourse in women who are already suffered from breast cancer. Imagine the loneliness of having already gone through all the treatments for breast cancer, and now that you've survived, and you've lived through radiation, perhaps chemotherapy, perhaps surgery, and now you're left with the inability to use estrogens that are needed to maintain the lubrication that's involved with comfortable, sexual, intercourse.

Unlike decreased arousal, where a woman who loves her husband can accommodate, or decreased orgasm, where a woman can still enjoy sexual intercourse without orgasm, dyspareunia makes a woman actually avoid her husband. Her fear is often that if she arouses the husband, then the husband becomes more frustrated. I hear of women who will even avoid touching or holding their husband's hand, even though she loves him, because of fear of arousing him, and then causing frustration because they can't have sex. The things that have been tried for this ... The thing is, it separates lovers.

Now, who am I? My name is Charles Runels; I'm the inventor of the O-Shot® Procedure, so I'll just tell you right now, we're coming to talking about how that might be a solution to this problem. I've been treating women for sexual dysfunction for the past 18 years. I've been a physician for 20 plus years, and I've done research in the area and I think we have something to help maybe.

Mum who felt like she was "having sex with sand paper" gets the O-Shot® procedure and tells all<--

But let's go ahead and talk more about what's been tried, and we'll get to what's new. If you look at a search on PubMed, which is the main way for finding research that physicians use worldwide. If you look at the different solutions that come up, not a lot of research in general, when you search dyspareunia and breast cancer, but if you look at the answers, it's really very frustrating.

The conclusion of this one is, "Breast cancer survivors with menopausal dyspareunia ..." In other words, they cannot use estrogens for fear of recurrence of the breast cancer ... "can have comfortable intercourse after applying liquid lidocaine." So, she's back to accommodating, but not necessarily enjoying, and I'm not saying this is a horrible thing, it doesn't mean it's not something that can be used. But, if you look at the research that's shown here, it involves basically, numbing things. It can get on her lover, and so they both can now put their genitals together which allow some closeness, but it really doesn't allow the pleasure of sex, like it could be if you just made the pain go away instead of numbing it down.

So you look at this other one. Look at what they're recommending here ... Aqueous lidocaine. Not so good. These are the most relevant searches for this problem. If you look at this one, "Olive oil, exercises, and moisturizers." So, when it comes right down to it, it's a long way of saying that the current best practices are a combination of lubricating, numbing, and some sort of counseling. Counseling as in learning how to stay close without the pleasure of sexual intercourse.

Find nearest O-Shot® [Orgasm Shot®] provider (click)<--

Read the research reviewed in the video above<--

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My hats off to all the research that's gone into finding a solution. I'm not angry at the solutions or the people that have tried to find these solutions. I'm very angry that this is the best we have. Starting about eight years ago, I started using Platelet Rich Plasma (PRP), first to inject Platelet Rich Plasma into the genital-urinary space, and we published some research about that, which you can find if you go to O-Shot®.info or O-Shot®.com, it wants ... Puts you on the same web page, and then click on research. When you click on the research, you'll see a list of various things that can be done to help with sexual dysfunction, and other problems secondary to that effect ... Wait a minute ... Then, at the top of that, you'll see a paper that we publish, this is me, and we talk about all the reasoning why using Platelet Rich Plasma maybe of help, and we showed that we were able to decrease female sexual distress significantly, extremely significantly by using Platelet Rich Plasma to cause rejuvenation of the tissue. Platelet Rich Plasma has been demonstrated in multiple studies. Look at how many studies you have with Platelet Rich Plasma. Over 10,000 the last time I looked.

Yeah, there you go. 9,987 papers about Platelet Rich Plasma. This is not some new thing, and they go back over 20 years. It's been known to help with healing of hard-to-heal tissue. The dentists have used it quite a bit. Orthopedic surgeons are trying to heal. Both of those specialties have to heal bone and cartilage, with not a good blood supply. And so it's been used in that arena, and in 2010 I started using it for the vaginal periurethral space, and we published this study soon after that.

Now, there's a new ... We've been seeing this help for the past eight years, but a new study came out supporting it, and I want to get to demonstrate and talk more about what they did with this study, where they used Platelet Rich Plasma combined with hyaluronic acid for the treatment of vulva vaginal atrophy in post-menopausal women. You can see here they did not .... It wasn't just about the atrophy. They followed dyspareunia, and saw female sexual distress improved significantly with that treatment. I propose that it would have improved much, much more had they used our protocol. But still, it was statistically significant. So we're back to my protocol, but let's ... Let me break this down to what we initially did in our study, so that you can understand what they did.

In the study that we did, we took the Platelet Rich Plasma and then ... which you get by doing a centrifuge, and then the centrifuge separates out Platelet Rich Plasma from the red cells, and I can show you a picture of what that looks like right here. So you start off with a tube that looks like just a tube full of blood, has an anticoagulant in it, and then when you get through with the centrifuge, you'll have red cells at the bottom, but instead of a buffy coat and platelets on top of it, and plasma on top of it, there's a gel that separates them so that now they'll remove the plasma and inject it into the area. So, it mimics what happens every time you have surgery or injury. This is not a new idea, it happens every time you have to heal a wound that the platelets release growth factors, and then those growth factors cause recruitment and activational plural potent stem cells that migrate from the bone marrow and heal the tissue.

This is very well known in the orthopedic and dental space, so much so that it's quit being about whether it works or not, it's the best way to use it. You can see here's one from the National Journal of Implant Dentistry, where looking at using calcium chloride to activate the Platelet Rich Plasma. Now, what does activation means of this FDA approved, and what does this all mean?

Your blood does not require approval by the FDA. It's your blood. Just like your saliva, your hair and your skin. But if you're going to isolate a part of the blood for re-injection to a human body, you should use a device that's FDA approved for that purpose. Those devices vary based upon method that isolates the platelets and how the platelets are activated. For example, this one uses a gel that I just showed you, and to separate it. But others use filters, and double centrifuges and pipe fitting techniques and all sorts of things, so, that's not the only way to do it. This one has a gel that separates. There's the gel ... the red cells from the plasma, and then the plasma's re-injected.

Activation is widely accepted within the orthopedic and dental literature as being helpful, because it tells the platelets to release all those growth factors. That activation can be done with vacuum, calcium chloride, calcium gluconate, and with a hyaluronic acid filler, like Juvederm or the orthopedic versions, like Hyalgan, because the platelets interpret that to being a form of collagen, which causes the platelets to release those growth factors and cytokines.

This particular kit has a small amount of hyaluronic acid, which is again like a Juvederm, or Restylane, or Hyalgan, or Synvisc, or all hyaluronic acids, that comes with the kit, there are other kits that come with calcium chloride. Some kits don't come with anything, and you have to add the calcium chloride or the calcium gluconate, or the HA yourself. So, this kit was sponsored by a company that makes a kit ... Region makes a kit, that comes with an HA. The point I'm making is that there's really two variables here, right? They're injecting two things. Platelet concentrate, which they're calling ... That's the word they're using for Platelet Rich Plasma, and hyaluronic acid. That's two different variables. So, don't let that confuse you though, because the HA is just a way of activating, and you never cause rejuvenation of tissue of any significant degree with an HA, although there is a mild effect. The major effect is from Platelet Rich Plasma.

Now, how do I know this, and what's my background? In addition to inventing the O-Shot®, also invented the Vampire Facelift®. This was something that most people don't know, but when I was experimenting this, which Kim Kardashian did, and many celebrities have now done, when I was inventing this, I was actually doing this as a way to figure out how to use it in the genital-urinary space. Now, of course out of it came a useful cosmetic procedure, but as a wound care physician, I had already been looking at this in other arenas. For example, this one. Where PRP is used in combination with a HA for healing a wound, and others like it, where ... But others like it, for example this one. Using PRP combined with an HA, and it helps heal wounds. But it's the PRP that's active and you have many, many studies showing PRP as a stand-alone for healing wounds.

So, if you go to PubMed and you put in Platelet Rich Plasma, and then you put wounds behind it, or wound healing, you get lots of stuff and most of these don't use an HA as part of the process. And you can see it's all about it heals muscle, there's collagen, there's new blood flow, and so it's really a very well-documented way of regenerating tissue, all tissue types, nerve, blood flow, collagen, even fat cells.

Participate in our research<---

There are 1,700 studies. Back to what we're doing here with the dyspareunia secondary to dryness from lack of hormones, particularly estrogen, in the case of someone who's had breast cancer, what we're doing is using the PRP to recruit plural potent stem cells that grow the new tissue, and the HA as an activator. Go into more detail about what the studies show. They measured vaginal health index, which you can see I said that ought to do with fluid, the PH, the moisture, and they did a Xylocaine cream, but we use a Bupivacaine/Lidocaine/Tetracaine cream that works I think better than this. So, our pain ratio would be different. They injected four CCs in the vestibule in the first three centimeters of the vagina using a point-by-point technique. This is not needed. This would hurt more, because you ... PRP spreads so easily through the tissue. You don't have to do so many injection points. In the posterior vaginal wall, and the posterior wall of the introitus.

You can see here where they're putting the injections. The thing about this is that it's missing out on the anterior wall. Now, why would they skip the anterior wall? The reason is that there are multiple studies showing that HAs in the anterior vaginal wall, hyaluronic acid in the anterior vaginal wall can cause granulomas, it can lead to obstruction. That's not a good thing. But by leaving out the anterior vaginal wall, you miss rejuvenating the Skene's glands of the periurethral glands. Let me show you where those live.

If you look at the cross-section through the vagina and urethra, the Skene's glands or the periurethral glands are very near the opening here on the front side of the vagina. So, if you're doing all the injections back here, it's not going to do anything with that. So, why is that important? Why is the Skene's glands or the periurethral glands important?

Actually, let me get this where you can see it better. Here's the urethra, here's the vagina, here's the periurethral glands or the Skene's glands. Here's another picture of it showing you where it may open up just near the opening of the urethra. Here's another view of it, showing the Skene's glands are right there, all of it on the front side, but these guys if you go back and look are injecting on the back side. That's not a bad thing, they help the woman, but it's a less than it could be thing. Now, had they injected the anterior vaginal wall, actually my feeling is that there's not enough HA in that particular kit to cause a problem. I've used it, it's a good kit, I don't think it's enough to cause a problem.

But, I don't know that I'd want to risk it in someone without a study showing that I'm not going to see granulomas, like [Swissman 00:16:15] demonstrated before. So, when we do our O-Shot®, we inject PRP here, but we do not use an HA, so we use a PRP that's activated with calcium chloride, like we talked about over here, using calcium chloride instead of an HA to activate. Back to our study, when they did this they activated with an HA and now these platelets have released their growth factors, we don't even care about the platelets anymore, the growth factors are in the plasma, and that's what gets injected here, after it's been activated.

If you look what happens, it's pretty spectacular that the effect of it ... Now, this is PH and vaginal health, and you can see it levels off at about three months, which is what you see in most soft tissue studies. When they ask the women would you like to repeat it, 19 out of 20 of them said that they would. But then if you go back and you think well wow, what if they would have actually injected here, just like the men's prostrate excretes a lot of fluid, it's the main thing that makes the fluid when a man ejaculates, a woman's Skene's glands do as well. We actually have women who ejaculate for the first time after using PRP in the anterior vaginal wall. I think they miss some of the benefits. When we did our study, we had a larger improvement of female sexual distress than they did ... they saw with their study.

But, I'm still very grateful. It's a good study that shows that PRP with an HA can help, but I'm telling you, we've been doing it for eight years, and PRP injected the way we do with our O-Shot® does more than an improvement ... The improvement in the female sexual distress that was shown here. So what the heck is the female sexual distress scale? This is what it looks like. You can see the most you could get ... The more of the ... All these questions, 13 questions are answered, and each question has a maximum of four, with a higher score means you're having more problems. So, if you're worried about your sex not at all, it gets a zero, all the time gets a four. So, the most you could get was four times 13 and we were able to see a large percentage of our people go from distressed to not distressed when we used PRP the way we do with the O-Shot®, which is anterior vaginal wall and the clitoris.

It's a really important study. I think it backs up what we're doing. But, I think that we have a better technique that we can use. I think if you want to know more about it as a patient, you would go to our O-Shot® website, which you just type in O-Shot®.com, or dot info either way, it gets you there. O-Shot®.com. Then, when you're there, if you click on ... You could read all about it. Read the research. You could see if you go to research thing here, you can see me covering other research projects that have to do with what we've done like in necrosis, urinary incontinence, all sorts of things. There's a chapter about it in this textbook, and you can see some lectures where I've lectured various places.

Find nearest O-Shot® [Orgasm Shot®] provider (click)<--

Read the research reviewed in video above<--

Read more research about the O-Shot® procedure (click)<--

Apply for training as an O-Shot® provider<--

That's the place to read the research. If you want to see one of our providers, almost every page has a place on it somewhere that says that. Click here to find provider, and then once you're there just click on your country, or your state and it will show you people in that area, or if you give it permission to know where you are, it will just show them nearest to farthest away. So, we have multiple countries, and multiple states here. So almost every state, and 50-something countries. Now, if you're looking for someone who does other things, like treats lichen, use radio frequency, a laser, or has Emsella machine, then you'll see those icons by their name as an indication that they treat that. So, this doctor for example uses laser and treats Lichen Sclerosus. This means that they're a teacher for us, and I think that's all you need to know. That's where you go obviously, nothing works all the time ever, ever. Results do vary, so you should speak with your physician and speak with one of our physicians about being treated this way.

Now, if you're a physician, you go here, under physicians and there's a place to get free information. You just fill this out, and we'll send it to you. Tell me where your office is, and you can get any kind of free information you want. If you actually want to go ahead and apply for either online or hands-on training, you go to O-Shot®.info/members, and that's where we list a place for you to apply to become a member of our provider group. We have a very specific way of doing this. As you can see, [inaudible 00:21:22] every way that you inject PRP matters, and we have a very specific method that we teach. As a matter of fact, if you don't see someone listed on our directory, then they're not licensed to use our name, and they may be doing something better, but more likely they're doing something not as effective. I highly recommend you use someone off of this list, and if someone's using our name O-Shot® and not on this list, they're pretending to be part of our group when they're not. So, you can make your own conclusions about what that means morally.

Anyway, here's where you would apply, O-Shot®.info/members, if you're interested in being part of us. This is under the umbrella of the Cellular Medicine Association, where we do research. We spend hundreds of thousands of dollars every year researching the areas of female and male sexual dysfunction. We have teachers around the world. We also have online training that you can apply for. I hope that's helpful to you. I think this is really important research, and I'm very grateful to these guys for doing this. But, there's a lot more to know and we would love to help you learn more about it, whether you're a teacher or a provider. Thank you very much for your attention.

Find the nearest provider<--
Apply to O-Shot® provider group<--

 

 

Charles Runels, MD

Cystoscopy view of Urethra before and after the O-Shot® procedure

Case Report

48 year old G5P2 perimenopausal female presents with menorrhagia, uterovaginal prolapse and urinary incontinence. Patient demonstrated stress urinary incontinence on formal urodynamics testing (Laborie Medical). During preoperative counseling, patient expressed she did not want to have any polypropylene sling placed. Discussed the injection of platelet rich plasma (O Shot) and patient signed formal consent.

She underwent an uncomplicated robotically assisted total laparoscopic hysterectomy with anterior and posterior colporrhaphy. Patient’s blood was harvested and centrifuged utilizing the Stryker Vitagel kit. During the last step of the procedure, cystoscopy was performed (Figure 1) with a 30-degree cystoscope (Stryker). 4 cc of platelet rich plasma with 0.2 cc of 10% of CaCl was injected 1” from hymenal ring with 27 Gauge needle and 1 cc of platelet rich plasma with 0.05 of 10% of CaCl was injected into the clitoris.

5 minutes after the O shot was performed, a 30-degree cystoscope was inserted again which revealed ureteral jets bilaterally as well as the view of the urethral sphincter shown in Figure 2.

 

 

Postoperatively, patient came back to my office 1 week later. She did not have any urinary leakage and was satisfied with the outcome. Shown in Figure 3 and Figure 4 are before and after of the vaginoplasty.
These images are available in my realself.com gallery

Patient has signed permission to use her images as long as she was deidentified. This release waiver is signed and filed in my office.

Urethral Bulking for Female Stress Urinary Incontinence
There have been similar results described in the literature with synthetic soft tissue bulking agents such as Macroplastique. One of the side effects, however is granuloma formation.

Future
This case has inspired me to use formal urodynamics study how the urethral pressures change during the placement of platelet rich plasma in the Grafenberg spot. Using wireless Bluetooth catheters may quantify and guide to clinician with greater accuracy on where (and possibly how much) volume of platelet rich plasma to inject for optimal result with regard to treating urinary incontinence.

Edward Tangchitnob, MD, FACOG

Medical Director, Center of Excellence for Minimally Invasive Gynecologic Surgery
Master Surgeon in Robotic Surgery, Surgical Review Committee
www.tangchitnobMD.com


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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

Transcription Below...

Find closest O-Shot® provider<--

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More about the Cellular Medicine Association<--

O-Shot® Reviews<--

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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1 in 5 People Live in a Sexless Marriage

Needed information about how to make things better...

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, 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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Questions about the O-Shot® Procedure (and on-going research)

1. Does the PRP always come from the patient's own blood?

Always Always ALWAYS the PRP comes from the patient’s own blood.  And the FDA approved kits are disposable, so we are always using a new kit to prepare the blood and then throw that kit away before we treat the next woman. Most of us even process the blood in the same room with the patient so that they can see that it’s always their blood.  Hence, there is zero chance of them catching something from another person.


2. What year did the O-Shot originate and how many professionals have been trained to give it in the US?

Dr. Runels did the first O-Shot alone with his lover in early 2011 (after first treating many faces and treating his own penis (with the Priapus Shot® procedure) and the penis of other men—the anatomy and cell biology of the penis mirror the clitoris). Since then, over 1,000 physicians in the US alone representing most states (and other providers in over 50 countries) have been trained, and he's trained faculty from 5 different medical schools in the US alone.

Faculty of the Cellular Medicine Association (click to see) have trained many more physicians world-wide.

All Licensed providers are listed here (click)<--

3. I've read about complications if PRP in general isn't prepared correctly, but what are the potential side-effects related to the O-Shot?

2 Parts to this answer.

1. Serious side effects (infection, granuloma, scaring, death) do NOT happen (at least none reported after MILLIONS of PRP injections). 

Anything can happen anytime. And no procedure is perfect (even antibiotics fail 1 in 5 times for those hospitalized with pneumonia). Also, the most simple of procedures can lead to complications. Patients can crash their car driving to the office…so just driving to the doctor’s office has a risk. But, if someone saw a life-threatening reaction to PRP—anywhere it may be injected other than the eye—it would be the first reported case.
Another important point...we are creating a "hematoma" of sorts by injecting blood into an area. This is not a drug, like morphine where the cells of the body start reacting differently, This procedure encourages healthy tissue growth.
During the first phase there can be side effects (good and bad) from the fluid injected and the resultant vasodilitation etc.
The actual benefits from the procedure happen with new cell growth which takes 3 to 12 WEEKS or more (in orthopedic procedures the full effects can be 6 to 12 MONTHS).
So, both side effects and benefits are likely to be temporary until the 12 week mark, then you have a better idea of the effects of the procedure. Even after that, there can be continued changed due to remodeling of the tissue prompted by the PRP.
Any benefits, problems, or side-effects seen in the first 3 weeks, are likely to be from the PRP injected ---which all goes away!  It's the effects of the new cell growth that provide the lasting effects.
.
Of the over 9,000 research papers published on PubMed (click to see) about PRP, there has been no serious life-threatening side effects in any of those papers, which makes sense because you’re injecting the blood component that’s normally made to repair tissue. So, we are injecting what the body would normally make to recover from surgery. Regen alone (one of the suppliers of FDA-approved PRP prep kits) sells over one MILLION kits per year—so the number of procedures being done in general number in the millions.
With the numbers of procedures being done, the safety profile is shockingly very very good.  For example, in comparison with PRP, three THOUSAND people per year die from bleeding from aspirin (click).
2. We have seen a variety of less serious (nonlife threatening) side effects with the O-Shot® [Orgasm Shot®] procedure.
a. Women with recurrent vaginal herpes see the frequency and severity of recurrence go DOWN (they suffer less). The "side effect' here is a GOOD effect. This decrease in outbreaks makes sense because PRP enhances the body’s immune system against foreign pathogens. The platelet activation is normally a part of the wound healing process, so it makes sense that there’s intelligence about the response (not a simple-minded growth of whatever’s there like if you throw fertilizer on your lawn).  This goes along with the fact that those with acromegaly and abnormally high levels of growth hormone have 25% less cancer than the general population. There are healing effects in the growth factors that make the results good from normal tissue and detrimental to pathogens and abnormal tissue (hence the effect of helping scars go away by remodeling the tissue back to a more normal configuration click).
b. Some women see hyper-sexuality that can be very very intense requiring almost constant sexual activity and not relieved well by orgasm. This happens in less than 1% and has never persisted more than a few days.
c. We’ve seen 6 or so reported cases (in over 50,000 procedures) of decreased ability to have and orgasm. We think this is happening from the effects of the edema caused by the injection. PRP has been shown to heal nerve tissue (click to read), so the PRP should not be damaging to the sensation. Is there micro damage in these women from the needle? Possibly, but not likely since there are multiple small nerve fibers, not one main nerve in the area we inject.  Could the decreased sensation in these six women be related to something else going on with the woman? For example, one woman said the procedure caused back pain, but on a closer interview, it turns out that she and her husband were having such vigorous sex after the shot from her improved libido that she had a muscle injury that got better with a few days rest.  Another woman thought the procedure CAUSED urinary incontinence, but on a closer interview, she simply had ejaculation with orgasm for the first time.  Still, for some reason, we’ve seen sensation go DOWN instead of up in 6 reported cases, In all cases except one, the sensation came back to normal after 3-12 weeks.
d. The development of ejaculation with some orgasms.
e. Urgency, and frequency of urination for a few days.
f. Pain during injection. Usually, we can keep the pain at or near zero, but sometimes, just like at the dentist, the anesthetic may not be perfect.
g. Spotting after the injection. It IS and injection in the vaginal opening—where there’s much blood flow—so we she may see a few spots of blood.
h. Sexual arousal with urination for a few days.
i. There can be a change in the relationship. When a woman’s libido goes up, if her partner is not healthy, there can become a mismatch in sexual libido. If she now wants to have sex more than her partner, that can cause some tension. Better sex does not always mean a more peaceful relationship, though with most couples it does help.
j. There may be something unexpected happen that we’ve not yet seen. So, we have a consent form that includes mostly possible side effects that we’ve not seen.
k. If the woman is being treated for sexual problems and suffers with urinary incontinence, she will often see the "side effect" of the urinary incontinence going away.
l. If a woman receives the O-Shot® for treatment of urinary incontinence, she will often see the side effect of increased sex drive and increased intensity and increased frequency of orgasm (unlike a mid-urethral sling which can sometimes damage the nerves and decrease orgasmic ability and intensity).

Research

Not all women will qualify for this research project. Please consider helping if you do qualify.

Filling out the following form applies you for the option to participate in a double blind placebo controlled study of the use of the O-Shot® for the treatment of female sexual dysfunction. Your treatment, should you be accepted, will be free. Your information will never be shared. If you qualify, you may be contacted by text message or by phone.

This previous pilot study showed benefit (click to see) but we need more detailed data with a placebo-controlled study (which is the purpose of the present study).

Other related research (click)<--

We need more research to help women cure sexual dysfunction. There will be other projects; filling out this form tells us that you may be interested in participating (not all will qualify for this study but we will notify you of future studies). Become a hero to your daughters and nieces and to all women of future generations by helping us with this research.

If you are on a cell phone,
then click here to see the survey (click)<--
If you are on a desk top, then you can fill out the questionnaire here...

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O-Shot® for Improved Sexual Function. International Society of Cosmetogynecology. Vegas 2018

International Society for Cosmetogynecology<--

Cellular Medicine Association<--

Transcript

Dr. Marco Pelosi III: Our next speaker is probably best described as the Michael Jordan of platelet rich plasma, Dr. Charles Runels from Alabama, that pioneered the O-Shot® [Orgasm Shot®], the Vampire [Face]lift®, the P-Shot® [Priapus Shot®], and he's taken all the abuse and he's given the world some very, very useful procedures for everyone. He's going to talk about the studies he did and the studies done in platelet rich plasma in regards to sexual function. Dr. Runels, it's a pleasure to have you here.

Dr. Runels: Thank you for having me.

I'm going to go through a whirlwind look at research that's been done where people have used PRP to help with sex. Much of the research has been done by the people in our group, and I've described many of them in this room who have done this research. It's a for-profit organization, but we pay for research, we pay for education, we pay for marketing for our providers. Just to echo what you just heard, sex is much more than about just having fun. Rainer Maria Rilke said it's just so correlated to the creative experience that it's affecting how we do our work, how you do your presentation, and how - of course - relationships and families.

I want to echo that sentiment, and remind us that back in 1980, if you look in 'Urology' - this was 'Urology' 1980 - the most common cause for erectile dysfunction was thought to be 85% psychogenic. Here's a quote from 'Urology' where urologists were encouraged to become counselors, because most of erectile dysfunction was thought to be psychogenic. Of course, I'm echoing the penis stuff because if you take a penis and shrink it and unzip it, that becomes a clitoris. I'm thinking most of the research will eventually apply to that. Certainly, our attitude is applying because we're back in the ... We're not, I'm preaching to the choir, but many of our colleagues are back in the 1980's and saying the main thing we have for sexuality for women is counseling.

My thinking that perhaps, as you guys do, some of the pathology that applies to the penis may apply to the clitoris, and maybe some of these women are suffering from actual genital histopathology, not just psychogenic problems. We have this one FDA approved drug now for female sexual dysfunction that's a psych drug, flibanserin. It's a useful drug, but obviously, we need much more and maybe we should think in terms of systems, like we do for the rest of the body.

Platelet Rich Plasma.

Obviously, this is not a new idea. This is from, this month, over 9,000 papers indexed in PubMed about platelet rich plasma. Our orthopedic colleagues, our dentist, our facial plastic surgeons have worked with this, and all we have to do is take their ideas and then hopefully people in this room will extend what I'm about to show you and just take those ideas and adapt them to the genital space. Here's some of the growth factors we know about. There are many more. They have these effects. These are good things for the genitalia. Down-regulating autoimmune response, proliferation of fibroblasts, new angiogenesis, the adipocytes enlarge and multiply - think labia majora, collagen production, neurogenesis and maybe some glandular function.

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There's never, in all those 9,000 papers, I still cannot find one serious side effect. No granulomas, no serious infection. PRP is what your body makes to heal when you do your surgeries and help prevent infection. Obviously, there are always certain things that can happen, bruising and such, but if you have a serious life-threatening complication from PRP, you will have the first recorded in all of that 9,000 plus papers. That's a nice thing.

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We have commercially available methods for preparing it, within 5 or 10 minutes of the bedside, and the devices are FDA approved. So you guys don't get confused, obviously the FDA does not approve your procedures. That's a doctor business. They don't approve blood that belongs to you, just like your spit and your saliva and your skin. They tried, at one time, to control eggs and the gynecologists said, "Hell no." So they don't control eggs and they don't control blood, but you should use an FDA approved device if you do this [approved for preparation of PRP to go back into the body].

Autoimmune Disease

Here's some of the ideas about down-regulating autoimmune response. We have split-scalp studies showing that PRP helps alopecia areata better than triamcinolone. More hair growth that comes in thicker. Here's rat studies looking at rheumatoid arthritis. What do we have in the genital space? We have lichens sclerosus. We did some before and after pictures where you use stem cells mixed with PRP, and before and after pictures show improvement. Of course, that's two variables because you have stem cells and you have the PRP.

We took the same idea and just used PRP. Andrew Goldstein worked with me on this, and we had two blinded dermatopathologists. The protocol was biopsy, PRP, wait six weeks later, another PRP injection, and then six weeks after that, another biopsy. Two blinded dermatopathologists out of George Washington University did not know the before or the after. We showed statistical improvement in both the histology and symptomatology. Here's our histology. You can see obviously, that's the same magnification and we're showing decreased hyperkeratosis. That's obviously healthier tissue. A layperson could tell that's better. Of course if you look at the gross pictures, lady on the left as you guys know, she has pain wearing her blue jeans. The lady on the right is back to making love to her husband. They've invited me into their close Facebook groups and I saw a post a few months ago. Quote says, "I was sitting next to my husband, whom I love, last night. I was afraid to hold his hand because I was afraid he would become aroused and I'm bleeding and hurting today." That's what you guys are helping.

We published that in 'Lower Genital Tract Disease'. We extended it because it worked. We published this past January in the journal of the American Academy of Dermatology. You have some science to go do this now.

One of our providers, Kathleen Posey, who's a gynecologist out of New Orleans, took this idea and then she said, "Let's do some dissection in the office", and she presented this in Argentina, published it in the same journal 'Lower Genital Tract Disease'. Here's one of her patients, where you can introduce [inaudible 00:06:44]. It had been 12 years since she had had sexual intercourse, penis and vagina intercourse, with her loving husband ... 12 years. She was being followed by a dermatologist on high dose clobetasol. Kathleen dissected it out in the office and then injected PRP ... 8 weeks later, she's having comfortable sex with her husband. She's now 3 years out. She's had to be treated with PRP, not repeat surgery ... PRP now, 2 other times a year apart to maintain that result. She now has a series of 60 or so patients that she's now going to publish with similar results, where she's dissecting out - as you guys know how to do - treating the [inaudible 00:07:27], but then following that with PRP injections to help the healing and decease the autoimmune response.

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That same doctor, Casabona, repeated his study with lichen sclerosus in men [BXO], and showed with just PRP alone ... This study of 45 men with repeat treatments ... It is cumulative, 2 to 10 treatments, the same thing. All of them stopped their steroids. None of them started back. Only one went on to have circumcision.

Peyronie's

Peyronie's disease, another autoimmune disease ... This came out this month out of Wake Forest, where they took men and they followed their results with Peyronie's disease. Not only did their Peyronie's improve statistically, but they also improved their erectile dysfunction by 5 on that scale of 5 to 25 that the urologists use. For some reason, thankfully, they threw in one woman just for good measure, and showed that it helped her incontinence. They just tucked that in as an aftermath.

Ronald Virag, as you guys know as the legendary vascular surgeon who was first to present the idea of intracavernosal injections for erectile dysfunction, out of Paris. His big thing now is PRP for Peyronie's. He just published a study where he showed that this is comparing PRP with Xiapex, which is a $50,000 series of injections, FDA approved version of collagenase. He showed that PRP works better with few side effects. There's a risk of about 1 in 30, that actually go from a bent pencil to a fractured pencil and a limp noodle. You don't see that with PRP. You see the side effect is the erectile function improves. He showed the same thing, actually, in his studies that erectile dysfunction improves by an average of about 7 on that 5 to 25 point scale.

Wound Healing/Scar Resolution

Let's think about the [inaudible 00:09:29] literature. Look at this, there's so much of this out there. This is looking at post-operative adhesions, lots of studies looking at scarring with microneedling and PRP. This is a split-face study comparing PRP with microneedling verus PRP ... Excuse me, microneedling with saline or Vitamin C serum and split-faced studies in PRP wins. Dr. Sclafani did some studies in the cosmetic space looking at increased collagen production and fibroblast activity, and never a neoplasia documented. People worry about that. This is not indiscriminate blindness blind growth. You don't worry about carcinogenesis when you do surgery and it's the same PRP that's causing healing. There's actually some helpful immune processes that go on, that you could argue actually might help prevent cancer. I'm not going to make that argument but it might need to be made one day.

If you look further, here's a wound healing study looking at reepithelialized exposed bone and tendon of the foot and ankle. When I took that and applied, this is a hypertrophic scar that was a year old from cortisone, and then using PRP and Juvederm or HA filler, this is a few days later, a month later, and that's a year later. Now, take that and think, "How could I use that in the genitourinary space?" Doing that anecdotally, we have many of the members of our group are seeing help with episiotomy scars or dyspareunia, pelvic foreplay instead of injecting that pelvic floor tenderness with triamcinolone. Physiatrist for the past ten years has been using PRP, your sports medicine doctors. Now, when you palpate it, consider injecting with PRP instead. Dyspareunia from mesh and that unknown dyspareunia, we're seeing this is where we need you guys to help extend the research. The science is there that it should help and it seems to be helping. Not 100%, but about 80% in people with dyspareunia.

Mesh Pain

Here is a look at a gentleman who did ... He took the mesh out and then he patched the hole with a gel form of PRP and showed benefit. We're finding anecdotally - no one's done this study yet, here's another one for you to pick up ... I'm giving you low hanging fruit. We're seeing anecdotally that if you inject in the distribution of the pudendal nerve, which seems to be inflamed in some women with mesh pain, that their pain will frequently go from 9 out of 10 down to 1 or 2 out of 10, without even taking the mesh out. Just another place where we need some research done.

Interstitial Cystitis

Here, we have rat studies looking at inflammation. Let's think about this one. Here's a rat study where they modeled cystitis and we are seeing in chronic interstitial cystitis without even infiltrating the bladder, just infiltrating in the periurethral space, some of our women are getting better. I've had two separate urologists call me and say, "Charles, I can't believe it. I was doing this and expecting not this to happen. I have these patients now who have had chronic interstitial cystitis pain for years, and it's gone." Not 1005 but finding out who's going to respond and who's not and why, there's a lot of variables that need to be thought about that you guys will hopefully do the research.

Penis Growth

Here's a study that came out in the 'Journal of Sexual Medicine', where a guy took ... the [inaudible 00:12:51] men who have an erection of 3 inches or less and then he treated them with PRP, combined with a pump, and showed that if you repeated it every time you did it, it grew by about 7 millimeters. I've always thought if I could give you a guarantee half an inch to an inch with anything, I'd get my picture on a postage stamp. I don't have that yet, but I can tell you that we're seeing about 60% of the time we do this procedure, men will see some sort of growth.

If you look at the neovascular space, there was a study out of Southern California that was published in the 'Journal of Sexual Medicine' where they transferred adipocyte stem cells to the penis of diabetic rats. They showed new endothelial cell growth and increased nitric oxide activity in the dorsal nerve. Would that be helpful in the clitoris? Probably, but the interesting thing is the adipocyte-derived stem cells were attacked and they died. The postulate was the improvement was from the growth factors.

Penile Rehabilitation and Erectile Dysfunction

I have seen what [inaudible 00:13:52] have seen in that when you inject this in the penis, erectile function goes up on the average of about 5 to 7 per injection. Think about nerve repair. We have rat studies modeling prostrate surgery, showing that the nerves improved with PRP and so we have, again, another clear place where we need studies if you add this now to the usual protocol for rehabilitating the penis post-prostate surgery ... would you see benefit? We have seen that in some of our patients who are a year or two out who failed the rehabilitation part of that. Would that help your patients who have, say, numbness and decreased function from riding their bikes too much, or trauma? I don't know, but it's worth thinking about and publishing research about.

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In thinking about where to put this, where we do our O-Shot, when we do PRP to the anterior vaginal wall, we're putting it as distal from the bladder as possible. We found that it works better. We're essentially making a liquid sling. Think infiltrating and getting ready to put in the mesh. That's what we're doing. Very simple, only we're using a material that has never caused a granuloma ever. Doing that, frequently our patients will have their incontinence go away that day from the actual liquid and as it's replaced with new tissue, it never recurs. Usually, you'll have to repeat the procedure at a year or two out depending on the etiology. Sometimes it lasts longer.

The interesting idea is what might be happening with those [inaudible 00:15:21]. They become more active, and does that help with sexual function? The other place we put it is in the actual corpus cavernosum of the clitoris. We use [inaudible 00:15:29] ultrasound visualization and see it flow down into the body of the clitoris by the pubic ramus and the wave form goes to what you see in a flaccid penis to what you see in an erect penis.

Improved Orgasm & Libido in Women

That's my time, almost done. Just 30 more seconds. Here's a pilot study we did where we showed that in women with female sexual distress, that it dropped by an average of 10 and female sexual function went up by 5 when you do what I just showed you. Here's a study that Dr. Neto, who may be here, published where he looked at incontinence and sexual function down in Brazil and showed that 94% of the people loved it. The question here is how would you combine it with your energy source? It works great in the face if you do laser and follow it with PRP ... better results, faster healing. Is it going to ... We need people to help us work out the algorithms. Not everybody has laxity, but when you have something, when do you use which treatment and when do you combine it with PRP? We need those answers, because I don't have them yet. This is possible helps.

I am done. Thank you very much for having me. I put all these references at that website, if you want to go download them. Thank you. You guys have a wonderful conference.

Dr. Marco Pelosi III: Thank you Charles. Beautiful

More about the Cellular Medicine Association

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Dr. Runels (inventor of the O-Shot® procedure) & Nory Talk about Female Orgasms & Spirals that Go Up & Spirals that Go Down.

Transcript...

Nory: So, Dr. Runels, let's begin by you telling our readers a little bit about your medical background and anything else you'd like to share with them.

Dr. Runels: As far as my background as a scientist and a physician, I had a strong math interest and worked for three years as a research chemist, and then I went to medical school and wound up doing emergency medicine for 10 years or so, 12 depending on when you want to start counting. My boards were in internal medicine, so I started doing some research and opened a practice, did some research with hormone replacement, so 18 years ago, before Suzanne Somers wrote her first book I was doing testosterone pellets and did some research projects with growth hormone. That's what made me in tune with women's sexuality. I didn't set out to be a sex doctor. I set out to take very good care of women as a physician.

I don't really even like the word. I don't like when people say that's "alternative medicine." This isn't alternative medicine. This is medicine that looks for what works, and if it happens to be something not in a bottle that you buy at the pharmacy that doesn't make it alternative. So, if I'm using, say, nutrition, how is it that two milligrams of medicine can be more powerful than the pounds of food that you put in your body? Or, if I'm using exercise or if I'm using your blood in the case of these procedures, if I'm using things that are backed up by research, like walking three miles a day has been proven to do more for your heart and your blood pressure and your risk of heart attack than any drug on the market, including blood pressure and diabetes drugs. So, that's not alternative, that's science.

So, anyway, I have a strong science background and I was doing research, but I also had a background, i used to work as a trainer at the YMCA, so I understood physiology and exercise from a personal standpoint and from coaching a lot of people back in my college days as an exercise guru sort of guy. So, all those things sort of meshed together and as I was taking care of women in the most excellent way I could think of, using science, but not always medicine. I'm not anti medicine, but using science and hormone replacement all of a sudden I had a flood of women 18 years ago realizing that somehow they were getting better and their friends were getting much better than what was being done down the road by what was done for women 20 years ago which was just Premarin, basically, don't do any blood tests, throw a little estrogen at you and hope that your hot flashes go away.

So, that's sort of how I got to where I am as far as being attuned to women's sexuality because they would come crying to me about what was happening with their life, and you can't do their hormone replacement, in my opinion you can't take care of people well unless of think of endocrinology and you can't do endocrinology and hormones without asking questions about sex. It turns out that those questions I was comfortable asking about sex were unusual, and I didn't know it at the time but most doctors are afraid to talk about sex. They don't want to talk about sex. And research shows that if a woman asks their doctor about sex, which most of them never do, only 14% ever ask their doctor a question about sex, even though half of them have problems, research shows that the doctor will change the subject after answering the first question over half the time.

So, I didn't realize I was being unusual in listening and trying to heal the relationships when women would come crying and say, I love my husband so much but I'm afraid to tell him that I'm having pain when we have sex or that I'm not aroused, because I love him and I don't want to tell him, I don't want to hurt his feelings. And they've never told their doctor, their husband, or their preacher or their best friend.

So, that's sort of the quick version of how I got to be the guy that's now ... has done research in this area and working with a couple thousand doctors in 50 countries.

Nory: What gave you the idea for the O-Shot®?

Dr. Runels: The O-Shot® was a sort of a coming together of ideas, one, with the research background as a chemist I was already into instrumentation. I actually did some work, one time considered becoming a biochemical engineer, not a biochem but a medical engineer, designing instrumentation. So the centrifuge has fascinated me. I ran a wound care center at a hospital nearby when I was a [inaudible 00:04:51] so I was into healing of wounds. Then I had the women crying about their sexuality and I had an injection practice because I found that women oftentimes want to quit losing weight, because when they lose the weight in their face their wrinkles start to show up more. So I had made myself an expert at cosmetic injections, not just for the benefit of that but to help encourage women to continue to lose weight with me when I got their metabolism right.

 So, now you got wound care, injections, and all those things come together, and I thought, oh, wow, what if you took this technology where you're using platelet rich plasma and heal tissue and I pulled it over and used it in this arena where women have problems with pain or sensation or function of the genitourinary space. So, that's kind of how it all came together.

Nory: I read a story about the Priapus Shot® and feel free to tell this or not, and we don't need to include it in the interview but I sort of remember that you had a partner, wife or a girlfriend who said, hey what about me?

Dr. Runels: I gave you the short version. So I'll fill in the blanks. So, when I was first introduced to platelet-rich plasma someone was telling me ... because I was doing cosmetic injections, use it like Juvederm in the face, you get new volume, new blood flow, and there's never been a documented side effect, serious. So, to this day there's still with over 9,000 research papers, now getting to Priapus or the penis shot, but there's never been, in 9,000 published research papers one serious side effect from platelet-rich plasma, as in no infections, no necrosis, no neoplasia, no granulomas. But you get new blood flow. It's been documented in multiple biopsy studies you get new blood flow, you get healing, all the [inaudible 00:06:47] regulation hyperimmune status and other things.

So, when he told me that, new volume and new blood flow, I thought, well, I've got a better place than my face for a new volume and blood flow, thinking like a man. So, I thought I'm going to do things with the face before I try this in my penis. So, for four months I injected faces and I watched and yeah, people would come back and their face would be glowing, and they would tell me their friends and family were saying their face was glowing. So I thought, okay, let's try it. It took me a while to get up my courage because I thought when it makes this matrix, which it forms a yellow goo like surrounding a scab, when the matrix forms, that goo forms, that's what holds the growth factors in place. But if that's in a wound say, on your hand, you've got blood flow coming from beneath so it's not a big problem. I was thinking if that goo formed inside a penis it may cause necrosis or cause something bad to happen, maybe an erection that won't go away or priapism or something.

But I tried it and it worked. It seemed that it was helping a little bit with size and a little bit with erection and some of my patients, a lot. So, I had been doing that for a few months, and following the other part, because I actually, to this day, take care of more women than men. I was doing this for selfish reasons, thinking how to make things better for men, and I thought shoot, if I could make it to where the average man could grow his penis a half an inch I'll get my picture on a postage stamp.

Three Categories of Women Who Suffer with Sexual Dysfunction

So, I'm working on that but I'm still mostly taking care of women, and I have a heart for women and actually part of what led to me taking care of the men is that, when I would get women happy and make them ... take a woman who's 40 pounds overweight, she's 40 years old, she feels tired and her sex drive is low. When she loses the weight and her sex drive is high and she can think well again, three things could happen. I got to where I could almost tell when the woman walked in the room, which of the three it is.

Okay, picture that woman. If she's got a lover who's kind to her, who's healthy, who has a good sex drive, they could live happily ever after, there's nothing left for me to do. If she's got a lover who's been abusive to her because she's been overweight and low self esteem and now she gets her sex drive back, she's out the door, there's probably nothing I should try to do. I don't know, but there's probably nothing I can do because she's been kind of under the thumb and now that she's got her sex drive and her health back she's gone.

The thing that bothered me was the third category, and that's the woman who comes in and she loves her husband and he's not well. Now, you make her well, she's got a sex drive, and the man or woman that she loves can't keep up with her. Now you got a problem, because they love each other and you've created a mismatch that's causing a conflict. That bothered me. So, for that reason I made myself an expert at men's sexuality.

I'm working on that part of it but I have been following what has been done for injecting around the urethra. That's been done for the past 15 years, with collagen, with hyaluronic acid fillers, with collagen, with hyaluronic acid fillers, with, it's really what you're doing with the sling. It's just a way of changing the contour of that area with some of the surgeries. So, finally I had this girlfriend at the time, who said, "Hey, I want to try that." So I said, "Okay, let's try it." And the first 24 hours she was so, I mean, she was always a good, she always enjoyed sex, but she became really almost like she was on some sort of drug. If you think about it, drugs are, you know the only bad thing about drugs is that they make you sick, they get you put in jail, but what if you had a drug that was legal, that made you happy, and wasn't going to put you in jail? That'd be a good thing.

You could say running becomes a drug like that for some people. The endorphins from running. So all of a sudden, here's something I've done that in theory should make her body healthier, but it was like a sex drug to her. So I thought, and she was just insatiable for about the first 48 hours, so I thought, I should try this with some people that have problems, because it makes sense it should work. So the first woman I treated after my lover had been abused by her ex-husband in the genitalia. She was scarred in the vagina and the anus to the point where she couldn't have relations without horrible pain, so she came over on her lunch hour and I treated her and a few months later she was literally engaged to an old high school lover because the pain was gone, and something that took me 30 minutes on her lunch hour just changed her life.

She's the one who actually said, "Hey, this has made my incontinence go away. I've lost weight because I'm running again." I thought, 'Well Josh should've thought of that.' So my patients, the people, the women and men who've trusted me are really the people who are responsible for this coming about, because they trusted me enough to let me do what the science said should work. Again, [play the 00:12:02] words, plasmids, that's been researched for the past 15 years for wound healing, but using in that space was a new idea and the people who loved me and trusted me enough to do that were really the ones who taught me the procedure.

I had an old teacher that told me, he said, "You know, if you want the best textbook, it's not the textbook, it's the patients you're taking care of." And my patients, if you're writing the textbook, then you're writing it from what your patients are teaching you, and that's what's happened with me.
(Chapter 15 introduces the O-Shot® Procedure & is Written by Dr. Runels)

Nory: You know, it's just a beautiful philosophy and your humbleness is, tells me a lot about you.

Dr. Runels: Well, I don't know, it's really, there's really no, I don't know if you can call it humble when there's really nothing that I can claim, except maybe tenacious, being tenacious. Because you know, I didn't go make this brain, I came with it, and I, the people who've been around me gifted me with their trust, but it's kind of you to say. But I still think most of what we have is a gift from somewhere, wherever you decide that's from is your philosophy, but I feel like most of the good things we have are gifts. Then we decide if we're going to take care of them or not. That's kinda how it works.

Nory: You know, Erin told me, this is a little off subject and we don't need to include it in the video if you don't want, but she called you a 'transcendentalist.'

Dr. Runels: Oh, I don't, I'm not even sure I'm 'good,' but I think that ... Emerson had it right when he said really our goal in life should be to be a perfect pipe. But the pipe becomes most useful when it becomes as empty as possible. I don't know what that makes me; maybe just makes me an Emerson fan, but that's kinda my goal.

Nory: Well I come from a Unitarian Universalist background so I just said, "He's close to my heart."

Dr. Runels: Yeah, he's an amazing guy. I think he came pretty close to being an empty pipe, didn't he? Or clean pipe.

Nory: Getting back to our interview, I think you've answered a lot about how your women patients' problems impact their lives, but I'm curious to know, besides the O-Shot® and the nutritional supplements and the hormonal supplements and the other [techniques 00:14:43] you use with them, do you use any other technologies besides the O-Shot®?

Dr. Runels: ... The things that can go wrong with sexual function really almost cover almost everything that can go wrong with the body. Sexual function is, I consider it like the cherry on the top of good health. For example, if someone's depressed, for whatever reason; hypothyroidism, tragedy, whatever it is, sex drive's gone. If someone's in pain, for whatever reason, there's no sex drive. If someone's got a fever. The sex drive, in my opinion, it can be faked, it can be maybe become artificial through some drug like cocaine or whatever, or maybe through someone being drunk or high or something, but true, healthy sex drive evolves out of many things that have to do with good health, good relationships, good connections. The best, even on a spiritual plane.

So as far as, when you say 'what other modalities would I use?' Let's just take, for example, a problem like can't have an orgasm. That could be low testosterone, and in that case they need testosterone. It could be pain because they've got a scar from having a big baby and they're associating sex with pain, so that's not gonna lead to orgasm. In that case the O-Shot® may help. It may be decreased sensation in which the O-Shot® might help. Maybe from previous surgery or childbirth. It could be they're recoiling from sex because they were abused at some point. At which point sexual therapy might help or some other form of family counseling.

So I like to think of the O-Shot® as a tool, and when the dysfunction involves any sort of dysfunction of the tissue of the genitalia, then that tool comes into play. Now, there's this dichotomy of thought, and I think you can tell I respect the idea. I mean, I'm a big fan of Erickson as well, I respect the idea that the mind is very powerful ...

and can do things that we're probably very not close to understanding at this point, but the idea to try to cure something with therapy that might be made better with something, a physical thing, seems to me like taking things ... Jefferson, Thomas Jefferson, 'I always grab things by the smooth handle.' The smooth handle is not always therapy. But sometimes it is THE handle. So, for example, if someone has, back to that example, if someone has trouble with orgasm and they have the pain from intercourse, sending them to therapy is not the right thing. I like to think of it like a system. On the other hand, if they were abused and their genitalia is working normally, the O-Shot® is not the right thing.

I've been in situations where the therapist somehow had the impression that I thought I had a magic shot that makes everything better. I don't, but on the other hand I don't think therapy necessarily makes everything better either. I like to think of it as a system, and it's a very complex system. For example, we think of a respiratory system, and if you said you're short of breath, that could be because you're anemic. It may not have anything to do with your, if you're profoundly anemic because you're, whatever, you've had colon cancer for the past 20 years or 5 years and you, without anyone knowing it, your red cell count is low, you can't carry oxygen, so you're short of breath because you're anemic. Where another person it may be bronchoconstriction. So one person needs a blood transfusion and iron and a colonoscopy, and the other person needs a bronchodilator.

I think because, again, because of these archaic, almost Middle-Age attitudes that it's not okay to take care of a vagina, it's not even okay to say the word 'rejuvenation' in the same sentence with the vagina, even though it's okay to say it with a face, it's okay to 'rejuvenate your face,' but let me talk about 'rejuvenating your vagina' and somehow I'm doing something ethically wrong, that's just archaic. In my opinion.

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To avoid that sort of 'I've got a hammer so everything's a nail' mentality, I like to think of a system. You can have a respiratory system but I think because of that archaic thinking, no one's ever said, "Hey, let's think of an orgasm system." It's a pretty complicated thing, and it involves having ... Let's talk about the respiratory system; the nervous system has to be working, sending the signals to breathe, which can be changed by lots of things. You have to have ... Bronchials have to be the right diameter. You have to have the right amount of red cells flowing through your blood stream. A lot of things have to do with respiration.

In the respiratory system, you have a neurovascular system, a nervous system, and endocrine system, and the reason we think about systems is because it emphasizes the interplay of lots of different components, and there in my opinion, there's an orgasm system. Testosterone has to be high enough, prolactin has to be low enough, you need a little dab of estrogen for some carrying, probably need a little bit of oxytocin for some love in there. At the same time you need to have sensation. You need to be conscious, you need to be not in pain. You need to have the right serotonin and dopamine, mill you and your brain to have libido. You get it. There's this whole complicated system, and all the O-Shot® does, all it does is make the tissue, that part, those receptors, and the functionality of the genitalia more healthy. That's all it does.

Orgasm & Spirals Up & Spirals Down

Having said that, it can have profound effects on all of it because we were taught ... I was taught in medical school, this is how sexuality works. You have arousal, then you have a plateau, then you have an orgasm, then you have a refractory period. There's this up, flat, and then down like that. It's actually much more complicated than that, especially for women. With men, maybe we're more simple minded. I feel pretty sure we are, actually. What we know for sure, that women are much more sex machines. How many men can have five orgasms back to back to back, with no refractory period? That's not so uncommon for a woman. How many men feel energized after an orgasm? Very common for a woman.

There seems to be, no matter what you want to say the cause of it, there seems to be a different ... I can talk to you a few hours about what I think it is, and what's going on there, but there seems to be a different reaction to sex. That's just the orgasm part. That's not even counting all the rest of it. What I'm getting to, and how the O-Shot® may affect multiple components, including the psychological ... If a woman, there's a spiral and it go up and down, if a woman has arousal, and then she has sex, and then it's a bad experience, she's ... For whatever reason. We can think of lots of horrible reasons it might be bad. But, it's a bad experience for her. Then, she doesn't go back to baseline. She's at a level now to where it's more difficult to even become aroused.

Let's say she tries again, and it's another bad experience. She's spiraling down. I think there's some women that are spiraled so far down because of abuse, and they attempt something with a lover and maybe they're abused again, or something bad happens, and they're so down, they just spiraled, spiraled down. Now, the other side of that, someone becomes aroused, a woman, and she has an encounter and she's ... It's glorious for her. She's respected, she's loved. She has this beautiful experience. Physically, emotionally, spiritually. Now, when it's time for possible sex again, she's at a different state. She's more easily aroused and there's a spiral up.

Women's Health Talks About the O-Shot® (Orgasm Shot®) Procedure

That spiral up and down, that's not my idea. That was actually presented, and its been talked about for a few years in the Journal of Sexual Medicine, and other places. What might be new is that, I think it's possible, that in some women my O-Shot® can help break the trend down. Or maybe help accelerate the trend up. For sure, I've seen it in women who have pain, break the trend down. We do the procedure, and then I have some techniques that I tell them to do so that they can test the waters, so to speak, on their own. Then they find, "Oh. Maybe I'm not having pain." Maybe they tentatively have sex with their lover and, "Oh. Wow. I didn't have pain." That doesn't mean they're not still worried about it, but they spiraled up a notch.

The next time they're not as tentative. There are ... Maybe that might apply, in even cases that don't have to do with pain. I think we're seeing our shot affect other areas because of that complicated system. It triggers other things in the mechanism. It's still not a magic shot.

Nory: Remarkably complex. Remarkably complex, the woman's ... The whole ethos. Not just her sexual response, but all that goes into making that ability to orgasm, or not. You're painting a very much bigger picture for me than I had had.

Dr. Runels: I think it's really ... It's very ... Prideful for us to think we have a deep understanding. Even when you expand it this broad, for example, we know that if you have a massage, your oxytocin level goes up. It makes people more open to pleasure. Oxytocin’s a small peptide chain made by the pituitary gland, which is attached to the brain. You might as well say it's part of the brain. There are over 200, that's 2 with 2 zero's behind it, peptides made by the pituitary gland. When we do some extensive blood tests, we get 20 blood values back. Oxytocin, DHEA, free and total testosterone, on and on and on. Still, just Kindergarten compared with what's going on up there.

The idea that you might push one button and it affects 10 other things ... For a simplistic example, if I raise your growth hormone level because you've had brain trauma and it's low, it's going to lower your thyroid level. If I raise your testosterone level, it's going to lower your thyroid bonding globulin, and you'll have more thyroid because I gave you testosterone. It will probably also increase your insulin like growth factor I, or your Somatomedin C because you'll probably create more growth hormone. That's just one example, of one hormone affecting two others.

Who knows what's happening with the other 200. That pituitary gland, remember, is attached to your brain. When you get fearful, and your heart rate goes up, it's because your cortex said, "Hey. I'm afraid." And your pituitary gland spat out some stuff that told your adrenal glands to release some stuff. It all started up here. I don't mean to say that what's going on up here is not important. I think it's extremely important. I do think there are ways to push buttons, whether it's hormonally or physically with our O-Shot® that have rippling effects throughout the whole system that can be beneficial.

Nory: That seems like a pretty good place to conclude the interview. I know that you're a little pressed for time.

Dr. Runels: I was honored to speak with you, Nory. I commend you ... I know we had some conversations earlier, so before we wrap it up I just want to commend you for having the courage to, one, talk about sex, because it's a courageous thing to do. Just bringing ... Broaching the topic will bring criticism, even to healthcare people like ourselves. Whether it be writers, therapists, doctors, doesn't matter. When people broach the subject of sex, there becomes a recoil that you can't even run ... I've been banned from Facebook. You can't run an ad, even if it's bringing people to something that's a medical procedure. I can't ... My Facebook ads have been banned because I talk about sex.

It's troublesome that there's this idea that ... As we spoke earlier, there's somethings that people can have go wrong, and they invite the utmost sympathy from everyone. You can have the flu, and people want you to get well, and you let them know without hesitation. They send you get well cards, or you can have cancer. Try getting schizophrenia. Or bipolar disease. And even though those are chemical imbalances, that it's not fault of the person, there's no reason to be ashamed of it, nevertheless, there's ... Continuing, we're not in the ... This is not the middle ages where we should be saying these people are witches or something, or they're possessed with the devil, but it's a chemical balance. They shouldn't have to be ashamed of it, but they are.

Many of them are. And they're ... In the same way, sexual problems, you won't see anybody posting to Facebook. They might post they got the flu, or they broke their arm, come sign my cast. You aren't going to see anybody post to Facebook, "Oh. I've got painful intercourse. Would you pray for me today." Or, "I couldn't have an orgasm last night with my husband. Would you give me a prayer?" Have you ever seen that on Facebook? You'll see broken arms all day long. And it's because there's a social stigma for it. But yet, that same thing, is so critical ... Emerson said sex and beauty is the ... He actually just said beauty, but I throw in the sex part, because I think that was his generic way of saying sex. But he said beauty was the scaffolding of love.

Yeah, you may reach a place where you don't need the scaffold, but I think most mortals need the scaffold to build a relationship. That's why I think more younger women, and older women complain. That's my long way of bragging on you, for you having the courage to talk about this. I'm happy to wrap it up, but it should go through this. If there are other questions that you get from your readers, or that just occur to you, we'll do Volume II. Anytime you want. Or III or IV.

Nory: You know, this was amazing. I didn't expect ... I was not expecting the depth. It was not what I asked for, but it was beautiful.

Dr. Runels: Thank you.

Nory: I feel way more optimistic I think, than you. Honestly, I do. I feel very optimistic. And I'm waiting for those bullets that you say are coming, those arrows. I know it would probably feel really good to you, to punch some people who have those attitudes about vaginal rejuvenation. Would you like ... Would you appreciate the opportunity to write a forward for my book? A short one, that does a little of that punching back?

Dr. Runels: Yes. I would love to write you a forward. The answer to that is yes. I would love to write a forward. As far as my, the way I visualize it, I see it more as ... When I was working in the ER, if someone came in just drunk and stupid, because of some drug they were on, and they would often try to hurt me. My goal is not really to punch back, it was just to control them from hurting anybody until they got their brain back. I look at these people, they're just so blinded by ... It's crazy to me.

I'll meet them in a thing and they'll say, "When you publish some research, then I'll start doing this." I'll say, "Well, you know we've already published five papers. And there's 9,000 papers about PRP. Have you read any of them? Or are you reading Marvel comics? What are you reading?" You're not reading any of this if you're reading Superman and Revenger. It's so funny to me that we're ... That's the way I look at it. It's not really punching back, as much as it is ... Anticipating their daggers, and building the intellectual shields to neutralize it until they get their brain back.

Nory: No. No. You're so nice. You're so nice, and I'm so grateful. I can't tell you.

Dr. Runels: All right. So, let's do this thing. I look forward to talking again, and I'll make this recording where you can take whatever you want and share it.

Nory: You are the best. Please give my regards to Erin. She's wonderful, too.

Dr. Runels: Thank you, Nory. Goodbye

Nory: Bye-bye.

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Transcript of Video...

Charles Runels: Hello, this is Charles Runels, and I'm extremely honored, very privileged and excited to be able to introduce Dr. Michael Goodman, who really needs no introduction. I've seen him lecture now on many occasions to other world-renowned gynecologists, and he always commands respect. He recently released a textbook that he edited about female genital plastic and cosmetic surgery.

One of the true pioneers who blazed the trail for the people who are doing it now, and I consider him to be actually one of the premiere physicians living today, and paved the way with some of his research for what's now widely practiced worldwide when it comes to cosmetic surgery in the female genitalia, and not just because it looks better, but how it actually contributes to a woman's functioning.

When I asked him to talk about the procedures he does, surgery versus the various devices, versus, of course, the O-Shot, how he uses those various modalities, combines them, and how he thinks about those modalities affecting a woman's sexual function. Of course, that has extremely far-reaching affects on her whole personality and her life, her family, and her career, and all that research has been done, but specifically how he combines these different modalities.

Hang on until the end, because when he's finished with demonstrating his ideas, I would like to ask him some more in depth questions about particularly how some of this relates to orgasms. Hang on until the end, and we'll some question and answer time.

Michael Goodman: What fun, Charles. I get to speak with you, one of my favorite people, about two of my favorite things, orgasms and vaginas. Without further ado, let's talk about that. Those of you that are looking at this podcast are well aware of orgasms. That's one of the reasons, probably, why you're looking at it and why you're either considering administering the O-Shot or are already.

Let's talk a little bit about how things really work, or the biomechanics of the whole process, and the physiology of orgasms, and the different types of orgasms. They certainly relate to the O-Shot, and they certainly relate to the whole idea of vaginal tightening. I really like to use that word, vaginal tightening, rather than the ubiquitous word vaginal rejuvenation.

That's an unfortunate choice of terms, because that term, vaginal rejuvenation, has been stolen out from under us by pretty unscrupulous marketers, who will have you think that all you need to do is put a wand in the vagina, either radio frequency and laser, and you will tighten the vagina, and you will improve orgasms, and no, that will not work.

Let's talk a little bit about terminology first. The term vaginal rejuvenation, by the way, refers to surgery alone, period. Vaginal rejuvenation was first popularized by one of the fathers of dental plastic and cosmetic surgery, David Matlock from Los Angeles, and was called Laser Vaginal Rejuvenation. By that, Dave meant the use of a Touch carbon dioxide laser as a cutting tool for surgery. Understand, vaginal rejuvenation refers to surgery. If someone's saying they're going to rejuvenate your vagina not using surgery, they are wrong, they will take your money.

Let's talk about why these operations work. If you look at the first slide, you see this lady had labioplasty also, we're not talking about labioplasty, which can happen [inaudible 00:04:01]. Why do vaginal tightening operations appear to improve sexual function and improve orgasms?

First, what are they? We talked a little bit about that. I got on my soapbox, which I tend to do when we're talking about that term vaginal rejuvenation. Really, a wonderful term is colpoperineoplasty, which is Jack Pardo's term from Chile. We don't use that that much, but really the best terms I feel, in my opinion, are perineoplasty and vaginoplasty.

Basically, these are surgical procedures designed to reapproximate the levator muscles, do basically a levatorplasty, bringing them together over the thinned out vaginal floor, decompress the rectocele, bulk and elevate the perineal body, to push up the penis or any inserted object to the anterior vaginal wall, excise all the scar tissue, to utilize a space closing, plicating 3-layer closure designed basically to tighten the outer half or two-thirds of the vaginal barrel, to result in greater stretch of the clitoral bulb and the anterior vaginal wall, and to result in greater penetration of the penis against the anterior vaginal wall and the cervix.

Additionally, and here's where these non-invasive technologies really may be helpful, is non-invasive technology such as radio frequency and fractional CO2 laser can be used in the far upper vagina, or what we call the [inaudible 00:05:50] of the vagina. That area of the vagina that has no musculature, that really has little fascia, that's only just mucosa, way up at the top.

That [inaudible 00:06:00] the skin. All these technologies do is resurface skin, and can increase collagen and elastin fibers way up at the top of the vagina, and also increase the stretchability and increase the elasticity underneath the base of the bladder, and certainly has been shown to help with minimal and modest urinary incontinence. Combining these two ends up with a really good procedure.

Again, we talked a little bit about the names of these procedures. I like, again, perineoplasty and vaginoplasty. The next slide I'm going to show you comes from my friends, Rob Moore and John Miklos from Atlanta. They are premiere vaginal reconstructive surgeons. I put down this quote in its entirety, because it really says a lot.

We can read it together. Vaginal rejuvenation surgery, again, surgery, is one of the latest trends in elective vaginal surgery for women. It is a repair of the vaginal caliber in women who suffer from decreased vaginal sensation, or of feelings of laxity, basically, that affects their sexual life. In many instances, women who present with these symptoms also have other pathology, such as prolapse. That must be addressed in any repair that's contemplated.

Sexual dysfunction, or decreased sexual sensation, may be one of the first symptoms that women suffer from in this progression from laxity to prolapse. There's ample evidence in the literature that prolapse and vaginal relaxation can create sexual dysfunction, and that repair may reverse these changes in many women. We're dealing with these early changes. When dealing with sexual dysfunction and the caliber of what's in the vagina, the surgical, underlining surgical, repair must be meticulous and exact to enhance sensation and function, and not impair it. This truly is the art of surgery.

With that introduction, what are the mechanics that we're talking about? This is a cross-section of a normal female nulliparous, in other words, no kids yet, anatomy. If you take a look here, and I'm not sure if you can see my arrow on the screen, hopefully you can. I'll put it all up.

Charles Runels: Yes, they can see your arrow.

Michael Goodman: Cool, good arrow. If this woman were supine you'd see that her vaginal barrel goes downwards. The angle of the vaginal barrel is downward. When a man is mounting her or she's on top of him, there is pressure, especially because of the angle, especially because of the pelvic floor, and very especially because of this robust perineal body here. There is pressure against the anterior vaginal wall, the G-spot, the internal clitoris, and then the dorsum of his penis, as you can see right here, the dorsum of his penis, the top of his penis, has pressure against there, has pressure against the clitoral glans, the clitoral body, and his pubic bone has pressure in that area, and all is fine.

But, but, but, with childbirth, or multiple childbirths, things change. The angle of that vaginal barrel no longer goes down, but is horizontal. It's lax. The floor is lax. You don't get that pressure against the anterior vaginal wall, you don't get the pressure against the G-spot, you don't get the pressure against the clitoris. It results in less stretch on these anterior vaginal wall receptors that we'll talk about in just a little bit. This is basically what I see, and what occurs frequently after childbirth. The procedure that we're talking about, perineoplasty and vaginoplasty can be performed ...

Section 1 of 5 [00:00:00 - 00:10:04]

Section 2 of 5 [00:10:00 - 00:20:04](NOTE: speaker names may be different in each section)

Speaker: We're talking about perineoplasty and vaginoplasty can be performed in the hospital under a general anesthetic. I perform virtually all of these, as does Red Allensade perform these. Red and I, I believe are the only two that perform these in the office under local anesthesia and kudos to my friend Red Allensade, who's also, by the way, written and helped to edit an excellent textbook on genital plastics. Red took a already existing tractor system, The Lonestar, changed it a little bit and made it a wonderful system for exposure that does allow performance of these procedures in the office, under local. As has another friend, Marco Pelosi, who's designed an amazing retractor that can be used.

So just very briefly walking you through what we're talking about when we talk about a perineoplasty and vaginoplasty, this is not meant to teach you how to do this operation. It just shows you a little bit about what we mean as a basis, as a foundation when we talk about the physiology and the biomechanics in just a little bit.

So here's a woman with a paris vagina, a little bit of laxity, a little bit of gaping. In making the incision, what we can't quite see is the perineal incision. This starts just inside of the hymenal ring, just inside the introitus at about 4:00, 4:30, goes down on the outside encompasses lax perineum to the nadir, just above the anal verge. Comes down also from around 7:30 or 8:00, that comes down on the outside, then we'll make a line. A horizontal line between these two. Size that line with different instruments. I like a radio frequency needle electrode. Make that incision. Go ahead and undermine. You can see the retractor system in place. We'll undermine. We'll go to above the rectocele. I get in six, seven, eight centimeters inside. We'll go ahead, we've already removed part of the vaginal mucosa. We will remove this other part, you can see the rectocele a little bit over here. You can see it better in the next slide. What I've done is I have just a stay suture on the recto-vaginal fascial layer. So you can sort of see the rectocele. The levator muscles, bulbocavernosus, ischiocavernosus, and so forth. The levators are against the pelvic side wall and they come this way.

They're not transverse, they're vertical and they stretch apart. So basically what you're doing in this repair is you are putting in vertical sutures way over here. We can retract and expose that. Suture goes in here, it comes across to the other side, it's tied, and that basically will bring the levators as a levatorplasty and cover over, build up the pelvic floor, cover over the rectocele either with that same layer or a separate layer. We will bring the rectovaginal fascia that we dissected down off of the vaginal mucosa. We'll bring that over to cover up the floor. The other thing we'll do, after we've developed the perineum, is to get rid of all of this scar tissue from lacerations and episiotomies. We'll take out a plug of tissue that literally is about two centimeters by two centimeters from this whole area. So when everything's brought together it's going to snug up the vaginal barrel. So here you see just finishing the procedure, again this is not teaching you how to do the procedure, just giving you an idea of what we accomplished.

So what we've done, again we're only looking at the outside, what we've done is we've built up this tissue. We've re-approximated the transverse perinealis muscle. We've re-approximated the perianal musculature. Inside we've brought the levators together and we've rebuilt the pelvic floor. So to understand why these procedures work, it's nice to understand a little bit about the physiology of orgasms. And understand that, again arguably there's a lot of argue about this. My opinion is that, and many opinions, many people's opinion is that basically there are two types of orgasm, clitoral and vaginal, or perhaps better said vaginally activated orgasms. And certainly the two can work in concert.

So many of you have maybe seen this, certainly if you've attended my lectures you've seen this slide before. There are a lot of things that go on in women's orgasm. And what we're going to do today is talk a little bit about the clitoris, both the external clitoris and also the internal components of the clitoris. Here's a slide that is seen in many different places. It's a wonderful slide. But the clitoris is not just the little pink button that you see. The clitoral glands, you know if you look at a woman's clitoris real closely, it's like in looking at a mini penis. It looks exactly like a tiny little penis. And like a penis, it's not just the head. There's the body, the clitoral body, and that comes down underneath, and really it wraps these internal organs of the clitoris, wrapped around the urethra and really make up part of the, I like to call "G" area rather than G spot.

There are the true ... There's a crus on one side, a crus on the other side. Together they're called cruri, or corpus cavernosum. There's the bulbs of the clitoris, these are in loose, a realer tissue. But both of these consist of erectile tissue. And you can get an idea of the formation of this. This is innervated by the clitoral nerve, a branch of the pudendal nerve, which comes out from the spinal column around a little bit from L4, mostly L5, S1, S2. But a very important thing to understand, and this is probably one of the most important slides of the whole presentation. Is this concept of unity, in just a moment I'm going to show you a slide of a reference, it's a wonderful reference to look up with this concept of unity. The distal or the outer vagina and the vulva. The clitoris, the urethra are not separate, really they have a shared blood supply, a shared innervation, and they really respond as a unit to stimulation.

The urethra orifice is a very sensitive area in a woman, as is obviously the clitoris, the vulva, many different areas. But really it's a shared, this is a shared concept. So it's really a complex, and I really like to talk about the clitoro, this is a mouthful, the clitoro-urethro-vaginal concept. Clitoro-urethro-vaginal complex, which is really a unit, an anatomic and a functional unit. And that unit is activated by stretch. The greater stretch, you see what we're getting to soon, the greater stretch, the greater activation. So the vulva outerlies the wrapping, there's the urethral orifice surrounded by erectile tissue of the clitoral bulbs. The clitoris is not just the glands, it's an important distinction. All of these have erectile tissue components. And please understand they don't have a single innervation. There are really two sets of nerves. In the whole body there's two sets of nerves. There's somatic or skeletal nerves, and there's the autonomic nervous system. Two separate nervous systems.

The nervous system that tells you when your bladder is full or when you have to have a bowel movement is very different than the nervous system that tells you that you've been punched in the face and you get ready to punch back. So the somatic nervous system as I said comes from the dorsal clitoral nerve, which is a branch of the pudendal nerve. Supplies the skin and some of the underlying stretchers. The more visceral, autonomic fibers come by a cavernous nerves, by the inferior hypogastric plexus, branches of our old friend the vagus nerve. For you doctors that are looking at this, you remember the vagus nerve. It starts at the top it goes to the bottom and innervates everything. So vascular engorgement involves both somatic and visceral nerves. And there's a reflex arc here with cutaneous and somatic afferants and visceral efferents. And this is the reference I was talking about, Helen O'Connel and [inaudible 00:19:18] Patriots, this is an article 2008, Journal of Sexual Medicine, called The Anatomy of the Distal Vagina Towards Unity. It's a wonderful article that talks about the clitoro-urethro-vaginal complex.

So let's talk a little bit about our friend the anterior vaginal wall, and it's sensitivity, and Charles knows a lot about this because he puts, he and several of us put platelet-rich plasma okay, which has growth factors and angiogenic factors, and where do we put it? Into the anterior vaginal wall. Why do we do it? Because of proximity to peri-urethral tissue.

Section 2 of 5 [00:10:00 - 00:20:04]

Section 3 of 5 [00:20:00 - 00:30:04](NOTE: speaker names may be different in each section)

Michael Goodman: -do it because of proximity to peri-urethral tissue, proximity to the clitoral bulbs and the crurae, and again, in this area there is both a skeletal and an autonomic nerve supply. While this slide is up I want to talk just for a minute about the peri-urethral glands, AKA Skene's glands. Skene's glands have their opening, their ducts, just around the urethral meatus. If you look real carefully, not in all women, you can see these little gland openings. Every once in awhile, they'll get plugged, and you can have a Skene's gland cyst, but female ejaculation, and not all women have well-developed Skene's glands, but there's a difference between squirting and ejaculation, and that's not the purpose of this to talk about. Squirting is losing urine. Female ejaculation is discharge of prostatic light fluid from the Skene's gland, little detour there.

So remember in medical school, at least I remember back in ancient times when I was a OBGYN resident, we were told that the vagina is poorly innervated, and indeed, one can go into a woman's vagina, one can visualize a woman's vagina, and can take a scalpel and cut that vagina, and the woman will not know that that happened. Okay. But that doesn't talk about stretch receptors, which certainly that organ, the vagina, has. So this organ, especially in its outer portion, and I love this quote. This is one of the best quotes I've seen from Glorida D'Amati and Emmanuel Jannini, two beautiful Italian women, and only an Italian, I guess could say it this way.

"This organ, especially in its outer portion, contains enough nerves to participate in sexual response as well as the whole biochemical machinery known to mediate excitation and arousal in the male copulatory organ."

What a wonderful quote. Do you have anything to say about that, Charles?

Charles Runels: Yeah. So I'm a big fan, as you know, of Dr. Gräfenberg, for whom the G-spot is named, but if you read Dr. Gräfenberg, he doesn't talk so much about a spot. He thought what was going on is exactly what you're saying. It really had to do with the whole complex, and especially the entire urethra, and not so much some magical spot. As a matter of fact, I think personally that the spot changes sometimes day to day in the same woman, but he was all about the whole urethra, and if you think about it, not only do you have this excitatory response from the stretch receptors itself, but by bringing those structures next to the vagina closer to what is making the stretch, if it's a man having sex with a woman, then you're going to have more pressure in the corpus cavernosi of the clitoris as well as on the urethra.

So lots of things are happening. That's why I like your phrase the ureal, clitoral, vaginal complex, because you get not only excitation from the stretch receptors on the vagina, but that stretch brings pressure simultaneously on the part of the clitoris that wraps down next to the vagina, as well as on the urethra. So absolutely. I'm over here cheering for you.

Michael Goodman: And I didn't need you to say that, but that just sort of segues into what we're going to talk about in just a little bit, which is vaginally-activated orgasm. I like the term "vaginally-activated orgasm" better than vaginal orgasm, but we're talking about the same thing. Again, these are relationships between clitoris and vagina. There is a reflex called a vaginal-cavernosus reflex, so what this is, is when there's vaginal distension, I mean inserting an object, that induces contractions of the bulbocavernosus, the ischiocavernosus, and the magnitude of that contraction, and this is research data, increases with the volume of vaginal inflation, therefore if there's increased inflation, or increased pressure from a tightened vagina, a large penis, or growth factors and androgenic factors in the anterior vaginal wall, this increase contact between the vagina and the congested clitoris leading to vaginally-activated orgasm caused by contact of the internal portions of the clitoris, again, somatic, skeletal innervation, and in the anterior vaginal wall stretch receptors, which are autonomic innervations.

This is research-based, and these slides have that research on them. Odile Buisson and Pierre Foldes, Emmanuel Jannini have done a lot of work on that, as have others.

So again, not to beat a dead horse, but there is a clear reciprocal relationship between the clitoris and the vagina, and remember, functional [inaudible 00:25:40]. Let's talk about these different types of orgasms.

Clitoral orgasm, caused by both digital stimulation, external stimulation, again clitoral nerves from the pudendal are warm, electrical kind of feeling. Vaginally-activated orgasm, arguably more intense, more internal, more deep, more throbbing, and this is triggered by stimulation and expansion of the vagina, the G-area. Anterior vaginal wall, autonomic innervation. Very interesting. Very interesting. It's research that's been done by Barry Komisaruk and Bev Whipple out of New York City. I think, Charles, you know probably Barry. I don't know if you've met Bev. They did seminal research where they studied women that had spinal cord transection. They had spinal cord transection above L4, L5, and found that ... So what you're doing there is cutting off any input from the pudendal nerves. Well, they don't have any innervation from the pudendal, and these women were still orgasmic, really proving that it's not all the pudendal nerve, proving that the activation and innervation from the autonomic nervous system plays a big role here. That was really seminal research that Whipple and Komisaruk did.

So we talked a lot about the anterior vaginal wall. I won't beat that again. This is research, again, from Pierre Foldes and Odile Buisson. So in contrast to clitoral orgasm, vaginally-activated orgasm is orgasm triggered purely by penile, vaginal intercourse or a surrogate. Very interesting and very controversial research is this study down here by [Stuart 00:27:54] Brody and I don't know Weiss. I haven't met Weiss. Stuart I know. This is from University of West Scotland in Paisley. Brody has written a lot. It's very controversial, and basically Brody feels that women enjoy men who have larger penises, that women have greater orgasm response, especially vaginal orgasm, in men who have larger penises. Why? Because there's more stimulation of the anterior vaginal wall.

What are we doing when we do vaginal tightening operations? I don't think we're increasing the size of men's penises, but Charles, you've commented a lot about that, and you certainly have research in that, and you are working in an area that actually does increase the size of men's penises, certainly by tightening the vaginal barrel, lifting up the perineal body, you're doing about the same thing. You're not making the penis larger, you're making the vagina tighter.

So basically, relaxed vagina, relaxed perineum, less penile pressure against the pubis, the clitoris, less stretch on the receptors of the anterior vaginal wall. So the goal then, of a vaginal tightening operation, is to reestablish the angle and to increase the anterior vaginal wall and cervical pressure, but one other thing that I haven't mentioned is that just tightening the vagina, just doing that surgical operation I think is leaving half the job undone. We're bringing these muscles in together, but just bringing the muscles in together is doing nothing but strengthening the muscles, so just doing an operation without working with that women, her pelvic floor, strengthening exercises, working with her or working with a pelvic floor physical therapist who works with her, I think it's imperative for really doing the job right.

So I'm going to show you a few of my photos [inaudible 00:29:57] labioplasties in addition to their pelvic floor operations. You obviously cannot see inside the-

Section 3 of 5 [00:20:00 - 00:30:04]

Section 4 of 5 [00:30:00 - 00:40:04](NOTE: speaker names may be different in each section)

Michael Goodman: -their pelvic floor operations. You obviously cannot see inside the vaginal barrel, but looking at this you can get a little idea of what we were talking about, what's accomplished with vaginal tightening operations.

With perineoplasty, working on the outside, that's perineoplasty, building up, reestablishing the angle, building up the clitoral body, bulking the clitoral body, doing an aesthetic repair of the opening, and then vaginoplasty, tightening the vaginal barrel.

These are just a few before and afters. Again, some of these have had minor labioplasties, or major labioplasties at the same time.

Different cameras, obviously here. We didn't do any work at all on the top. The labia are just so splayed outward here, where they're inward here, but you can get an idea of what's been done from here to here, as opposed to what obtains over here.

Same thing here. She's healing from her labioplasty. Again, this kite-shaped incision, we did no work to diminish these folds. This is just the incision that reconstructs the opening, builds up the perineal body.

You can see especially here, we've done no work on the anterior vagina, and this is a urethra seal, and there's nothing you can do really about a urethra seal, but we certainly have supported the perineal.

So concluding this part of the presentation, these so-called vaginal tightening operations, AKA perineoplasty, vaginoplasty, vaginal rejuvenation, surgical vaginal rejuvenation, appear to have good outcome via both mechanically tightening the barrel, forcing the penis more tightly against the anterior vaginal wall in Gräfenberg's area. Thanks, Charles. Which contain erectile tissue of the bulb and [inaudible 00:32:02] of the clitoris, as well as that rich autonomic supply, reestablishing the downward angle of the barrel with greater stimulation of the external clitoral structures by the top of the penis and by the partner's pubic bone.

So with that, I'm done with what I had to say. Any questions are welcome.

Charles Runels: Yes, okay. So-

Michael Goodman: And just one last thing before [inaudible 00:32:32]. There's no way on Earth that I could do the work I do without Nicole Sanders and Rachel Davis. Nicole's worked with me for 14 years, Rachel for five. They scrub on surgery. They work with women in every possible way, and we are truly a team, so I'll shut up.

Charles Runels: Beautiful. Well, it's a very elegant presentation, and the mechanics, when I talk with physicians, it's amazing how many physicians would have trouble drawing a clitoris, and the entire thing, and how many gynecologists have told me that they prefer to not talk about sex. I'm not so sure that's a bad thing. Perhaps they're more interested in treating ovarian cancer and sex is off-topic, but as you know, it's not always a comfortable thing for people to speak about, and I salute you for blazing the trail for making it more acceptable.

Now, what I would like to address is some of the objections that people have about what you and I do. Now, for example, there are those that would say we shouldn't pay attention to the labia's appearance at all, and what I think you did was lay out a very good explanation about why it's not just about appearance. It's truly about function, and I know you've published in this arena, but if you wanted to talk about the appearance itself, talk about what you've seen, what the research has shown about how appearance affects function.

Michael Goodman: Oh, [inaudible 00:34:18]. I'm going to go talk about something that I very recently had contact with and then back up a little bit. I review for some medical journals, and I just reviewed for the Journal of Bioethical Investigation. I just reviewed an article for the Journal of Bioethical Investigation, one of the top bioethics journals. This is done by a bioethicist, who is not a surgeon, has no interest in female plastic and cosmetic vaginal surgery, and looked into the area of adolescents and whether they should have labioplasties or not.

I've had the opportunity to operate on a modest number of adolescents. We're talking about young women between the ages of 14 and 18, and adolescents really come in with the largest labia of all the women that I've operated on. They come in with their moms who couldn't believe what they were talking about at first, and then understand. Basically, what this article talks about is the feeling that other people have that, "Well, if it's a big functional problem and it really causes infections and so forth, then maybe you should operate on it, but if it's a psychological problem, then you shouldn't."

And this group of bioethicists begged very strongly to differ, saying that we do a lot of procedures for people because of significant psychological situations, psychodynamic situations, self-esteem situations, and felt that there's really no difference between functional and self-esteem/psychological reasons. Certainly, that is borne out in the literature. We did a study several years ago, now seven or eight years ago. It still is the largest study in the literature on about over 250 women and 345 procedures, of which about 150 were labioplasties.

We took a look at sexual satisfaction in women that had labioplasties and the reasons for labioplasties are usually either psychological, meaning, "I don't like how it looks. It makes me very self-conscious. I don't want to have sex in the light. I don't want him to go down on me. I just don't feel good about it." And none of these men are complaining. We guys, we're just happy to be there, and we love our partners for who they are and whatever's attached to them is fine, but women feel very different about this, so we looked at sexual ... enhancement of sexual function, enhancement of sexual satisfaction with validated questionnaires in women that had vaginal tightening operations, separate issue, and women that had labioplasties.

And women that had vaginal tightening operations, these operations enhanced their sexual function in our study by 87.5%, in [Pardeau's 00:37:35] study by 90%, and interestingly, we asked the men, who were happy to begin with, but 82% of the men felt that these tightening operations enhanced sexual function.

Well, then we also looked at labioplasties. Now, you'd figure that a vaginal tightening operation, one would hope, would enhance sexual function, but a labioplasty, we're just doing appearance. It shouldn't do anything with sexual function, but in women, two thirds of the women, 67% felt that the labioplasty had either a moderate or a significant enhancement on their sexual function and sexual satisfaction, and we banged our palm on our forehead and said, "Of course." If a woman feels more self-confidence, if a woman feels that, even if the guy hasn't said anything, if a woman feels that she's prettier down there, and she's not worried about her labia escaping from her thong, her lacy thong underwear, she is going to be much more participatory and much happier in her sexual function.

The other thing we did is published a couple studies, and others have published studies looking at body image and sexual satisfaction in women that undergo genital plastic and cosmetic surgery, and it's well-known that if someone has a sexual dysfunction, true sexual dysfunction, or if someone has body dysmorphia, true body image issues, you're not going to cure that with surgery. Period. We know that. Plastic surgeons know that. Well, very interestingly in our last study, which was well [inaudible 00:39:13] and well brought out in time, this was on 120 women. We followed these women for two years. We got feedback prior to surgery. They filled out four questionnaires that looked at sexual function, looked at body image, looked at body image, body dysmorphia, sexual function, and I'm sorry. I'm blocking out one other thing.

We looked at them before surgery, six months, 12 months, and 24 months, and these women as a group, qualified as body dysmorphic. If you looked at the validated questionnaire we utilized for body dysmorphia, these women-

Section 4 of 5 [00:30:00 - 00:40:04]

Section 5 of 5 [00:40:00 - 00:52:42](NOTE: speaker names may be different in each section)

Michael Goodman: Questionnaire we utilize for body dysmorphia. These women were body dimorphic and their sexual function was generally poor. One would think that surgery would not change that, but at all points in time, moderately at six months, but very significantly in 12 and 24. This was a level two study. It was controlled. It was a controlled study that by 12 and 24 months the body image dissatisfaction, the so called body dysmorphia, had totally disappeared. This was not true body dysmorphia. This was body dissatisfaction, very different than body dysmorphia. Now, it disappeared and the sexual satisfaction went up to and actually went beyond that of the control group. I can go on, but hopefully that answered your question.

Charles Runels: Well, very elegantly and much of that research, I know that you spearheaded. I hear other physicians who are in hardcore science forums where they're talking about like Lichen sclerosus and other diseases. That will sing your praises because until that research was done, a lot of people did assume that anybody who wanted to change the appearance of their labia must have a psychological problem and they're better off with a psychiatrist than doing something about the labia. This research demonstrated that not to be the case. 67% is a strong number and still a year out and farther still working.

There are others that, as you know, strong movements among some of our colleagues, I think becoming more and more the minority, that we shouldn't even have before and after pictures of the labia or even say anything about it on the internet, which goes back, I think, more to do with relationships with sex than with medicine because, as you know, there was a time in the not so far past, 20, 30 years ago, where before and after pictures of the face with facial cosmetic surgery was considered to be unethical. Things changed because we realized you can't really demonstrate to a patient what's possible and what's not possible without photographs. I think this idea that it's okay to change a person's face to make them feel better about themselves, and obviously even facial plastic surgeons, as you said, they're not going to do surgery on someone who's psychologically, and we can find this out with an interview, they're not going to get better no matter what you do with them. They're going to have surgery after, surgery, after surgery and there's a way to discover that about a person with an interview.

There are those who get a legitimate facelift of something done cosmetically, they get their Botox or whatever, and it makes them feel better about themselves. If you think about it, the concept that it's okay to do that with the face, but yet if you apply those same ideas to genitalia, somehow that's wrong. It smacks or some Victorian era. It always surprises me that that idea still exists even though you've done the research to show the same thinking applies. The idea that a woman can go buy a dress and feel sexy and want to have intercourse tonight, but yet you couldn't make her feel better about her vagina to me just seems a little bit hypocritical. I'm just saying amen. I know that you did that research, which is why I wanted to bring that out and get it out there for people to think about.

When I post this video, I'll put some of those links to some of that research under the video so people can educate themselves. Just one other comment I'd like for you to elaborate upon. Let's just scenario here. People get married. They're 20, 30, whatever age, but let's say it's a typical young love. You get married, and you have children, and then you stay together. Now you have this soul mate of 10, 20, 30 years, 40 years. We see people 50 years in our office married, but the universe plays a bad joke, in my opinion, because by the time a man reaches 65, he loses half of the endothelium of penis. A woman delivers a child or two and estrogen levels change. His penis is literally shrinking and her vagina is growing. By the time they've been together for a while, these lovers who may have matched when they were younger now don't.

Again, the idea that you shouldn't do something about that because it's genitalia, where it's perfectly okay to do things to change your waistline or your neckline, to me, just seems a little bit hypocritical. Could you elaborate a little bit on this matching idea? That's why one guys penis may be too big for one woman and too small for another. If you're just thinking in terms of those stretch receptors, but when you think about these other modalities, like laser versus surgery versus the O-Shot, and talking to the woman about this matching of her lover, could you tell me maybe a few stories about people you've taken care of and integrate with it the way you think about the science?

Michael Goodman: Yeah. An interesting paper that I just reviewed for The Journal of Sexual Medicine and unfortunately was rejected by the editors, I think it should have a place in that journal, hopefully it'll be rewritten and resubmitted out of China, where they attract the anatomic changes of the relationships of different parts of a woman's vulva to her age as far as distance, distance between the pubic bone and the clitoris, distance between the clitoris and the vaginal opening, distance between the urethra and the perineum, distance between the perineum and the anus. What you mentioned anecdotally is true anatomically, that yes, with age, women's vaginas do fall down a little bit. The opening gapes a little bit. It becomes a little bit more relaxed and more open. That is saying that she's hormonally complete. Obviously if a woman after menopause is not on any hormone therapy at all, then sometimes the vagina can shrink if she's not sexually active.

As you mentioned, the size of a man's non-erect penis becomes somewhat smaller, so I understand, though I've not seen studies on that. Certainly a man's erection becomes less robust. I love that word, although you can use it both ways. A man's erections, for many reasons, become less robust. Certainly I work with men and a lot of times it's the partners of the women that I'm working with during their menopausal transition, where they weren't terribly interested in sex with all that was going on with menopause. Now they're feeling a whole lot better and a whole lot sexier, and the fact that now their partner can't either get or maintain an erection is an issue. Certainly working with testosterone, working with PDE5 inhibitors. I have not personally had experience with the Priapus Shot. You certainly have. Adding the Priapus Shot into that can all serve to increase the size of a man's penis.

There's a lot of things that couples can do. Obviously the use of fantasy, the use of toys. Love making is love making. Physical intimacy is physical intimacy and it doesn't all mean intercourse. It can mean using a toy in addition to the penis in the vagina to increase the stretch receptors. It can mean getting a Priapus Shot. It can mean taking testosterone and PDE5 inhibitor. It also can mean, for a woman, doing a surgical procedure to tighten the vagina. Obviously there's different age demographics. Certainly the age demographic for women who have having labiaplasties in my experience, and I've done about 750 labiaplasties and close to 200 vaginal tightening operations, the age demographic in women that are having labiaplasties is younger than women that are having vaginal tightening.

I've done vaginal tightening operations in women in their early 60s. I have not yet done it in women that are a more advanced age. I'm in my early 70s. My partner is in her early, mid 60s. Men and women in their 80s and 90s have sexual intercourse. A long winded way of saying, Charles, that there's a lot of different things you could do. That's the joy of sexual medicine is working with couples to improve their intimacy, which can be all of these different things.

Charles Runels: Yeah, it's so rewarding. We've both been involved in what others would consider to be more hardcore, life threatening type situations, but nothing has been more rewarding to me than having a couple to me than having a couple that's been married for any number of years, 10, 20, 50 years, come back to me and say, "We're rediscovering our bodies because they're responding more like they did when we were younger." Well, we could go on and on, but I just wanted to add that Dr. Goodman has several ways you can learn more from him. I highly recommend his book if you don't have it yet, of course. That's the place to start. Then he has hands on classes in his office where he mentors surgeons who want to learn more of the nuances of these procedures. He's been teaching for a long time. Many of the people who teach are his students. He's not also offering some didactic classes for those who qualify who can learn some of how we do the O-Shot, how to integrate that with some of the other methods that he's discussing with surgery.

I think your next class is coming up in Atlanta. There'll be others who will be posting and so I highly, highly recommend that, even if you've done these classes before, if you have the opportunity, spend some time with Dr. Goodman. He's recognized as the godfather of a lot of these procedures. Yes, sir?

Michael Goodman: I'm teaching classes in Atlanta in October and April and in Sacramento in January and July. The classes are excellent accommodations at airport hotels. They're two different classes. They're both didactic and experiential. I have full length surgical videos. The whole idea is to work with surgeons, whether they're cosmetic surgeon, gynecological surgeons, to basically teach the technique and to discuss how to work with women. We also talk about noninvasive techniques. We talk about platelet rich plasma for different indications including the O-Shot. We talk about the use and misuse of noninvasive laser and radio frequency. There's wonderful uses of both of them, and there's some misuses.

Charles Runels: Yeah. This is going to be some amazing stuff and I know there'll be other classes after that. I'll post links to them all. With that, I'll just tell you thank you. Unless there's something else, we'll end this call and I'm sure you'll be hearing from some of the people watching this video. Thank you very much, Dr. Goodwin.

Michael Goodman: Awesome. Thanks very much. It has truly been a pleasure.

 

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Difference Between the O-Shot® & the G-Shot® (also called G-Spot Amplification)

Chapter 15 is about the O-Shot® (Orgasm Shot®) procedure.

Find a member of the O-Shot®  (Orgasm Shot®) Provider Group (click)<--

Apply to Become a Member of the O-Shot® Provider Group. Physicians & Physician Extenders<--

Let’s Talk Vaginas With Cindy Barshop, Dr. Carolyn Delucia, MD, FACOG, & Olivia


Find O-Shot® provider<--

Transcript...

Olivia: Are we good? Are we going? Hey guys! Olivia here with another episode of Distractify Live or Daily Dose of Useful Distraction. I'm here with Cindy Barshop who you might recognize from the Real Housewives of New York City, but we're here for an entirely different reason. She's the founder of VSPOT Medispa. Did I get that right?

Cindy Barshop: Correct.

Olivia: VSPOT Medispa.

Cindy Barshop: The fountain of youth for your vagina.

Olivia: The fountain of youth for your vagina. We're here to talk about vaginas. Woo!

Cindy Barshop: Woo hoo!

Olivia: I guess why did you start this?

Cindy Barshop: I started it because of my own personal problem and I really believe in sexuality and feeling good about yourself. This whole place is, sorry men, not for you, but it's about women-

Olivia: Sorry, Michael.

Cindy Barshop: And feeling good about yourself, having orgasms just, like a man does. As you get older, and I'm not talking that much older. Not my age older, but like 35 older. Lubrication, tightening. If you had a baby, it gets a little smaller. Friction. It's all about the women enjoying sex more, which is good for you guys, too, because then we want it more.

Olivia: Women watching and men that are watching, please ask your questions, like and share this video on Facebook. We want everyone to get their questions out there about sexual health, about vaginal rejuvenation, and then we have a little fun thing that we did today that we could talk about.

Cindy Barshop: Okay, good.


Olivia: First of all, let me just say why are vaginas and sex such a taboo subject to talk about and why are you okay with talking about it?

Cindy Barshop: I'm here to make sure other women talk about that because the more we talk about it, the more we could get it out there for everybody. It's not a taboo subject. Feeling good about yourself? That should not be taboo. And taking care of yourself right now by doing the femilift and all these different treatments, you're making yourself feel good and healthy. It's like doing a million kegels. How many years have they talked about kegels? Even my grandmother-

Olivia: My mom taught me about kegeling when I was, like, 15.

Cindy Barshop: The whole world doesn't know how to kegel, but now-

Olivia: Kegeling is important.

Cindy Barshop: Kegeling's important. Okay, but you could do one million kegels in one minute with this treatment. Oo, ding.

Olivia: Oops. You mentioned the femilift.

Cindy Barshop: Mm-hmm (affirmative).

Olivia: You do this at the Medispa.

Cindy Barshop: Yes.

Olivia: Tell everyone what the femilift is.

Cindy Barshop: Basically, what I was talking about before is it's actually regenerating tissue to make it healthy inside your body. It's like doing the 50 million kegels in five minutes. If you have any problem with dryness, which you may say, "Oh, I'm fine," but you could be better. If there's anything with, "Oops, I peed in my pants because I laughed so much."

Olivia: It happens.

Cindy Barshop: Which is very normal. And if you want to get a little more friction when you're in the bedroom, you come in. No pain, no downtime, no risk.

Olivia: Really nice. Then, something that we both shared in today.

Cindy Barshop: [crosstalk 00:02:43] I gave you what?

Olivia: I received an orgasm today, and so did you.

Cindy Barshop: Yes, I did. We did it together.

Olivia: Yeah, we did it together. If you go to Distractify Snapchat, I documented my entire experience and Cindy's experience with the O Shot. Talk about what the O Shot is.

Cindy Barshop: Okay. A lot of times women orgasm, but it takes a long time to orgasm or none of us orgasm while we're having sex. We have to kind of a little rubbing here and there. With this, it allows you to orgasm quickly, but not too quickly, and allows you to kind of intensify it, and then there's some women who really don't have great orgasms. Basically, what we're doing is we're taking your own blood, platelet rich plasma.

Olivia: Right here.

Cindy Barshop: How come I didn't get a bandaid?

Olivia: You must've [crosstalk 00:03:26].

Cindy Barshop: Anyway, straight from there. It's injected into the hood, which we learned today.

Olivia: The hood.

Cindy Barshop: And the g-spot, and it actually pushes it out. It's all good.

Olivia: There's no pain involved, which I experienced today. I thought it was important to get the shot myself to talk about it and make sure that everyone knows it's not a lie. There's no pain involved. I felt nothing. I felt pressure, but normal pressure.

Cindy Barshop: You know I had no pain.

Olivia: Yeah.

Cindy Barshop: I have the world renowned gynecologist, Dr. Caroline Delucia.

Olivia: Okay.

Cindy Barshop: She is a specialist in women's sexual health. Show your face, please.

Olivia: Come in here, say hi to everyone.

Cindy Barshop: Hi. She just did the [crosstalk 00:04:04].

Dr. Delucia: Hi.

Cindy Barshop: She did it with us.

Olivia: She's been really busy today with our vaginas.

Cindy Barshop: And everybody else's.

Olivia: Thank you.

Dr. Delucia: My pleasure.

Olivia: If you have any questions, make sure to ask, ladies, about VSPOT, about the O Shot. There's probably a lot of frequently asked questions that you get all the time.

Cindy Barshop: Yeah, there's tons of them. One, does it hurt, or am I going to be orgasming when I'm walking? No, you're not. Is it healthy, is there any downside, or any risk? There's no risk. You're using your own blood, but I will tell you this. Make sure you go to a gynecologist to get it done who's been certified by Dr. Delucia because she trains everybody. It makes a difference. You're not going to go to a, I don't know, any doctor club. This is what I get sometimes. Can I say this?

Olivia: Yeah.

Cindy Barshop: How much is it? Really? How much is it? We're talking about the best in the world.

Olivia: The best ever. How much is it?

Cindy Barshop: Too much for you, then. For the O Shot, it's 2500.

Olivia: It's totally worth it. I already love it. I already love it, so I'm gonna keep everyone posted and tell everyone what I think of my experience with the O Shot.

Cindy Barshop: Good, you should.

Olivia: I guess what stages of life do you see women in here?

Dr. Delucia: All stages.

Olivia: All stages?

Dr. Delucia: Absolutely. Someone young like yourself who just wants good to be better, and there's no harm in that. Really it just magnifies the pleasure that you can derive from [crosstalk 00:05:30].

Cindy Barshop: A lot of moms.

Dr. Delucia: A lot of moms.

Cindy Barshop: Lots of moms. That's a big thing. Mostly it's either your age who like the better sex, unless there's a little problem and they don't lubricate enough.

Olivia: Yeah.

Cindy Barshop: Well, not even looking for more. Increased desire increases relationships, I think. You have no choice

Olivia: I feel like men are probably a really big fan of this, as well.

Cindy Barshop: Of course.

Olivia: It helps relationships.

Cindy Barshop: The pleasure. Wait a minute-

Dr. Delucia: Exactly.

Cindy Barshop: Think about taking the pill. Every guy out there, you should buy your girlfriend an orgasm in a box for the holidays. You know why?

Olivia: I received an orgasm today and I know a lot of men would probably like it if their women also experienced an orgasm.

Cindy Barshop: It takes the pressure off.

Olivia: It's a lot less pressure.

Cindy Barshop: A lot less work. It feels better for the woman.

Olivia: You guys, ask your questions about vaginas. We're here to talk about vaginas. How many times can I say vagina in one video?

Cindy Barshop: Never enough.

Olivia: Please like and share this if you're interested in vaginas or if you're interested in what VSPOT is doing. How can people find VSPOT/-

Cindy Barshop: They can just go online. VSPOT Medi, M-E-D-I, Spa, S-P-A, or call, or call!

Olivia: Call.

Cindy Barshop: Call 1-800. Wait, I don't even know. 408-VSPOT. That's it?

Olivia: Oh, I have it. Here.

Cindy Barshop: Oh right.

Olivia: We'll put it on the comments section below with the website, since no one can remember a random phone number. I do want to say I don't want women to come here because they feel like they are not good enough in bed or this is their problem.

Cindy Barshop: Thank you for bringing it up. It's about empowering women. It's about empowering women to take control of your life and your sexuality to make sure you feel good. There's no reason. How many times, let's be honest, we're like, "Oh, you're great." That's the truth. How many times ... Have you ever done it, said, "You're great,"?

Olivia: Yeah.

Cindy Barshop: No, everybody's gonna be great. But then, there's also-

Olivia: Everyone's so great.

Cindy Barshop: I know, but then everyone's gonna be good. It's gonna be like, "Oh." No, no. The other thing is we really do help women, especially moms who've gone through the child birth. Nothing bounces back. This is simple, it's painless, it's not surgery. This technology has caught up right now. We don't have to kegel anymore. I'm not saying don't exercise, but take care of something that's so important in your life.

Dr. Delucia: Absolutely.

Olivia: I'm kegeling right now.

Cindy Barshop: You don't have to kegel anymore.

Olivia: Well, I am, just-

Dr. Delucia: Just because it's fun because it feels really good right now.

Olivia: Can you tell? Random question. I'm comparing my vagina, the surgery ... Not the surgery, the procedure that I just did, like I'm a vampire and I just sucked my blood into my vagina.

Dr. Delucia: Yes.

Olivia: That's kind of ... I'm trying to put it into non medical terms for people.

Dr. Delucia: The vampire vagina.

Olivia: The vampire vagina.

Cindy Barshop: The guy who started it, right? With the vampire facial. It's the same idea.

Dr. Delucia: That's right, Dr. Charles Runels. Yeah.

Cindy Barshop: You're taking your own blood and you're putting it in your vagina.

Dr. Delucia: Yes.

Cindy Barshop: I like that, the VSPOT Vampire Vagina.

Olivia: Vampire Vagina. What kind of testimonials have you heard from women who have come in and gotten either the femilift, or the O spot?

Cindy Barshop: Can I say [inaudible 00:08:30]?

Dr. Delucia: Please.

Cindy Barshop: I have to tell you, this is one of the best businesses I've ever been in because it makes me feel good when they come back and they basically say, "You changed my life." If you can't have sex, and you're not lubricated enough, and you're not orgasming, and now you are, think about it. It really, really makes you feel good.

Dr. Delucia: Absolutely. The whole thing about these procedures is that it's away of women being able to voice their desires in their own female sexual health to improve their participation in intimacy. I think that we all should enjoy it, and we shouldn't have to fake it, and we should be able to really feel fantastic. When that happens, everyone's happier in that moment.

Olivia: Yes.

Cindy Barshop: I'll say one thing.

Olivia: Yeah, what?

Cindy Barshop: I did it, right, for incontinence because I used to pee a little in my pants.

Olivia: She pees, she pees.

Cindy Barshop: Think about this. Just think about a scenario. I couldn't wear a skirt when I went out, I couldn't wear silk because, oops, how embarrassing is that. When I worked out, I had to wear a pad.

Olivia: I almost told a really embarrassing story of my mom's just now, but I'm gonna keep it locked, but it involved peeing. [crosstalk 00:09:38]

Cindy Barshop: As you get older, peeing doesn't seem like the same thing. After you have a baby-

Olivia: Michael, stop.

Cindy Barshop: When you have parents who are older, all you do is talk about what comes out of the body.

Olivia: It's always, it's always.

Cindy Barshop: Thank god we're only on the pee level.

Olivia: Reminder, we're at VSPOT Medispa. I've along with Cindy, the founder, just got the O Shot and I've had five orgasms just sitting here. Just kidding, but it is national chocolate chip cookie day and I might eat a cookie and, whoop, there it goes. Okay.

Cindy Barshop: Who's going to be eating the cookie? Where are you gonna put the cookie? I didn't mean it ... I did mean it like that.

Olivia: In my vagina. Okay. Will there ever be a P Shot for men?

Dr. Delucia: There is a P Shot for men.

Olivia: Michael!

Dr. Delucia: It's called the Priapus Shot and it works miraculously. Again, we draw blood, we spin it down, we take the platelet rich plasma, and we inject it directly into the penis, painlessly at that.

Olivia: Painlessly.

Dr. Delucia: Once again, it works on erectile tissue. It's for magnifying erections, making them stronger, better, more durable, things like that. They can help men with premature ejaculation and just the effectiveness of their erection.

Olivia: This is amazing.

Dr. Delucia: It's fantastic.

Olivia: If anyone has any questions for these professionals or just [inaudible 00:10:58] now, I'd be happy to answer from a personal perspective. If not, we have rapid fire coming on.

Cindy Barshop: What's rapid fire?

Olivia: Rapid fire is my favorite part, and I think everyone's favorite part. Don't take this too serious, okay? Let's have fun.

Cindy Barshop: Okay, go.

Olivia: We're gonna have fun. Okay. You can both answer, whatever. Favorite sex position?

Cindy Barshop: 69.

Olivia: 69?

Dr. Delucia: Mine?

Olivia: Yes.

Dr. Delucia: Probably me on top.

Olivia: You on top? Woo! Yes, queens. I like it from behind. Your least favorite sex position?

Cindy Barshop: Blow jobs. That's embarrassing.

Dr. Delucia: Is that a sex position?

Olivia: I-

Cindy Barshop: I don't know. I was just thinking about sex, what comes to my head first. That's what came to it.

Olivia: Blow jobs. She doesn't like them.

Cindy Barshop: I'm not into.

Olivia: If they had the P Shot maybe, though.

Cindy Barshop: Yeah.

Olivia: Maybe then. Least favorite, okay we did that. Favorite type of vibrator or do you like vibrators?

Cindy Barshop: I'm beginning to love vibrators.

Olivia: Yeah?

Cindy Barshop: I have [inaudible 00:11:57]. Honestly, [inaudible 00:12:01]. It looks like the [inaudible 00:12:02]. I wish I had it.

Olivia: Where is it?

Cindy Barshop: It's in the other room.

Olivia: Okay.

Cindy Barshop: Wait, this is the coolest thing. We actually had this vibrator [inaudible 00:12:11]. It's to help with urinary incontinence, but it also has a rabbit on it. Then, it has this micro current. I'm telling you, I orgasm internally with it.

Olivia: Really?

Cindy Barshop: I'll give you one.

Olivia: I'll take one. I want to [inaudible 00:12:24].

Dr. Delucia: I took one.

Olivia: Woo! Best piece of advice for women struggling to orgasm besides getting-

Cindy Barshop: Besides getting the shot? I would say kegel, use a lot of vibrators, and know where your spot is.

Dr. Delucia: Yeah, learn your own body. I think that's the biggest thing is don't be shy in exploring and experimenting. I think that women need to be comfortable to do that. Once they figure that out, they can guide their partner in doing the same.

Olivia: Yes.

Cindy Barshop: Let's not make a joke of it. I don't believe in the whole mirror thing, look in a mirror and all that. I don't believe in that.

Dr. Delucia: Oh no.

Olivia: I've never done that.

Cindy Barshop: Okay, good.

Olivia: That's not ... yeah. Estimate how many orgasms have you faked in your lifetime.

Cindy Barshop: Oh, god. I mean, I can't count it.

Olivia: Like, I can't. It's so many.

Cindy Barshop: No, I've pretty much faked it with everybody I've been with at one point.

Olivia: Could you win an Emmy for your-

Cindy Barshop: No.

Olivia: Can you fake one right now?

Dr. Delucia: Cindy Barshop faking an orgasm.

Olivia: Cindy Barshop fakes an orgasm on Facebook Live.

Dr. Delucia: I suck at that.

Cindy Barshop: Come on, come on. Imagine you're fucking some [inaudible 00:13:36].

Olivia: Alright, alright. It's the shot, it's the shot. We're getting [crosstalk 00:13:42].

Cindy Barshop: [crosstalk 00:13:43] in this?

Olivia: Yeah, we do it all the time.

Cindy Barshop: Okay.

Olivia: True or false ... Oh, actually we already did that. True or false, woman on top is the best way to orgasm.

Dr. Delucia: Yes, it is.

Cindy Barshop: Really?

Olivia: Yes.

Dr. Delucia: Yes.

Olivia: Okay.

Dr. Delucia: Yeah, because we're in control. We can control the depth of penetration, plus the amount of friction necessary. That's why.

Cindy Barshop: Really?

Dr. Delucia: Absolutely.

Olivia: Everyone out there, ladies, let's try living on top tonight, huh?

Dr. Delucia: If you haven't tried it, it's liberating.

Olivia: Okay, this is true or false and I hate this kind of stereotype. If her vagina is loose, she's been around the block.

Cindy Barshop: False.

Dr. Delucia: Absolutely false. Absolutely false. No. There is no correlation and there's no way to tell. Looseness. Matter of fact, a woman who's truly aroused will be pretty loose. That just means maybe he's doing his job.

Olivia: Good job dudes, but don't judge her if it's loose.

Dr. Delucia: Exactly, exactly.

Olivia: Just take pride, take pride.

Dr. Delucia: Enjoy it, enjoy it. Exactly.

Olivia: Okay, last true or false. Your vagina looks the same for your whole life.

Dr. Delucia: Absolutely false.

Cindy Barshop: False.

Olivia: False.

Dr. Delucia: False.

Cindy Barshop: Sorry.

Dr. Delucia: We go through changes. Does our face look the same throughout our entire life?

Olivia: Certainly not.

Dr. Delucia: Therefore, it helps ... And do men's genitalia look the same their whole life?

Olivia: No.

Cindy Barshop: No.

Dr. Delucia: Neither does [crosstalk 00:14:58].

Cindy Barshop: But we can make it look pretty without surgery.

Dr. Delucia: Absolutely, we can-

Cindy Barshop: [crosstalk 00:15:01] the surgery.

Dr. Delucia: Yeah.

Olivia: Okay, this is a question for you. You don't have to answer. Will you be showing up on the Real Housewives of New York.

Cindy Barshop: I don't know.

Dr. Delucia: She doesn't know.

Cindy Barshop: You mean this year?

Olivia: Whenever.

Cindy Barshop: I think I'm on it next week.

Olivia: Okay, well everyone [inaudible 00:15:17].

Cindy Barshop: [inaudible 00:15:19].

Olivia: I was a big fan and then I met her and I was like, "You're the coolest human being alive." Is there anything I forgot about VSPOT?

Cindy Barshop: No, I think she covered it. I love you. I think you're awesome.

Olivia: I love you guys.

Cindy Barshop: I think you're fun.

Olivia: I love vaginas.

Dr. Delucia: I think [crosstalk 00:15:34].

Olivia: I think we should do-

Cindy Barshop: Wait a minute, you love vaginas and-

Olivia: I mean-

Cindy Barshop: Lets clarify the line vagina.

Olivia: I love the fact that we are empowering women to love their vaginas.

Dr. Delucia: Yes!

Olivia: That was what I meant to say.

Dr. Delucia: I think that's wonderful.

Olivia: We're going to put the link to your website and the phone number in the comments section. Ladies, if you are too shy to comment or whatever, this is in New York City where?

Cindy Barshop: Call and we can answer all your questions. Honestly, this should feel good and comfortable.

Olivia: Yeah.

Cindy Barshop: I would pretty much answer the phone 50% of the time, so you could get me and we'll talk about it.

Olivia: Maybe I'll be here getting something else.

Cindy Barshop: We're always together.

Olivia: Because I love coming to you.

Cindy Barshop: We've become BFFs.

Olivia: Yeah. Oh my gosh, I got my O Shot today and it was the best experience, pain free, and amazing. Loved it and I can't wait to have some orgasms while I'm eating cookies today because it might happen. [inaudible 00:16:30] have an orgasm today.

Dr. Delucia: Cookie day?

Olivia: Today, I might. Go follow on Snapchat @distractify because I'm going to be live snapping the Drake and Future concert. We'll be back tomorrow at 2:30-

“Don’t do it to Single People…”

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Transcript

Speaker 1: Don't do it to single people unless they're sexually active, because it is ... Holy mackerel.

Speaker 2: Well, tell me what you're feeling. Because you only had it done a few days ago.

Speaker 1: I felt, immediately, well, not immediately, not a day but maybe the next day, very ... I feel like I can't touch myself. I'm so sweaty [inaudible 00:00:21] but ...

Speaker 2: Okay. What do you ...

Speaker 1: Just very, very, highly sexual. So it seems like a great thing. Here I am, my age, and I just feel good that ...

Speaker 2: How old are you again?

Speaker 1: 66.

Speaker 2: Okay.

RESULTS WILL VARY<--

Speaker 1: And, gosh, it really ... I'd rather not explain it. But I will never do this again until I get married, because it's a little bit hard to concentrate sometimes.

Speaker 2: Okay.

Speaker 1: I'm telling you. It's amazing. So, it works.

Speaker 2: All right. Well, I hope that's not causing you too much trouble.

Speaker 1: I'm just like, "Oh, my gosh."

And my girlfriend goes, "Why did you do it?" Oh my gosh.

Speaker 2: But did it help with ...

Speaker 1: Oh.

Speaker 2: Well, I guess it's kind of too early to tell, for the incontinence.

Speaker 1: Well, yeah. I still have that urgency to go to the bathroom. I still wake up and have to go to the bathroom. And the other one, Thermi-Va, helped with that really good.

Speaker 2: Yeah.

Speaker 1: But I was in a relationship then, and it didn't really do what this does sexually. I think I could brush up against something, it just really works, it works, sexually it works. So, just to let you know. I feel embarrassed, but it really works.

Speaker 2: Thank you.


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