A Story of a Small-Town Internist

Charles Runels MD started out as small town internist with a passion for science, a drive to excel and a knack for marketing. His career has been shaped by a series of challenges.

Today his name is synonymous with the most popular platelet rich plasma (PRP) procedures in the specialties of cosmetic dermatology, gynecology and urology. But that's only the tip of the iceberg.

Relax and enjoy the fascinating story of a talented entrepreneur.
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Dr. Charles Runels can be reached at CellularMedicineAssociation.org

Dr. Marco Pelosi III can be reached at DrMarcoPelosi.com

Lasers + O-Shot® Equals Dry in Australia

I was looking through the most recent research about stress incontinence, and saw this really important paper that came out of Adelaide, Australia from some of our colleagues down that way. Stress incontinence is really a severe problem that people don't think about. They think about it more of as a hygiene problem. But when you have stress incontinence, it interferes with your life. You have trouble sleeping. It can make it difficult to exercise, so you have weight gain. You're up in the night, trying to urinate, so you're not as rested the next day. It interferes with your focus at work. So it can be a problem that really changes your life.

That's the definition of stress incontinence, if it's a hygiene problem or it interferes with your life. It's pretty common. Close to half of the women that are 50 and up, and it's 1 in 20 of women in their twenties, so it's a really common problem. It's worth looking at because all the things that have been tried are useful. Some women are able to help this with Kegels. The surgeries are still an important tool that should be used when necessary. The mid-urethral sling, 90% of people get good results with that, only 10% have problems or have it fail. But the problem is that, with the surgery, there is some risk to the nerves that are involved with sexual response. And of course diapers are a last resort.

So there's this new thing called the O-Shot®, where you use plasma, PRP, to inject it in the right place. These authors, they combine the use of our O-Shot® with a laser. So the lasers usually go about the thickness of a business card, not much thicker than that. So it's not a really deep laser, but it's enough to cause some changes and improvement in the structure and the health of the tissue, especially when you combine it with our O-Shot®.

Physicians apply for training and licensing to provide the O-Shot® procedure (your patients will thank you)<---

So let's look at what happened. I think this summarizes it the best. If you look at this picture, in the beginning, at baseline, the people who participated, 62% percent of them were frequently bothered by their incontinence, and 37% were bothered daily. But by the time they finished the study, it was more that shifted quite dramatically, so that you can see that many of them were not bothered at all or occasionally, and only 10% were daily, where it was more like 100% were either daily or frequently in the beginning.

The fun thing about this procedure is that, the procedure being both the laser and combination with the O-Shot®, is that the downside is minimal so that if it doesn't work, you can still go to surgery. But if it does work, and we're seeing over 90% effectiveness with either the O-Shot® alone or combined with the laser, and when it works, you see great results, with the side effect of sex getting better.

So I think it's worth discussing this research with your physician. If you want to find someone who's expert at the O-Shot®, check out our list of providers on our directory, those who are actually licensed to perform the procedure under the standards that we've come up with. So check out the research, read it, and share it with your doctor.

Here's where to read the research<---

Here's where to find the nearest O-Shot® provider<--

A new way to use O-Shot® technology to improve fertility in women

Transcript

This is a very important, extremely important article about the very difficult and heart-wrenching problem of how to help a woman become pregnant who is struggling with a particular form of infertility where the lining of the endometrial cavity is or the endometrium is too thin. If you think about it, and this was pointed out in the article, it's really miraculous that a woman can have bleeding and shedding of the endometrium every month throughout her reproductive years without scarring. Any other tissue in the body would have trouble with scarring. But unfortunately, there are some women who do scar, it's talked about in this study, is Asherman's syndrome where intrauterine adhesions happen, which the miracle is that all women don't have that as this bleeding and shedding takes place every month. Or then some people just seem to have somewhat genetic propensity to it. And then there is this lactobacillus-dominant endometrial microbiome that's supposed to be happening and sometimes that happens to not be the case. There's something other than lactobacillus dominating the endometrial microbiome.

And I know that there are those who poo-pooed the studies of putting yogurt in the vagina, but just as a sideline, it makes sense. There's only two places I know of in nature where lactobacilli live, the woman's vagina, the endometrial cavity and in yogurt. So unflavored yogurt, it really just does help change the flora and there are studies to support that. How many studies we need to make it a prescription accepted thing, I don't know. But I know this, if there was a medicine that had the same sort of biological and logical reasoning for working and I had a patent behind it, you'd see ads about it on television. But anyway, that's a sideline. The bottom line is that some people don't have lactobacillus-dominant endometrial microbiome and some women do have scarring and some people do have thinning.

So there were two studies that are referenced in this article about using PRP, which is known in dentistry and known in wound healing, plastic surgery, orthopedics for 20 years. This is not new science in those arenas, but as pointed out here, it's new to the arena of gynecologists. And you see gynecologist jumping up and down saying, "There's no research to support this." Well, this as in using PRP or platelet rich plasma to help women with urogynecological problems, it's because they've lived in a bubble where this research hasn't existed. If you read dental research or if you talk with dentists, orthopedists, they've quit debating about whether platelet rich plasma does anything. It's not the magic cure-all be-all, but their discussions are on a deeper level about what does it do and what can we do with it and what can we not do with it.

Hence, you're starting to see, as pointed out here, that there has been minimal investigations in date in gynecology about PRP, but minimal in relations to other domains or specialties like dentistry and orthopedics, but still a growing number. And hopefully in the next 10 years, it's usually 20 years for a new idea to take effect, we're 10 years in with the O-Shot®, so probably in the next 10 years it will become widely done. Just watch, it will happen.

So what's happened is there've been two people published studies showing that infusing the uterine cavity or in bathing the endometrium with PRP helps rejuvenate the tissue to make it healthier, to enhance the probabilities of becoming pregnant for a woman with the problems that happen with endometrial thinning. So hence, this study to say, "Okay, we have those clinical reports. Let's look on a cellular basis in vitro, in a culture, outside of the body with those cell types and see what happens with platelet rich plasma."

So they use saline as a control. They use platelet rich plasma and platelet poor plasma, and they found that platelet rich plasma does enhance the growth of the right kind of tissue and migration of the right kind of cells to the right place for the same things you see in dentistry to prevent scarring and to grow healthier, more vascular tissue, which in theory would explain why they saw the effect in the two studies that were done to show that it may actually help women with this as a cause of their infertility. The other thing is that we have in vitro studies showing that PRP, which is what your body normally makes ... It's not some esoteric thing. When you scraped your knee as a child, PRP is what caused the scab and the healing and the regeneration of the skin. PRP's what happens every time you have surgery or you have a wound. That's how it heals. The platelets bring growth factors, the [inaudible 00:05:11] cascade happens and you recruit stem cells to the area and you grow new tissue.

It's not a new idea. It's been around since people have been wounded. When people fought in the middle ages with swords, the PRP healed the wound. So it's not a new idea. The newness is, how can we take what's already happening in the body and harness that to help people with disease. The other thing is because we know that's part of the healing process, we have multiple studies showing that PRP has anti-microbial ... It acts as an antibiotic. And it could be that's another reason that's happening, because it may help take care of the bad microbes and therefore help the good microbes or lactobacilli flourish.

That's a reach for the explanation, but it's in line. It's not homeopathy or some weird idea from outer space. Homeopathy as not in nutrition as some people apply it, but homeopathy is one part in 10 million somehow make something happen, which doesn't happen. So this is not homeopathy. This is a logical thing that's backed up by every time you heal a wound and by 20 years of research in other arenas and now it's finally becoming more commonly done. We've done it with the O-Shot® now for the past 10 years to help rejuvenate the tissue around the urethra. It doesn't work in everybody, just like antibiotics don't' working in everybody. 5 to 10% of people in the hospital with pneumonia still die, even with antibiotics. 30% of the people in the intensive care unit with pneumonia still die even with antibiotics. But we don't say antibiotics don't work. They just don't work all the time because sometimes a person, their milieu or their body's not able to heal itself for whatever reason.

In the same way, maybe the problem isn't the vagina. Maybe the problem with infertility is hormonal issues or low sperm count with a man. This isn't the end-all, be-all, cure-all, but it's a very intelligently designed way to help a woman who has endometrial thinning or scarring of the endometrium as a cause for her infertility and it should definitely be studied. The problem is, as we found with the O-Shot® procedure, funding is difficult because there's no patent on blood, so yay for these investigators who had to do this out of their own pocket as we have had to done with the O-Shot®. I've spent over $300,000 just in a couple of years with research on the O-Shot®. More coming. We'll spend another 100,000 this year. It's funded by the physicians in our group, who by the way, should be giving money back and almost all of us do, if a patient isn't happy.

You can't be preying on people's pocketbook if you're not keeping their money, if they're not happy. I started taking cash in 2003. I've never kept a penny of a patient who wasn't happy. In that case, we've lost our money and we've lost our time and we're very sorry the person isn't well and we try to find something else to help them. Every procedure is with risk and without 100% guarantee. Every procedure has risk and every procedure is without 100% guarantee. So there's a consent form with our procedure. If you have the O-Shot® or if you have PRP infused into your endometrium, you should read the consent form. You should understand that you don't have to be treated at all. You certainly don't have to be treated with PRP. You should make sure that someone in our group has agreed to use FDA devices that are designed to prepare platelet rich plasma to go back into the body.

If things don't work well, you should discuss it with your physician and continue to demand that someone help you. Don't give up. Sexual function is so important. It's more than about pleasure. It's about relationships. It's about the psychology of feeling whole. It's about even spiritual enlightenment. Hence, the ideas of chastity when it comes to spiritual enlightenment in many cultures and religions. Sexuality has to do with creativity and personality. So it's not just about pleasure, it's about part of the foundation. Emerson said it was the scaffolding of love, hence the scaffolding of our families to build. Maybe you don't need a scaffolding after the empire is built, but it helps build the building of your relationship with your lover. So consider this talk with your physician about it. If your physician wants training, we have training. We have teachers around the world. We have over 2000 doctors in our group. We have people in over a dozen medical schools. We have ongoing research. Read it, think about it, talk with your doctor about it, and let's push our tools for healing women.

It breaks my heart when, when it comes to sexual dysfunction, we keep offering women vibrators and lubes or psychological. Everything's not in your head. If you have an endometrium that's thin, that's not in your head. That's in your endometrium. If you have scarring from having a big baby that tore the vagina, that's not in your head. Hence, the treatment is not psychological medicines that affect the brain. And there's better treatments than just a lube and a vibrator. We have so much better science than we did. I hope that you'll investigate. Read the science for yourself. Don't just blindly listen to the naysayers. Usually, 20 years for a new procedure to take effect in medicine. Read the science. Talk with your doctor and take care of your body and value your sexuality. I hope this helps you or someone you love.

Read the research-->>(click)-->In vitro evidence that platelet-rich plasma stimulates cellular processesinvolved in endometrial regeneration<--

Yogurt for healthier vagina-research

PRP as antibiotic--research

More O-Shot® research<--

Find nearest O-Shot® provider

Physician training for O-Shot® procedure

Cellular Medicine Association

Research for Incontinence and for Better Sex

Here's new research about how to improve urinary continence in women...

Click here to read the research<--

So stress incontinence is a really serious problem that can affect your life and in ways that are sometimes difficult to deal with it, both in your personal and your business life. It can make it difficult to focus at work. It makes it difficult to get through a meeting, difficult to travel without stopping, it wakes you up at night, it makes it hard to exercise because you might be leaking urine and you're not sleeping well so it makes it hard to feel rested during the day so it's a significant problem and a lot of research going on trying to find an in between.

The pills that you take can sometimes cause anticholinergics can cause trouble with constipation, trouble thinking and associated with dementia and surgery is a viable option but all of us would like to avoid surgery if we can. So here's a really interesting study where they looked at successfully using autologous drive muscle STEM cells. Autologous muscle drives cells to grow, not STEM cells, but muscle drives cells to grow the bulk of the sphincter that helps a woman control her urine and actually it's not a circumferential sphincter like a man, it's more like a flap which makes it more difficult to hold urine and that flap is only a few cells thick so increasing the strength, just like you strengthen your bicep might help with that and that's exactly what they showed; significant increase in sphincter volume as in a larger bicep muscle instead of larger sphincter volume or muscle to hold the urine in when compared with the placebo group.

So check this out. It's not something that's mainstream yet as far as being able to offer but you might want to talk with an alternative which does something similar which is using PRP. In the athletic committees have sometimes even banned platelet rich plasma because not only does it heal tissue, but can add sometimes strength to the muscle.

So it's possible that one of the reasons our O-Shot is improving incontinence is because platelet rich plasma can increase the muscle strength as well as improve the health and the blood flow around the tissue. So a side effect could be improved sexuality response with orgasm or ability to have orgasm. So you might want to talk with your physician about this if they're not a provider, there's training on the website and we have a list of licensed providers on the website that are already trained, agreed to follow strict criteria and with the FDA approved devices.

It's not for everybody but that's who I would contact to find out more information about this or talk with your physician about becoming certified or licensed to do the procedure. Hope you find it helpful and you'll share this idea with your physician or with someone who might be suffering with incontinence.

Find nearest O-Shot® provider

Urinary Incontinence & Vaginal Laser. New Research

Transcript

Charles Runels, MD: So urinary incontinence can be an extremely family and social disruption for you. Surprisingly common, it's around half of the people by the time they reach 50. Half of women have incontinence and incontinence defining as interfering with your social life or your hygiene. You know a few drops doesn't matter, but if you're having to stop doing the things that you do or wear a pad that's incontinence. And then occurs in one in 20 women in their twenties about 5% of women in their twenties. So young women may have to stop their cheerleading or their gymnastics because of incontinence. It's not just from childbirth or from aging.

So it's really important that we find better answers. We have surgical solutions, but before we go to surgery it's nice if we can find something more quickly or acting with less trouble and less downtime.

So people are starting to look at using lasers. This is a really nice study that was published this month. Obstetrics and Gynecology Reproductive Biology, respected journal where they talk about using a laser. Now, the interesting about these lasers is that the depth of them is about the depth of two or three pieces of paper. It's actually more shallow than a business card. So it's really, a tiny pinpoint laser made holes that are in a grid, but it's no deeper than several pieces of paper. So it's reasonably safe and in the right hands it can really change lives.

So these people did this study showing that not only did it help many women with their incontinence, but it also as a side effect helped their sexuality. So worth looking at if you have this problem and asking your doctor about.

Now most of the leaders, and the thought leaders using lasers to help with urinary incontinence are also combining it with platelet rich plasma and a procedure called the O-Shot. And it seems to enhance the effects of it.

Lasers have been known to improve the results and the speed of healing for facial lasers for 15 years. So we're seeing the same thing when you combine the laser with PRP. So ask your doctor about it. If you want to know more about it, there's some links below this video to check out. Hope you find this helpful.

 Find nearest O-Shot® provider<--

Here's where to read the research<--

Treating dyspareunia (painful sex) after breast cancer

research from Menopause<--

Research about building healthier vaginal tissue<--

Transcript

Charles Runels. Somewhere around one in eight women in the United States will eventually suffer with the effects of breast cancer. Thankfully most women who have breast cancer will survive it, but unfortunately they survive with some problems that might plague their love life. One of those is dyspareunia, or painful sexual intercourse, due to the fact that vagina may be dry with hormonal changes that are secondary to the treating of breast cancer. So it might be helpful to look at a couple of papers involving that.

This paper was published in SKINmed here on PubMed. You can see the whole paper if you click up here and find it. But these guys talked about using platelet rich plasma and how it uses the same technology, or the same bowel Segler strategies, that are used in the face and in growing hair, to help the tissue of the vagina become healthier, even when there's no estrogen. Which it's better to have estrogen on board, but if you can't have it because of breast cancer, as much as you would like, this is a great way to help the tissue become healthier and more moist. And so this is one paper that talked about it.

Another one of my favorite research papers appeared in Menopause, a highly respected journal, where they use platelet rich plasma and documented that the pain from the sex went down because they were lubricating better after having an O sharp procedure done. So I highly recommend you forward this to anyone you know who may be struggling with this. There's ... breast cancer is ... it's not just about the cancer. It's how it affects families and love relationships. So it's a serious problem. And there are other ways to do it. You could use a lubrication, you could use lidocaine cream, but it seems to me nothing would be better than actually making the tissue healthier. So I'll put links to this research below the video, and I hope you'll share it with anyone who might be helped.

Find nearest O-Shot® provider<--

 

 

 

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)<--

Here's where to find the nearest provider<--

Here's where physicians and physician extenders may apply for online training<--

Here's our next hands-on courses with live models for qualified providers<--

More about the Cellular Medicine Association<--

Reviving Ovaries to Improve Life



Find provider<--

Read the research mentioned in the video<--

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<--

Find nearest O-Shot® provider<--

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<--

Find nearest O-Shot® provider<--

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.

Apply to become an O-Shot® provider<--

British Journal of Medicine Mentions O-Shot® for Stress Urinary Incontinence

Click to Read

References

British Journal of Medicine<--

Medical Hypothesis<--

More Research<--

 Find Nearest Provider<-

Apply to become a provider<--

FOX News Talks Sex in Women After Breast Cancer (and More)

Ageless Expressions <--

Find nearest O-Shot® provider<--

Apply to become an O-Shot® provider<--

The Clitoris Unveiled (What Every Doctor and Lover Should Know about the Hidden Clit)

Every doctor and every lover who wants to truly understand the Clitoris (all of it, even the hidden parts, should read this book).

By Dr. Elizabeth Owings, MD

 

 

 

with Anne Kent Rush

Click to see on Amazon

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<--

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

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<--

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

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.

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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.

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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.

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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.

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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.

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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...

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Charles Runels:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Sexless Marriage

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

So how do you rev up the sexless marriage?

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

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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.

Find O-Shot® provider<--

For physicians & nurse practitioners interested in applying to our provider group<--

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.

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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.

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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

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