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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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.
Nory: So, Dr. Runels, let’s begin by you telling our readers a little bit about your medical background and anything else you’d like to share with them.
Dr. Runels: As far as my background as a scientist and a physician, I had a strong math interest and worked for three years as a research chemist, and then I went to medical school and wound up doing emergency medicine for 10 years or so, 12 depending on when you want to start counting. My boards were in internal medicine, so I started doing some research and opened a practice, did some research with hormone replacement, so 18 years ago, before Suzanne Somers wrote her first book I was doing testosterone pellets and did some research projects with growth hormone. That’s what made me in tune with women’s sexuality. I didn’t set out to be a sex doctor. I set out to take very good care of women as a physician.
I don’t really even like the word. I don’t like when people say that’s “alternative medicine.” This isn’t alternative medicine. This is medicine that looks for what works, and if it happens to be something not in a bottle that you buy at the pharmacy that doesn’t make it alternative. So, if I’m using, say, nutrition, how is it that two milligrams of medicine can be more powerful than the pounds of food that you put in your body? Or, if I’m using exercise or if I’m using your blood in the case of these procedures, if I’m using things that are backed up by research, like walking three miles a day has been proven to do more for your heart and your blood pressure and your risk of heart attack than any drug on the market, including blood pressure and diabetes drugs. So, that’s not alternative, that’s science.
So, anyway, I have a strong science background and I was doing research, but I also had a background, i used to work as a trainer at the YMCA, so I understood physiology and exercise from a personal standpoint and from coaching a lot of people back in my college days as an exercise guru sort of guy. So, all those things sort of meshed together and as I was taking care of women in the most excellent way I could think of, using science, but not always medicine. I’m not anti medicine, but using science and hormone replacement all of a sudden I had a flood of women 18 years ago realizing that somehow they were getting better and their friends were getting much better than what was being done down the road by what was done for women 20 years ago which was just Premarin, basically, don’t do any blood tests, throw a little estrogen at you and hope that your hot flashes go away.
So, that’s sort of how I got to where I am as far as being attuned to women’s sexuality because they would come crying to me about what was happening with their life, and you can’t do their hormone replacement, in my opinion you can’t take care of people well unless of think of endocrinology and you can’t do endocrinology and hormones without asking questions about sex. It turns out that those questions I was comfortable asking about sex were unusual, and I didn’t know it at the time but most doctors are afraid to talk about sex. They don’t want to talk about sex. And research shows that if a woman asks their doctor about sex, which most of them never do, only 14% ever ask their doctor a question about sex, even though half of them have problems, research shows that the doctor will change the subject after answering the first question over half the time.
So, I didn’t realize I was being unusual in listening and trying to heal the relationships when women would come crying and say, I love my husband so much but I’m afraid to tell him that I’m having pain when we have sex or that I’m not aroused, because I love him and I don’t want to tell him, I don’t want to hurt his feelings. And they’ve never told their doctor, their husband, or their preacher or their best friend.
So, that’s sort of the quick version of how I got to be the guy that’s now … has done research in this area and working with a couple thousand doctors in 50 countries.
Dr. Runels: The O-Shot® was a sort of a coming together of ideas, one, with the research background as a chemist I was already into instrumentation. I actually did some work, one time considered becoming a biochemical engineer, not a biochem but a medical engineer, designing instrumentation. So the centrifuge has fascinated me. I ran a wound care center at a hospital nearby when I was a [inaudible 00:04:51] so I was into healing of wounds. Then I had the women crying about their sexuality and I had an injection practice because I found that women oftentimes want to quit losing weight, because when they lose the weight in their face their wrinkles start to show up more. So I had made myself an expert at cosmetic injections, not just for the benefit of that but to help encourage women to continue to lose weight with me when I got their metabolism right.
So, now you got wound care, injections, and all those things come together, and I thought, oh, wow, what if you took this technology where you’re using platelet rich plasma and heal tissue and I pulled it over and used it in this arena where women have problems with pain or sensation or function of the genitourinary space. So, that’s kind of how it all came together.
Nory: I read a story about the Priapus Shot® and feel free to tell this or not, and we don’t need to include it in the interview but I sort of remember that you had a partner, wife or a girlfriend who said, hey what about me?
Dr. Runels: I gave you the short version. So I’ll fill in the blanks. So, when I was first introduced to platelet-rich plasma someone was telling me … because I was doing cosmetic injections, use it like Juvederm in the face, you get new volume, new blood flow, and there’s never been a documented side effect, serious. So, to this day there’s still with over 9,000 research papers, now getting to Priapus or the penis shot, but there’s never been, in 9,000 published research papers one serious side effect from platelet-rich plasma, as in no infections, no necrosis, no neoplasia, no granulomas. But you get new blood flow. It’s been documented in multiple biopsy studies you get new blood flow, you get healing, all the [inaudible 00:06:47] regulation hyperimmune status and other things.
So, when he told me that, new volume and new blood flow, I thought, well, I’ve got a better place than my face for a new volume and blood flow, thinking like a man. So, I thought I’m going to do things with the face before I try this in my penis. So, for four months I injected faces and I watched and yeah, people would come back and their face would be glowing, and they would tell me their friends and family were saying their face was glowing. So I thought, okay, let’s try it. It took me a while to get up my courage because I thought when it makes this matrix, which it forms a yellow goo like surrounding a scab, when the matrix forms, that goo forms, that’s what holds the growth factors in place. But if that’s in a wound say, on your hand, you’ve got blood flow coming from beneath so it’s not a big problem. I was thinking if that goo formed inside a penis it may cause necrosis or cause something bad to happen, maybe an erection that won’t go away or priapism or something.
But I tried it and it worked. It seemed that it was helping a little bit with size and a little bit with erection and some of my patients, a lot. So, I had been doing that for a few months, and following the other part, because I actually, to this day, take care of more women than men. I was doing this for selfish reasons, thinking how to make things better for men, and I thought shoot, if I could make it to where the average man could grow his penis a half an inch I’ll get my picture on a postage stamp.
Three Categories of Women Who Suffer with Sexual Dysfunction
So, I’m working on that but I’m still mostly taking care of women, and I have a heart for women and actually part of what led to me taking care of the men is that, when I would get women happy and make them … take a woman who’s 40 pounds overweight, she’s 40 years old, she feels tired and her sex drive is low. When she loses the weight and her sex drive is high and she can think well again, three things could happen. I got to where I could almost tell when the woman walked in the room, which of the three it is.
Okay, picture that woman. If she’s got a lover who’s kind to her, who’s healthy, who has a good sex drive, they could live happily ever after, there’s nothing left for me to do. If she’s got a lover who’s been abusive to her because she’s been overweight and low self esteem and now she gets her sex drive back, she’s out the door, there’s probably nothing I should try to do. I don’t know, but there’s probably nothing I can do because she’s been kind of under the thumb and now that she’s got her sex drive and her health back she’s gone.
The thing that bothered me was the third category, and that’s the woman who comes in and she loves her husband and he’s not well. Now, you make her well, she’s got a sex drive, and the man or woman that she loves can’t keep up with her. Now you got a problem, because they love each other and you’ve created a mismatch that’s causing a conflict. That bothered me. So, for that reason I made myself an expert at men’s sexuality.
I’m working on that part of it but I have been following what has been done for injecting around the urethra. That’s been done for the past 15 years, with collagen, with hyaluronic acid fillers, with collagen, with hyaluronic acid fillers, with, it’s really what you’re doing with the sling. It’s just a way of changing the contour of that area with some of the surgeries. So, finally I had this girlfriend at the time, who said, “Hey, I want to try that.” So I said, “Okay, let’s try it.” And the first 24 hours she was so, I mean, she was always a good, she always enjoyed sex, but she became really almost like she was on some sort of drug. If you think about it, drugs are, you know the only bad thing about drugs is that they make you sick, they get you put in jail, but what if you had a drug that was legal, that made you happy, and wasn’t going to put you in jail? That’d be a good thing.
You could say running becomes a drug like that for some people. The endorphins from running. So all of a sudden, here’s something I’ve done that in theory should make her body healthier, but it was like a sex drug to her. So I thought, and she was just insatiable for about the first 48 hours, so I thought, I should try this with some people that have problems, because it makes sense it should work. So the first woman I treated after my lover had been abused by her ex-husband in the genitalia. She was scarred in the vagina and the anus to the point where she couldn’t have relations without horrible pain, so she came over on her lunch hour and I treated her and a few months later she was literally engaged to an old high school lover because the pain was gone, and something that took me 30 minutes on her lunch hour just changed her life.
She’s the one who actually said, “Hey, this has made my incontinence go away. I’ve lost weight because I’m running again.” I thought, ‘Well Josh should’ve thought of that.’ So my patients, the people, the women and men who’ve trusted me are really the people who are responsible for this coming about, because they trusted me enough to let me do what the science said should work. Again, [play the 00:12:02] words, plasmids, that’s been researched for the past 15 years for wound healing, but using in that space was a new idea and the people who loved me and trusted me enough to do that were really the ones who taught me the procedure.
I had an old teacher that told me, he said, “You know, if you want the best textbook, it’s not the textbook, it’s the patients you’re taking care of.” And my patients, if you’re writing the textbook, then you’re writing it from what your patients are teaching you, and that’s what’s happened with me. (Chapter 15 introduces the O-Shot® Procedure & is Written by Dr. Runels)
Nory: You know, it’s just a beautiful philosophy and your humbleness is, tells me a lot about you.
Dr. Runels: Well, I don’t know, it’s really, there’s really no, I don’t know if you can call it humble when there’s really nothing that I can claim, except maybe tenacious, being tenacious. Because you know, I didn’t go make this brain, I came with it, and I, the people who’ve been around me gifted me with their trust, but it’s kind of you to say. But I still think most of what we have is a gift from somewhere, wherever you decide that’s from is your philosophy, but I feel like most of the good things we have are gifts. Then we decide if we’re going to take care of them or not. That’s kinda how it works.
Nory: You know, Erin told me, this is a little off subject and we don’t need to include it in the video if you don’t want, but she called you a ‘transcendentalist.’
Dr. Runels: Oh, I don’t, I’m not even sure I’m ‘good,’ but I think that … Emerson had it right when he said really our goal in life should be to be a perfect pipe. But the pipe becomes most useful when it becomes as empty as possible. I don’t know what that makes me; maybe just makes me an Emerson fan, but that’s kinda my goal.
Nory: Well I come from a Unitarian Universalist background so I just said, “He’s close to my heart.”
Dr. Runels: Yeah, he’s an amazing guy. I think he came pretty close to being an empty pipe, didn’t he? Or clean pipe.
Nory: Getting back to our interview, I think you’ve answered a lot about how your women patients’ problems impact their lives, but I’m curious to know, besides the O-Shot® and the nutritional supplements and the hormonal supplements and the other [techniques 00:14:43] you use with them, do you use any other technologies besides the O-Shot®?
Dr. Runels: … The things that can go wrong with sexual function really almost cover almost everything that can go wrong with the body. Sexual function is, I consider it like the cherry on the top of good health. For example, if someone’s depressed, for whatever reason; hypothyroidism, tragedy, whatever it is, sex drive’s gone. If someone’s in pain, for whatever reason, there’s no sex drive. If someone’s got a fever. The sex drive, in my opinion, it can be faked, it can be maybe become artificial through some drug like cocaine or whatever, or maybe through someone being drunk or high or something, but true, healthy sex drive evolves out of many things that have to do with good health, good relationships, good connections. The best, even on a spiritual plane.
So as far as, when you say ‘what other modalities would I use?’ Let’s just take, for example, a problem like can’t have an orgasm. That could be low testosterone, and in that case they need testosterone. It could be pain because they’ve got a scar from having a big baby and they’re associating sex with pain, so that’s not gonna lead to orgasm. In that case the O-Shot® may help. It may be decreased sensation in which the O-Shot® might help. Maybe from previous surgery or childbirth. It could be they’re recoiling from sex because they were abused at some point. At which point sexual therapy might help or some other form of family counseling.
So I like to think of the O-Shot® as a tool, and when the dysfunction involves any sort of dysfunction of the tissue of the genitalia, then that tool comes into play. Now, there’s this dichotomy of thought, and I think you can tell I respect the idea. I mean, I’m a big fan of Erickson as well, I respect the idea that the mind is very powerful …
and can do things that we’re probably very not close to understanding at this point, but the idea to try to cure something with therapy that might be made better with something, a physical thing, seems to me like taking things … Jefferson, Thomas Jefferson, ‘I always grab things by the smooth handle.’ The smooth handle is not always therapy. But sometimes it is THE handle. So, for example, if someone has, back to that example, if someone has trouble with orgasm and they have the pain from intercourse, sending them to therapy is not the right thing. I like to think of it like a system. On the other hand, if they were abused and their genitalia is working normally, the O-Shot® is not the right thing.
I’ve been in situations where the therapist somehow had the impression that I thought I had a magic shot that makes everything better. I don’t, but on the other hand I don’t think therapy necessarily makes everything better either. I like to think of it as a system, and it’s a very complex system. For example, we think of a respiratory system, and if you said you’re short of breath, that could be because you’re anemic. It may not have anything to do with your, if you’re profoundly anemic because you’re, whatever, you’ve had colon cancer for the past 20 years or 5 years and you, without anyone knowing it, your red cell count is low, you can’t carry oxygen, so you’re short of breath because you’re anemic. Where another person it may be bronchoconstriction. So one person needs a blood transfusion and iron and a colonoscopy, and the other person needs a bronchodilator.
I think because, again, because of these archaic, almost Middle-Age attitudes that it’s not okay to take care of a vagina, it’s not even okay to say the word ‘rejuvenation’ in the same sentence with the vagina, even though it’s okay to say it with a face, it’s okay to ‘rejuvenate your face,’ but let me talk about ‘rejuvenating your vagina’ and somehow I’m doing something ethically wrong, that’s just archaic. In my opinion.
To avoid that sort of ‘I’ve got a hammer so everything’s a nail’ mentality, I like to think of a system. You can have a respiratory system but I think because of that archaic thinking, no one’s ever said, “Hey, let’s think of an orgasm system.” It’s a pretty complicated thing, and it involves having … Let’s talk about the respiratory system; the nervous system has to be working, sending the signals to breathe, which can be changed by lots of things. You have to have … Bronchials have to be the right diameter. You have to have the right amount of red cells flowing through your blood stream. A lot of things have to do with respiration.
In the respiratory system, you have a neurovascular system, a nervous system, and endocrine system, and the reason we think about systems is because it emphasizes the interplay of lots of different components, and there in my opinion, there’s an orgasm system. Testosterone has to be high enough, prolactin has to be low enough, you need a little dab of estrogen for some carrying, probably need a little bit of oxytocin for some love in there. At the same time you need to have sensation. You need to be conscious, you need to be not in pain. You need to have the right serotonin and dopamine, mill you and your brain to have libido. You get it. There’s this whole complicated system, and all the O-Shot® does, all it does is make the tissue, that part, those receptors, and the functionality of the genitalia more healthy. That’s all it does.
Orgasm & Spirals Up & Spirals Down
Having said that, it can have profound effects on all of it because we were taught … I was taught in medical school, this is how sexuality works. You have arousal, then you have a plateau, then you have an orgasm, then you have a refractory period. There’s this up, flat, and then down like that. It’s actually much more complicated than that, especially for women. With men, maybe we’re more simple minded. I feel pretty sure we are, actually. What we know for sure, that women are much more sex machines. How many men can have five orgasms back to back to back, with no refractory period? That’s not so uncommon for a woman. How many men feel energized after an orgasm? Very common for a woman.
There seems to be, no matter what you want to say the cause of it, there seems to be a different … I can talk to you a few hours about what I think it is, and what’s going on there, but there seems to be a different reaction to sex. That’s just the orgasm part. That’s not even counting all the rest of it. What I’m getting to, and how the O-Shot® may affect multiple components, including the psychological … If a woman, there’s a spiral and it go up and down, if a woman has arousal, and then she has sex, and then it’s a bad experience, she’s … For whatever reason. We can think of lots of horrible reasons it might be bad. But, it’s a bad experience for her. Then, she doesn’t go back to baseline. She’s at a level now to where it’s more difficult to even become aroused.
Let’s say she tries again, and it’s another bad experience. She’s spiraling down. I think there’s some women that are spiraled so far down because of abuse, and they attempt something with a lover and maybe they’re abused again, or something bad happens, and they’re so down, they just spiraled, spiraled down. Now, the other side of that, someone becomes aroused, a woman, and she has an encounter and she’s … It’s glorious for her. She’s respected, she’s loved. She has this beautiful experience. Physically, emotionally, spiritually. Now, when it’s time for possible sex again, she’s at a different state. She’s more easily aroused and there’s a spiral up.
Women’s Health Talks About the O-Shot® (Orgasm Shot®) Procedure
That spiral up and down, that’s not my idea. That was actually presented, and its been talked about for a few years in the Journal of Sexual Medicine, and other places. What might be new is that, I think it’s possible, that in some women my O-Shot® can help break the trend down. Or maybe help accelerate the trend up. For sure, I’ve seen it in women who have pain, break the trend down. We do the procedure, and then I have some techniques that I tell them to do so that they can test the waters, so to speak, on their own. Then they find, “Oh. Maybe I’m not having pain.” Maybe they tentatively have sex with their lover and, “Oh. Wow. I didn’t have pain.” That doesn’t mean they’re not still worried about it, but they spiraled up a notch.
The next time they’re not as tentative. There are … Maybe that might apply, in even cases that don’t have to do with pain. I think we’re seeing our shot affect other areas because of that complicated system. It triggers other things in the mechanism. It’s still not a magic shot.
Nory: Remarkably complex. Remarkably complex, the woman’s … The whole ethos. Not just her sexual response, but all that goes into making that ability to orgasm, or not. You’re painting a very much bigger picture for me than I had had.
Dr. Runels: I think it’s really … It’s very … Prideful for us to think we have a deep understanding. Even when you expand it this broad, for example, we know that if you have a massage, your oxytocin level goes up. It makes people more open to pleasure. Oxytocin’s a small peptide chain made by the pituitary gland, which is attached to the brain. You might as well say it’s part of the brain. There are over 200, that’s 2 with 2 zero’s behind it, peptides made by the pituitary gland. When we do some extensive blood tests, we get 20 blood values back. Oxytocin, DHEA, free and total testosterone, on and on and on. Still, just Kindergarten compared with what’s going on up there.
The idea that you might push one button and it affects 10 other things … For a simplistic example, if I raise your growth hormone level because you’ve had brain trauma and it’s low, it’s going to lower your thyroid level. If I raise your testosterone level, it’s going to lower your thyroid bonding globulin, and you’ll have more thyroid because I gave you testosterone. It will probably also increase your insulin like growth factor I, or your Somatomedin C because you’ll probably create more growth hormone. That’s just one example, of one hormone affecting two others.
Who knows what’s happening with the other 200. That pituitary gland, remember, is attached to your brain. When you get fearful, and your heart rate goes up, it’s because your cortex said, “Hey. I’m afraid.” And your pituitary gland spat out some stuff that told your adrenal glands to release some stuff. It all started up here. I don’t mean to say that what’s going on up here is not important. I think it’s extremely important. I do think there are ways to push buttons, whether it’s hormonally or physically with our O-Shot® that have rippling effects throughout the whole system that can be beneficial.
Nory: That seems like a pretty good place to conclude the interview. I know that you’re a little pressed for time.
Dr. Runels: I was honored to speak with you, Nory. I commend you … I know we had some conversations earlier, so before we wrap it up I just want to commend you for having the courage to, one, talk about sex, because it’s a courageous thing to do. Just bringing … Broaching the topic will bring criticism, even to healthcare people like ourselves. Whether it be writers, therapists, doctors, doesn’t matter. When people broach the subject of sex, there becomes a recoil that you can’t even run … I’ve been banned from Facebook. You can’t run an ad, even if it’s bringing people to something that’s a medical procedure. I can’t … My Facebook ads have been banned because I talk about sex.
It’s troublesome that there’s this idea that … As we spoke earlier, there’s somethings that people can have go wrong, and they invite the utmost sympathy from everyone. You can have the flu, and people want you to get well, and you let them know without hesitation. They send you get well cards, or you can have cancer. Try getting schizophrenia. Or bipolar disease. And even though those are chemical imbalances, that it’s not fault of the person, there’s no reason to be ashamed of it, nevertheless, there’s … Continuing, we’re not in the … This is not the middle ages where we should be saying these people are witches or something, or they’re possessed with the devil, but it’s a chemical balance. They shouldn’t have to be ashamed of it, but they are.
Many of them are. And they’re … In the same way, sexual problems, you won’t see anybody posting to Facebook. They might post they got the flu, or they broke their arm, come sign my cast. You aren’t going to see anybody post to Facebook, “Oh. I’ve got painful intercourse. Would you pray for me today.” Or, “I couldn’t have an orgasm last night with my husband. Would you give me a prayer?” Have you ever seen that on Facebook? You’ll see broken arms all day long. And it’s because there’s a social stigma for it. But yet, that same thing, is so critical … Emerson said sex and beauty is the … He actually just said beauty, but I throw in the sex part, because I think that was his generic way of saying sex. But he said beauty was the scaffolding of love.
Yeah, you may reach a place where you don’t need the scaffold, but I think most mortals need the scaffold to build a relationship. That’s why I think more younger women, and older women complain. That’s my long way of bragging on you, for you having the courage to talk about this. I’m happy to wrap it up, but it should go through this. If there are other questions that you get from your readers, or that just occur to you, we’ll do Volume II. Anytime you want. Or III or IV.
Nory: You know, this was amazing. I didn’t expect … I was not expecting the depth. It was not what I asked for, but it was beautiful.
Dr. Runels: Thank you.
Nory: I feel way more optimistic I think, than you. Honestly, I do. I feel very optimistic. And I’m waiting for those bullets that you say are coming, those arrows. I know it would probably feel really good to you, to punch some people who have those attitudes about vaginal rejuvenation. Would you like … Would you appreciate the opportunity to write a forward for my book? A short one, that does a little of that punching back?
Dr. Runels: Yes. I would love to write you a forward. The answer to that is yes. I would love to write a forward. As far as my, the way I visualize it, I see it more as … When I was working in the ER, if someone came in just drunk and stupid, because of some drug they were on, and they would often try to hurt me. My goal is not really to punch back, it was just to control them from hurting anybody until they got their brain back. I look at these people, they’re just so blinded by … It’s crazy to me.
I’ll meet them in a thing and they’ll say, “When you publish some research, then I’ll start doing this.” I’ll say, “Well, you know we’ve already published five papers. And there’s 9,000 papers about PRP. Have you read any of them? Or are you reading Marvel comics? What are you reading?” You’re not reading any of this if you’re reading Superman and Revenger. It’s so funny to me that we’re … That’s the way I look at it. It’s not really punching back, as much as it is … Anticipating their daggers, and building the intellectual shields to neutralize it until they get their brain back.
Nory: No. No. You’re so nice. You’re so nice, and I’m so grateful. I can’t tell you.
Dr. Runels: All right. So, let’s do this thing. I look forward to talking again, and I’ll make this recording where you can take whatever you want and share it.
Nory: You are the best. Please give my regards to Erin. She’s wonderful, too.
I completed an O-Shot yesterday. The patient had no pain during the injection or issues. I used 4 ml of the PRP in the anterior vaginal wall. Today, she is complaining of fullness in the bladder. She is urinating, but states that she feels that she has to urinate all the time. I have not had a response like this so far. Is this the PRP still needing to absorb and causing some irritation or is there something else going on?
So the way she describes this, it sounds like she did everything perfectly well, and actually, these sorts of symptoms, in my opinion, mean that you got it right. And the way I’m visualizing this, of course I could be proven wrong, but the way I’m visualizing this is whenever you have, let’s say an abrasion and/or a scab, and you have this healing wound. Now, if you think about it, even as a child, you remember that scab itched, and you wanted to scratch it, and you felt burny and all sorts of feelings, sometimes throbbing.
So we’re basically creating this artificial signal to the body because the body hasn’t really been injured, but we’re taking these platelets, releasing all these chemotactic factors and growth factors and vasodilators, and the tissue says, “Whoa. We’ve been injured.” And there becomes lots of sensations surrounding this artificial hematoma that we’ve created.
Then if you imagine translating all those sensations around the urethra or into the clitoris, you might have all sorts of interpretations of that, and the things I’ve heard are everything from almost everything you can think of, hypersexuality. One woman said she felt like she became very aroused and even almost orgasmic every time she urinated. Interestingly, this was a woman who was competing in a fitness contest and was drinking lots of water as part of that getting ready for that contest, so she was having lots of arousal.
Others have urinary urgency, frequency, dysuria, all sorts of sensations. The bottom line is almost anything you can imagine they might feel it for the first three to seven days. Once you get to the two-week mark, really by the time you get to the one-week mark, all that stuff is usually gone, and by the time you get to the two to three-week mark, that stuff is gone, and now you’re starting to see the beneficial effects of the procedure itself.
So hopefully that helps, and again, the first time it happened to me, I thought, “What’s going on here?” But I hear this a lot from all of our providers.
I would highly recommend that you also check out the webinars. A lot of these tips are there. I just cannot over emphasize how many pearls and tips about patient selection and doing better with the people that you do treat you’ll find if you go to the webinars and watch some of those, maybe one a week, just check them out.
So, now you got wound care, injections, and all those things come together, and I thought, oh, wow, what if you took this technology where you’re using platelet rich plasma and heal tissue and I pulled it over and used it in this arena where women have problems with pain or sensation or function of the genitourinary space. So, that’s kind of how it all came together.
(Chapter 15 introduces the O-Shot® Procedure & is Written by Dr. Runels)
