{"id":4983,"date":"2026-05-24T20:40:08","date_gmt":"2026-05-24T20:40:08","guid":{"rendered":"https:\/\/oshot.info\/members\/?p=4983"},"modified":"2026-05-24T20:40:08","modified_gmt":"2026-05-24T20:40:08","slug":"jcpm2026-05-19-nitrous-oxide-problems-treatments-bont-dosing-in-male-bedroom-female-sex-new-definitions","status":"publish","type":"post","link":"https:\/\/oshot.info\/members\/jcpm2026-05-19-nitrous-oxide-problems-treatments-bont-dosing-in-male-bedroom-female-sex-new-definitions\/","title":{"rendered":"JCPM2026.05.19 | Nitrous Oxide (problems &#038; treatments) | BoNT dosing in Male Bedroom | Female Sex &#8211; New Definitions"},"content":{"rendered":"<p class=\"c12\"><span class=\"c26\">The following is an edited transcript of the <\/span><span class=\"c14 c26\">Journal Club with Pearls &amp; Marketing<\/span><span class=\"c2\"> (JCPM) of May 19, 2026, with Charles Runels, MD. \u00a0<\/span><\/p>\n<blockquote>\n<p class=\"c12\"><span class=\"c15 c34\"><a class=\"c10\" href=\"https:\/\/cellularmedicineassociation.org\/wp-content\/uploads\/2026\/05\/JCPM2026.05.19-final-edit.pdf\">-&gt; The PDF transcript of this live journal club can be seen here &lt;-&lt;<\/a><\/span><\/p>\n<\/blockquote>\n<div style=\"padding: 56.25% 0 0 0; position: relative;\"><iframe style=\"position: absolute; top: 0; left: 0; width: 100%; height: 100%;\" title=\"JCPM2026.05.19\" src=\"https:\/\/player.vimeo.com\/video\/1195158848?badge=0&amp;autopause=0&amp;player_id=0&amp;app_id=58479\" frameborder=\"0\"><\/iframe><\/div>\n<p><script src=\"https:\/\/player.vimeo.com\/api\/player.js\"><\/script><\/p>\n<h1 class=\"c12\"><span class=\"c11\">Topics Covered<\/span><\/h1>\n<ul class=\"c42 lst-kix_list_11-0 start\">\n<li class=\"c4 c7 li-bullet-0\"><span class=\"c8\">It\u2019s All About Words: Redefining Female Sexual Dysfunction<\/span><\/li>\n<li class=\"c7 c4 li-bullet-0\"><span class=\"c8\">How the Definitions Relate to Our Procedures<\/span><\/li>\n<li class=\"c7 c4 li-bullet-0\"><span class=\"c8\">Nitrous Oxide, Vitamin B12, and Demyelination<\/span><\/li>\n<li class=\"c7 c4 li-bullet-0\"><span class=\"c8\">Pearls &amp; Marketing: Writing a Letter That Teaches<\/span><\/li>\n<li class=\"c7 c4 li-bullet-0\"><span class=\"c8\">A Warning About Topical-Only Products Used Off-Label<\/span><\/li>\n<li class=\"c7 c4 li-bullet-0\"><span class=\"c8\">The Other Side: The Strong Evidence Base for PDGF<\/span><\/li>\n<li class=\"c7 c4 li-bullet-0\"><span class=\"c8\">Practical Pearls from Today\u2019s Papers<\/span><\/li>\n<li class=\"c7 c4 li-bullet-0\"><span class=\"c8\">A Note on Teaching and Protecting the Protocol<\/span><\/li>\n<li class=\"c7 c4 li-bullet-0\"><span class=\"c8\">Adding Providers in Your Office to the Directory<\/span><\/li>\n<li class=\"c1 c4 li-bullet-0\"><span class=\"c8\">Q&amp;A: How Many Units of Neurotoxin for the Penis?<\/span><\/li>\n<\/ul>\n<p class=\"c12\"><a href=\"https:\/\/runels.com\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-3181\" src=\"https:\/\/cellularmedicineassociation.org\/wp-content\/uploads\/2025\/07\/image5-300x239.jpg\" alt=\"\" width=\"300\" height=\"239\" \/><\/a><\/p>\n<p class=\"c29\"><span class=\"c32 c35\">Charles Runels, MD<br \/>\nAuthor, researcher, and inventor of the Vampire Facelift\u00ae, Orchid Shot\u00ae (O-Shot\u00ae), Priapus Shot\u00ae (P-Shot\u00ae), Priapus Toxin\u00ae, Vampire Breast Lift\u00ae, and Vampire Wing Lift\u00ae, &amp; Clitoxin\u00ae procedures.<\/span><\/p>\n<h1 class=\"c23 title\"><span class=\"c27\">Transcript<\/span><\/h1>\n<h1 class=\"c9\"><span class=\"c11\">It\u2019s All About Words: Redefining Female Sexual Dysfunction<\/span><\/h1>\n<p class=\"c1\">We have four papers I\u2019d like to cover today. This one, I think, is probably the most important one that came out, and it\u2019s all about words.<sup class=\"c3\"><a id=\"ftnt_ref1\" href=\"#ftnt1\">[1]<\/a><\/sup><\/p>\n<p class=\"c1\"><span class=\"c0\">I used to look at these papers, and I\u2019d think, \u201cOh, well, don\u2019t people have better things to do than just come up with new names for things?\u201d<\/span><\/p>\n<p class=\"c1\">The people in the places of strongest influence have, over the 20 years or so that I\u2019ve been keeping up with sexual medicine in a detailed way, changed the definitions on multiple occasions. But there\u2019s one thing that\u2019s bothered me the most, and I think others, and it\u2019s that <span class=\"c30 c14\">you must be distressed if you\u2019re a female to be counted.<\/span><\/p>\n<p class=\"c1\"><span class=\"c41 c14 c43\">(If you have ED and are not distressed about it, you still have sexual dysfunction; but if you are female and have dyspareunia or anorgasmia and are not distressed about it, by definition, you do NOT have sexual dysfunction.)<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">And this matters a lot, of course, because when you\u2019re doing research, if you\u2019re trying to show a new treatment for female sexual dysfunction, and it has to do with a psychological change, that is a more difficult measure (than a physical change). And distress can be worsened by increased sex drive. In other words, you could have a treatment that improves sexual libido or desire or even improves orgasm, and it would be disapproved if you went by the strict definition and the increased desire increased distress.<\/span><\/p>\n<p class=\"c18\">=&gt;<span class=\"c6\"><a class=\"c10\" href=\"https:\/\/www.google.com\/url?q=https:\/\/cellularmedicineassociation.org\/procedures\/&amp;sa=D&amp;source=editors&amp;ust=1779658012348245&amp;usg=AOvVaw03BKLTXVqtAJxelIgtD2nW\"> Apply for <\/a><\/span><span class=\"c6 c14\"><a class=\"c10\" href=\"https:\/\/www.google.com\/url?q=https:\/\/cellularmedicineassociation.org\/procedures\/&amp;sa=D&amp;source=editors&amp;ust=1779658012348450&amp;usg=AOvVaw0o8C7r6Nhy1VhRnCsbLGcr\">Online Training for Multiple PRP Procedures<\/a><\/span><span class=\"c20\"> <\/span><span class=\"c0\">&lt;=<\/span><\/p>\n<p class=\"c1\">And if you don\u2019t have psychological distress, you do not have dysfunction, even though you might have dyspareunia or be unable to have an orgasm. So this article wasn\u2019t open source, so I wasn\u2019t able to give you the link, but I\u2019ll copy and paste <span class=\"c15\"><a class=\"c10\" href=\"https:\/\/www.google.com\/url?q=https:\/\/www.frontiersin.org\/articles\/10.3389\/fbioe.2026.1711058\/full&amp;sa=D&amp;source=editors&amp;ust=1779658012349048&amp;usg=AOvVaw103VlWSxFn8W_DSk3glPTC\">the DOI<\/a><\/span> into the chat box. It\u2019s in the Journal of Sexual Medicine Reviews, and so I can\u2019t give it away, but I can tell you the main things that I think will be helpful to you.<span class=\"c3\">1<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">They\u2019re shifting away, it seems, from this old idea that it\u2019s either psychological or biological. And talked about this forever, but if you go way back to see the extreme case of it, I remember training in the \u201980s. It was thought that eighty percent of men with sexual dysfunction had purely psychogenic problems.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">It\u2019s sad to think how many men were counseled that their problem was psychological. And then when PDE5 inhibitors came along, now we know that really eighty percent of ED is secondary to neurovascular problems.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">And unfortunately, it feels to me like that same mentality has been lagging and persistent in the female research. If you look at the three FDA-approved drugs to help women with sex, you have flibanserin and bremelanotide, both of which primarily affect the brain. So, we might not be calling it purely psychological, but our main FDA-approved treatments are psych drugs. The third one is a DHEA cream. And even flibanserin is still not indicated for women over sixty-five. Well, a lot of women have a lot of fun after sixty-five. So, I think this paper addresses that \u2014 they\u2019re all interacting simultaneously, and they stress that we should be thinking about it.<\/span><\/p>\n<p class=\"c1\">We talked about these numbers, not so long ago, I guess maybe two months ago, in our journal club. But the incidence of symptoms of female sexual dysfunction is around 90% of women. But then, when you include distress, it drops. If you include distress in the definition, the prevalence, not incidence, the <span class=\"c14 c32\">prevalence<\/span><span class=\"c0\"> drops to around 40%, but that\u2019s still significant.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">And surprisingly, it\u2019s more common in younger women. But not surprisingly, when you consider that you have to be distressed and maybe women who are through having children and maybe living alone, they may not be as distressed about it, so they may still have symptoms. There are some controversial or emerging definitions emerging.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">This whole thing about desire is that they\u2019ve had different definitions or with the semantics. Again, some\u2014 in some ways this feels like a word game, playing Scrabble or something, when you think, really, does it matter?<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">What really matters is when two people get together, do they have enough fun that they want to buy groceries and live in the same house and make a family, or go on vacation, or do they feel loved and connected, or do they at least have a good time or not and feel separated, depressed, and broken?<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">And the definitions matter because they determine where research funding is spent and whether a drug or a procedure can be approved. So we\u2019re in the process of going through the mechanism to get a new study published, and semantics matter a lot. So there are these new ideas about female cognitive arousal disorder, female orgasm illness syndrome, hard flaccid syndrome, and restless genital syndrome.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">, To me, restless genital syndrome is just being a teenager, but they have a different definition. Genital dysmorpho-phobia. So th-these are all new ideas that I think you\u2019re going to see coming out, and, and they\u2014 I-it\u2019s worth reading this paper. Again, I wish I could just dump it into your chat box, but I\u2019d be breaking copyright law.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">So I\u2019ll\u2014 I put a link to it in the chat box. Let me do that. And so you can go\u2014 at least go to where the paper is. But that\u2019s really the summary of it, I think you\u2019re going to see more discussion about that problem with defining it only if you\u2019re psychologically distressed.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">And now, how does that relate to our procedures?<\/span><\/p>\n<h1 class=\"c9\"><span class=\"c11\">How the Definitions Relate to Our Procedures<\/span><\/h1>\n<p class=\"c1\"><span class=\"c0\">If you\u2019ve done this for any length of time, you know that you\u2019ll see people who come for one thing, who would come for weight loss, but they\u2019ll say, \u201cI\u2019m not interested in having sex.\u201d<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">And they come back three to six months later, with a new lover, and now they want everything you have.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">So, as far as our procedures go, the most nitty-gritty way I see it happen is when someone comes in and says they\u2019re there for\u2026 They won\u2019t even say sex. They\u2019ll say they\u2019re for an O-Shot\u00ae because of urinary incontinence.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\"> What do you do with that? <\/span><img decoding=\"async\" title=\"\" src=\"images\/image1.jpg\" alt=\"A book cover with a rocket launch Description automatically generated\" \/><\/p>\n<p class=\"c1\"><span class=\"c0\">They\u2019ll say, \u201cI\u2019m not interested in the sexual function. I just don\u2019t want to leak.\u201d<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">And you\u2019ll give them an O-Shot\u00ae, and they\u2019ll come back with a new lover or smiling, with a deeper relationship with their spouse. And then the question has come up frequently: if they are there just for incontinence, do you still inject the clitoris? And I think you do because you have\u2014 you actually have some crossover histology, and you have erectile tissue surrounding the urethra of a female.<\/span><\/p>\n<p class=\"c1\">And you also have, especially now that we have our <span class=\"c15\"><a class=\"c10\" href=\"https:\/\/www.google.com\/url?q=https:\/\/clitoxin.com\/&amp;sa=D&amp;source=editors&amp;ust=1779658012357643&amp;usg=AOvVaw3eCjrd0F7o8uDY40IbUoSP\">Clitoxin\u00ae<\/a><\/span><span class=\"c0\">, you have autonomic signals coming from the clitoris, both for sexual function and incontinence or s- or urinary function. So I always treat both. And then, of course, this may not be a good enough reason on its own. There are people who will use the incontinence as a, an alibi to get the O-Shot\u00ae when they\u2019re really interested in sexual function.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">But I think probably the biggest take-home from that paper is that they\u2014 you\u2019ll, you\u2019ll see some cleaner endpoints. Hopefully, we\u2019ll migrate to a place where you don\u2019t have to have psychological distress to be counted as having dysfunction because, as a woman, it means there\u2019s less money, and it\u2019s harder to get new drugs approved. And you may see some of these new terms start to be used, like restless genital syndrome and genital dysmorphophobia.<\/span><\/p>\n<h1 class=\"c9\"><span class=\"c11\">Nitrous Oxide, Vitamin B12, and Demyelination<\/span><\/h1>\n<p class=\"c1\">This next one is interesting because it concerns nitrous oxide.<sup class=\"c3\"><a id=\"ftnt_ref2\" href=\"#ftnt2\">[2]<\/a><\/sup><span class=\"c0\"> I personally think that nitrous is just pleasant. It\u2019s just pleasant. And it\u2019s tempting to just have a little shot of nitrous every day just because it makes you happy.<\/span><\/p>\n<p class=\"c1\">But when you look at the research, you see problems with vitamin B12 function, and in one study they showed demyelination at a greatly increased rate in people who were using nitrous regularly.<span class=\"c3\">2<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">So if you\u2019re using it or treating someone who used it, that\u2019s the take-home. If you want to do a screenshot of that, that\u2019s sort of the paper in a nutshell: you can have all those things you\u2019re seeing there, gait disturbances, limb paresthesia. I don\u2019t think anybody worries about frostbite, but it\u2019s possible.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">The main things are plasma homocysteine levels, methylmalonic acid, and B12 function. And so they give you some ideas for treating it: a B12 shot once a week for several weeks and taking folate. Pretty easy, fun things to do anyway, B12 and folate.<\/span><\/p>\n<p class=\"c1\">I think it was <span class=\"c15\"><a class=\"c10\" href=\"https:\/\/www.google.com\/url?q=https:\/\/www.cbsnews.com\/news\/demi-moore-reportedly-hospitalized-after-inhaling-nitrous-oxide-what-are-whippets\/&amp;sa=D&amp;source=editors&amp;ust=1779658012361378&amp;usg=AOvVaw2SVZn-AwLHgP7tNUD8N9Kv\">Demi Moore who wound up in the ER once with a near stroke from doing nitrous<\/a><\/span><span class=\"c0\"> with her lover.<\/span><\/p>\n<p class=\"c1\">They talk about how prevalent it is. Something you should know is that it became prevalent when you could order it as part of your kitchen utensils to make whipped cream. <span class=\"c15\"><a class=\"c10\" href=\"https:\/\/www.google.com\/url?q=https:\/\/www.amazon.com\/Wellwhip-Whipped-Chargers-Cartridges-Dispenser\/dp\/B0GY7R1VHK\/ref%3Dsr_1_6?crid%3D1UWRXNKBGWVX6%26dib%3DeyJ2IjoiMSJ9.Ya70Z7x0QIHyqvaRVif7sTbd4I4xk4mj9ig-uB7cngR6tUT77W6fbYwG37e75E-EMbK1PJk08h3IlMprayrW7wpkUduYmkhJmyMYY9DVyCfvo2jkjGI4RwSyxOBGODRDP7D0h916ed0TuHZ3HGglqAEFsCsJZw1oeDL_RBQePPoBzJ-2_DflKlNZaDQss7wac8Dt3LNA1ABed9lLv8cSOTkMW4NR48EHQlEBePNBL2GAIwckx7GyPmzy7yqf5WvbCG8lkvJ1SlwNvctAIHrCpTON4neDnEVPtQ5H7PffpH4.xv0cKwSUY3u_U959qWA2f-XK7VmsvF0_NzaJGFKl1t0%26dib_tag%3Dse%26keywords%3Dnitrous%2Boxide%2Bcartridges%26qid%3D1779650773%26sprefix%3Dnitrous%252Caps%252C233%26sr%3D8-6&amp;sa=D&amp;source=editors&amp;ust=1779658012362354&amp;usg=AOvVaw0lpeXOWOmtk_mgIGVq8kRn\">So you can grab\u2014you can buy these canisters not just at smoke shops but also on Amazon.<\/a><\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">So this one is worth reading and knowing about.<\/span><\/p>\n<h1 class=\"c9\"><span class=\"c11\">Pearls &amp; Marketing: Writing a Letter That Teaches<\/span><\/h1>\n<p class=\"c1\"><span class=\"c0\">I call this journal club with pearls in marketing. So, how could you make this part of how you end up with the people you want to treat in your office? So, if you\u2019re interested in treating sexual function, why would you want to do that? Not only is it incredibly rewarding for your soul and has a positive impact on families, but it\u2019s also one of those categories where the insurance coverage for treatments can be minimal. Our procedures are now strongly supported by research, yet they\u2019re not covered by insurance.<\/span><\/p>\n<p class=\"c18\"><span class=\"c15\"><a class=\"c10\" href=\"https:\/\/www.google.com\/url?q=https:\/\/accma.memberlodge.org\/page-925782&amp;sa=D&amp;source=editors&amp;ust=1779658012363752&amp;usg=AOvVaw0O4N-l_45cSW3rPwVPFOPl\">=&gt;Next Hands-On Workshops with Live Models&lt;=<\/a><\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">That puts you in that sweet spot where you can be both a very good physician and do things that people who only take insurance do not do, and make profits that help you pay for the patients you might lose money on. And our procedures, of course, are very safe when using platelet-rich plasma.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">So, if you want to treat sexual dysfunction, how does this paper figure in?<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">Remember the three rules about marketing.<\/span><\/p>\n<p class=\"c1\"><span class=\"c31 c14\">First, the best marketing is to teach the sufferer about their disease. Teach them about the disease, and they trust you to treat it.<\/span><\/p>\n<p class=\"c1\"><span class=\"c31 c14\">The second principal worth making a poster about is that it\u2019s not the patient\u2019s responsibility to know what you know how to do: It\u2019s your responsibility to teach them.<\/span><\/p>\n<p class=\"c1\"><span class=\"c14 c31\">The third thing is that people don\u2019t want to be advertised to, but they love to get a letter that shows concern and teaches them how to make their life better. So you could write a letter about this one. Real simple.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">It could be, \u201cHey, there\u2019s a new paper that just came out.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">This is common, and you or someone you love may be doing it frequently. You should know the possible side effects of it and know that there are other ways to have fun.\u201d<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">You know, I have to go through the side effects. It could be quick. You could mention some of these things that could happen.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">And put a link to the article.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">Yes, I always talk to my patients as if they are physicians. I don\u2019t talk down to them. And then you put a link to the article.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">Basically, you write a letter as if you\u2019re writing to your sister, your brother, your niece, your nephew, or your mama. That\u2019s what you do.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">And then you would say, \u201cBut there are other ways to have fun, and if you come see us, I can help you out with that. We have our O-Shot\u00ae procedure.\u201d<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">Some of you are probably prescribing oxytocin, which is a nice one that makes people feel happy, and you don\u2019t stroke out from it, and whatever else you\u2019re doing.<\/span><\/p>\n<h1 class=\"c9\"><span class=\"c11\">A Warning About Topical-Only Products Used Off-Label<\/span><\/h1>\n<p class=\"c1\">This next one was a letter, an open-access letter.<sup class=\"c3\"><a id=\"ftnt_ref3\" href=\"#ftnt3\">[3]<\/a><\/sup><span class=\"c0\"> <\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">The main thing that caught my eye here is that, just like the PDGF exosomes, other things are happening, and now you have people selling products that might be labeled for topical use only.<\/span><\/p>\n<p class=\"c1\">And I\u2019ve had this happen more than once, but the drug rep who sells it to you winks and says, \u201cBut you could use it IV, it\u2019s sterile.\u201d<span class=\"c3\">3<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">And they would get and tell you that, but just don\u2019t talk about it on your website.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">That worries me because, of course, if anything goes wrong, you must go start selling shoes and your license goes in a scrapbook instead of on the wall.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">But he mentions it here and talks about PDGF and how it relates to PRP.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">But the main thing, we\u2019ve covered that in the past, and this one is open source, so let me throw it in there now into your documents, because this is one you could actually give to your patients as a warning.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">You could send a link to this one and say, \u201cHey, if you see somebody offering this, be careful because we do things the right way and not everybody does.\u201d<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">And then you, you give them this paper, and the ones who read it will come see you and give you lots of money and trust you to do the right thing when you\u2019re taking care of them. See if I put that in there.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">Yes. Okay. So that one\u2019s in your material section, and then the last one, and then I had one question I wanted to cover.<\/span><\/p>\n<h1 class=\"c9\"><span class=\"c11\">The Other Side: The Strong Evidence Base for PDGF<\/span><\/h1>\n<p class=\"c1\">This one is also open source, <span class=\"c15\"><a class=\"c10\" href=\"https:\/\/www.google.com\/url?q=https:\/\/journals.lww.com\/10.1097\/PRS.0000000000012426&amp;sa=D&amp;source=editors&amp;ust=1779658012370780&amp;usg=AOvVaw0b1Gaozqq0By5u7oH5EcSe\">so I\u2019ll put it in here<\/a><\/span>.<sup class=\"c3\"><a id=\"ftnt_ref4\" href=\"#ftnt4\">[4]<\/a><\/sup><\/p>\n<p class=\"c1\"><span class=\"c0\">Also, it\u2019s in your, in your handout section.<\/span><\/p>\n<p class=\"c1\">And so this is the flip side of how wonderful it is, and their main point is you\u2019ve got thirty plus years of research, one hundred and forty plus published human clinical studies, over fifteen thousand patients, and four FDA-approved PDGF protocols. So there\u2019s, there\u2019s reasons for it. It\u2019s mostly wound healing, and of course, anything that has to do with wound healing can often be adapted to what we do.<span class=\"c3\">4<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">I\u2019m not using these products, but some of you are, I know, and I wanted you to have both the good side and the warning, the positive endorsement and the warning about its use. And even if you\u2019re not using it, something to know when your patients ask. And again, if you are using a product for topical use, definitely just use it for that, because they\u2019ll get you.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">We do have a few people who have had to go\u2026 have been investigated by the FDA, breaking rules they don\u2019t really have to break. So I think the practical pearls to remember from these papers, and then I have one quick note on a question, and we\u2019ll call it a day.<\/span><\/p>\n<h1 class=\"c9\"><span class=\"c11\">Practical Pearls from Today\u2019s Papers<\/span><\/h1>\n<p class=\"c1\"><span class=\"c0\">This from the Tross paper is the, uh, distress is changing the prevalence estimates. And when you take that out, it\u2019s much more prevalent than people think. And especially on the female side, it\u2019s true\u2014 the people tried to squeeze it into three to four categories, but we\u2019re going to have these other categories that will be talked about, and we\u2019ll discuss them in upcoming journal clubs.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">I love the restless genital problem. I think I like having restless genitals. But anyway, we\u2019re going to talk about some of those in future journal clubs.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">Nitrous oxide abuse is pretty common and so know some of the bad downsides of it and how to treat it. If you\u2019re going to do it yourself or tolerate it in others, just make it rare.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">The things they talk about that could happen, to me, the most dangerous is not frostbite. It\u2019s that if you don\u2019t have an urge to breathe, if you don\u2019t have high CO2. So if you blow off your CO2 and your lungs are just full of nitrous, you do not feel the urge to breathe, but you don\u2019t have oxygen either.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">You have a low O2, decreased respiratory drive, and it could lead to a stroke. And reading between the lines in the news, I don\u2019t know what happened with Demi Moore, but I, I think some sort of TIA could be possible, so you\u2019ve got to be careful with it.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">And then injectable PDGF: do only what the FDA has approved for what\u2019s on the bottle in your hand, and know that this science is fairly mature, but mostly for topical, and I think using it in one of our procedures is not the thing to be done.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">Okay. So I had one question that I\u2019ll cover: One of our providers wrote in that he had been asked to teach a clinic, and I just want to mention that we need more teachers and the right way to go about it for the best results and for the best second income.<\/span><\/p>\n<h1 class=\"c9\"><span class=\"c11\">A Note on Teaching and Protecting the Protocol<\/span><\/h1>\n<p class=\"c1\">We have <span class=\"c15\"><a class=\"c10\" href=\"https:\/\/www.google.com\/url?q=https:\/\/accma.memberlodge.org\/page-925782&amp;sa=D&amp;source=editors&amp;ust=1779658012376672&amp;usg=AOvVaw2X-UVwN0NqnJa78KayIrku\">a list of upcoming classes and teachers that\u2019s been on display for the past 15+ years<\/a><\/span><span class=\"c0\">, we promote our other teachers, and we pay them.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">We don\u2019t take money from them. We pay them to teach.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">If you\u2019re going to teach, though, we ask that you let us know, as we have a separate training program for teachers.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">And if you teach A, A teaches B, and B teaches C, and we don\u2019t know about it, I promise you C will be doing something significantly different than A. So we need to have some control over what\u2019s being taught and a way to keep track of who is being taught. If someone is taught and we don\u2019t know about it, and they start advertising under our trademarked names, there\u2019s a good chance they will lose their website or social media account.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">We\u2019re still averaging 2.5 websites or social media accounts that go away per business day over the past 2+ years. We had another quarterly report with our attorneys in Israel, BrandShield.com, and without that, we would have people doing crazy, stupid things and calling them an O-Shot\u00ae, a P-Shot\u00ae, or a Vampire Facelift\u00ae.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">And, sometimes they\u2019ve done it even with our enforcement, and two people are in prison now for doing something stupid and calling it a Vampire Facial\u00ae when it was not. They\u2019re not one of our people. And other things have happened. So we want to support your students and support you if you want to teach. But, if it\u2019s done without us knowing, then some bad things can happen. In the same way, and this is the last point, I\u2019ll open up for questions, and we\u2019ll call it a day.<\/span><\/p>\n<h1 class=\"c9\"><span class=\"c11\">Adding Providers in Your Office to the Directory<\/span><\/h1>\n<p class=\"c1\"><span class=\"c0\">If someone in your office wants to do the procedures, we want them to do them. We need more people offering these procedures. But we need to know who they are. We had something as an example. We had someone show up to see my wife, who\u2019s in our group, and a gynecologist. She\u2019d had a procedure from another provider, not from the provider in our directory.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">The provider had taught her extender, but the extender had done something painful and ineffective. And we didn\u2019t even know the extender was injecting. But the extender was taught by the provider, who was taught by us. So even if we tell A and A tells B, if we don\u2019t know about B and B\u2019s not on our membership site, and B wasn't taught by us, there\u2019s a very good chance B will do something different that will be less effective or even dangerous.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">There\u2019s no problem if you want someone else in your office to provide the procedures if they have a proper license. Just call our office, and we\u2019ll get them trained up using either hands-on or online training. Get them tested, make sure they understand everything, and put them in the directory. And we don\u2019t even charge extra for that person to be on the directory.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">We have a training fee, but it\u2019s very reasonable. And then you\u2019ll have two listings in the directory, and we will know that that person knows our protocol and won't have someone else subjected to something painful and ineffective, and it will be called something it\u2019s not. Okay. Let\u2019s see if there\u2019s questions.<\/span><\/p>\n<h1 class=\"c9\"><span class=\"c11\">Q&amp;A: How Many Units of Neurotoxin for the Penis?<\/span><\/h1>\n<p class=\"c1\"><span class=\"c0\">Pete says, \u201cThe previous journal club mentioned using up to 300 units of neurotoxin in the penis. How many do you use? Does it require Botox specifically, or can you use Xeomin or Dysport?\u201d<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">Okay, great question. And, by the way, we just installed another AI bot on the membership sites to answer questions. I didn\u2019t like the other one.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">It was giving stupid answers and going outside our website to find answers that were just wrong. Remember, we have over 900 videos and millions of words. Hundreds of conversations over the past decade and a half on our websites. Not just me rambling with some sort of monologue but talking about research and interviewing multiple doctors in our group.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">And what we did have was just a plain old search bar, and when you put it in there, or you might get\u2014 say you put in this question, you just put in Xeomin or botulinum toxin and ED. You might get, even though that\u2019s only been something we\u2019ve talked about for two or three years, you might get a dozen different journal clubs or pages, and each one of our journal clubs is about three thousand words.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">So you might have an equivalent of a textbook to read to try to find your answer. Even though it\u2019s highlighted, it\u2019s work. So I installed the AI, and I asked it a few questions when I put it in. It seemed like it was performing. Then, about a week ago, it gave me a stupid answer, so we got rid of it, and we have installed another, much smarter, more expensive version.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">We have a, a new AI bot that will give you a smart answer.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">I\u2019ll give you the answer, but in the future, check out our new AI and let me know if you think it\u2019s working. If it\u2019s broken, I want to know so we can fix it.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">Now, the answer to your question. And the reason for that number, as you know, the Xeomin, Dysport, and Botox people all did studies.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">The Xeomin people, best I can tell, were the only ones who had a follow-up study, and 50 units were starting to wear off at 6 months, but 100 units were persisting at 9 months to 1 year. We don\u2019t have longer studies for the Dysport. I don\u2019t know if there\u2019s a study like this yet with Letybo.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">But a hundred units, if you do the math on the LD50 and from my years as an ER doctor and three years as a chemist before that, I do have some fascination with poisons and what it takes to kill somebody or hurt them with a poison. And of course, most things we use as medicines could be poison, but especially botulinum toxin.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">So I spent some time, embarrassingly too much time, reading about the LD50 and toxicity of botulinum toxin medically and for other uses. And then when you do all the calculations on it, the LD50 is literally if a man weighs 180 pounds, you will have to have 180 100-unit bottles of botulinum toxin or Botox, cosmetic Botox, 180 bottles and do an IV push to reach\u2014 approach the LD50.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">Of course, we don\u2019t do that, but that\u2014 I like that big safety margin. Now, to answer your question, if 100 units was what was done in the study, then it\u2019s the official starting recommended dose for Priapus Toxin\u00ae. And now, even with Clitoxin\u00ae in the clitoris, we bumped it to 100 units. But with migraine or its frequency to use more than 300 units, and even the face it\u2019s al- it\u2019s common to use 500 units or\u2014 So 300 units every\u2014 even if you\u2019re going every three months, which you won\u2019t be for ED because remember it lasts longer, up to nine months.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">But if it works, there\u2019s a good chance you\u2019ll get six months to a year out of it for 300 units versus just cosmetic use, maybe you might be going 450, 500 units every three months. So 300 units is still a reasonable amount, and that\u2019s the first thing I wanted to address: it\u2019s not a scary amount, which I\u2019m sure you probably know.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">But for those who don\u2019t, I wanted to put that in perspective. And now as far as how I do it, and, and this may change, right?<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">And our science is changing. But I start with 100 because in the study, 40% of men who were not responding to LD50s at high doses, the highest dose, those men, 40% of them started to get erections again at 100 units.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">I don\u2019t start at 50 because I don\u2019t\u2014 I like starting with what\u2019s going to last longer, and Daxxify is also one you can use. But I like starting at 100, and if it wears off soon or they have no results, maybe I\u2019ll add to it or bump it up to 200 or 300. You heard one of our providers talk maybe a month ago that he does an analysis of the person in the flaccid state, and if they have a, a penis that\u2019s turtling and, and not as noticeable as another that might be more s- more, noticeable in the flaccid state, you might start with 300 units.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">I usually start with 100, but this is where the art and the clinical come in. There\u2019s not a firm guideline on it. There was an article out this week that I did not put in here that came out regarding testosterone levels, cardiac dysfunction, and they mentioned that some with type 2 diabetes and obesity, even when young, have low testosterone levels.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">It\u2019s associated with that, which we, we knew, but another study documented that. So if you have someone that you suspect is m- a more difficult case because of body habitus and history, there\u2019s nothing wrong with starting at 300 units. But personally, I start at 100 units, combine it with a P-Shot\u00ae and then, uh, give it eight weeks. If after eight weeks they\u2019re not improved, I\u2019ll consider repeating either or both and increasing the dose.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">So hopefully that answered your great question, Pete. Thank you.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">All right. That\u2019s all I see in the way of questions, and I hope that was helpful to you. And, uh, and, uh, by the way, you realize every journal club we do, y- there\u2019s a half a dozen ideas for new studies, so that would\u2014 could be a study for one of us.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">Could be the one you need to do, Pete.<\/span><\/p>\n<p class=\"c1\"><span class=\"c0\">All right. Y\u2019all have a great week, and thank you for honoring me by being on the call. Hope that was helpful to you. Bye-bye.<\/span><\/p>\n<p class=\"c18\"><span class=\"c15\"><a class=\"c10\" href=\"https:\/\/www.google.com\/url?q=https:\/\/acrobat.adobe.com\/id\/urn:aaid:sc:US:bf4a1bbd-ce92-4d8f-a909-47a7d2395a0d&amp;sa=D&amp;source=editors&amp;ust=1779658012392348&amp;usg=AOvVaw0P52VZAaCk7WZ6TRg-a3Hi\">=&gt;Benefits of the Cellular Medicine Association&lt;=<\/a><\/span><\/p>\n<p class=\"c18\">=&gt;<span class=\"c6\"><a class=\"c10\" href=\"https:\/\/www.google.com\/url?q=https:\/\/cellularmedicineassociation.org\/procedures\/&amp;sa=D&amp;source=editors&amp;ust=1779658012392608&amp;usg=AOvVaw27zWATEJLPQhTzeUvFKxVt\"> Apply for <\/a><\/span><span class=\"c6 c14\"><a class=\"c10\" href=\"https:\/\/www.google.com\/url?q=https:\/\/cellularmedicineassociation.org\/procedures\/&amp;sa=D&amp;source=editors&amp;ust=1779658012392765&amp;usg=AOvVaw1WUM0DTPRN2unERpFVDH0q\">Online Training for Multiple PRP Procedures<\/a><\/span><span class=\"c20\"> <\/span><span class=\"c0\">&lt;=<\/span><\/p>\n<p class=\"c18\"><span class=\"c15\"><a class=\"c10\" href=\"https:\/\/www.google.com\/url?q=https:\/\/accma.memberlodge.org\/page-925782&amp;sa=D&amp;source=editors&amp;ust=1779658012393040&amp;usg=AOvVaw1l3db5I5Ht8YDYrnY7iwb7\">=&gt;Next Hands-On Workshops with Live Models&lt;=<\/a><\/span><\/p>\n<h1 class=\"c9\"><span class=\"c11\">References<\/span><\/h1>\n<p class=\"c1 c19\"><span class=\"c0\">Torres, Miguel A. Aristizabal, Michael H. Gold, and Alison J. Bruce. \u201c<\/span><span class=\"c0\">PDGF<\/span><span class=\"c0\"> In Aesthetics: Hype Outpacing the Evidence?\u201d <\/span><span class=\"c30 c14\">Journal of Cosmetic Dermatology<\/span><span class=\"c0\"> 25, no. 5 (2026): e70907. https:\/\/doi.org\/10.1111\/jocd.70907.<\/span><\/p>\n<p class=\"c1 c19\"><span class=\"c0\">Trost, Landon, David Rowland, Cindy Meston, et al. \u201cDefinitions, Classification, and Epidemiology of Sexual Dysfunction: A Consensus Statement from the Fifth International Consultation on Sexual Medicine 2024.\u201d <\/span><span class=\"c30 c14\">Sexual Medicine Reviews<\/span><span class=\"c0\"> 14, no. 2 (2026): qeag028. https:\/\/doi.org\/10.1093\/sxmrev\/qeag028.<\/span><\/p>\n<p class=\"c1 c19\"><span class=\"c0\">White, C. Michael, and Lyla R. White. \u201cNitrous Oxide Abuse Prevalence, Mechanisms, Treatments and Prevention.\u201d <\/span><span class=\"c30 c14\">Current Medical Research and Opinion<\/span><span class=\"c0\">, May 18, 2026, 1\u20139. https:\/\/doi.org\/10.1080\/03007995.2026.2670004.<\/span><\/p>\n<p class=\"c1 c19\"><span class=\"c0\">Younan, Samuel A., Thomas E. Ueland, Benjamin L. Savitz, et al. \u201cRecombinant Platelet-Derived Growth Factor in Tissue Repair: A Review Exploring Frontiers in Regenerative Medicine.\u201d <\/span><span class=\"c14 c30\">Plastic &amp; Reconstructive Surgery<\/span><span class=\"c0\"> 157, no. 4 (2026): 759\u201370. https:\/\/doi.org\/10.1097\/PRS.0000000000012426.<\/span><\/p>\n<h1 class=\"c9\"><span class=\"c11\">Tags<\/span><\/h1>\n<p class=\"c1\"><span class=\"c0\">female sexual dysfunction, distress criteria, sexual dysfunction prevalence, psychogenic vs biological, flibanserin, bremelanotide, DHEA cream, PDE5 inhibitors, erectile dysfunction, female cognitive arousal disorder, female orgasm illness syndrome, hard flaccid syndrome, restless genital syndrome, genital dysmorphophobia, O-Shot\u00ae, Clitoxin\u00ae, urinary incontinence, clitoris injection, erectile tissue urethra, crossover histology, platelet-rich plasma, PRP, nitrous oxide, whippets, vitamin B12 deficiency, demyelination, homocysteine, methylmalonic acid, folate, gait disturbance, paresthesias, stroke risk, topical-only products, off-label IV use, PDGF, exosomes, FDA-approved PDGF protocols, wound healing, regenerative medicine, patient education marketing, trademark enforcement, BrandShield.com, provider training, directory listing, Priapus Toxin\u00ae, P-Shot\u00ae, botulinum toxin, Botox, Xeomin, Dysport, Letybo, Daxxify, LD50, neurotoxin dosing, testosterone deficiency, type 2 diabetes, obesity, Charles Runels, Cellular Medicine Association, JCPM<\/span><\/p>\n<h1 class=\"c9\"><span class=\"c11\">Helpful Links<\/span><\/h1>\n<p class=\"c1\">=&gt; <span class=\"c6\"><a class=\"c10\" href=\"https:\/\/www.google.com\/url?q=https:\/\/accma.memberlodge.org\/page-925782&amp;sa=D&amp;source=editors&amp;ust=1779658012397434&amp;usg=AOvVaw2sQ3Qud_l0SHV_x_NwTB_a\">Next Hands-On Workshops with Live Model<\/a><\/span><span class=\"c15\"><a class=\"c10\" href=\"https:\/\/www.google.com\/url?q=https:\/\/accma.memberlodge.org\/page-925782&amp;sa=D&amp;source=editors&amp;ust=1779658012397541&amp;usg=AOvVaw0bm4b48qZwEMuxhJ3JLpSj\">s<\/a><\/span><span class=\"c0\"> &lt;=<\/span><\/p>\n<p class=\"c1\"><span class=\"c15\"><a class=\"c10\" href=\"https:\/\/www.google.com\/url?q=https:\/\/cellularmedicineassociation.org\/prp-training-runels\/&amp;sa=D&amp;source=editors&amp;ust=1779658012397883&amp;usg=AOvVaw1E6fboI5qp3JIyGduFvjXV\">=&gt;Next Hands-On Training with Live Models with Dr. Runels (includes marketing)&lt;=<\/a><\/span><\/p>\n<p class=\"c1\"><span class=\"c15\"><a class=\"c10\" href=\"https:\/\/www.google.com\/url?q=https:\/\/botoxclass.com\/workshop&amp;sa=D&amp;source=editors&amp;ust=1779658012398178&amp;usg=AOvVaw0kswngo1oPLeVdjSrV4nLH\">=&gt;Hands On Botulinum Toxin Workshop That Teaches Medical &amp; Cosmetic Uses&lt;=<\/a><\/span><\/p>\n<p class=\"c1\">=&gt; <span class=\"c15\"><a class=\"c10\" href=\"https:\/\/www.google.com\/url?q=https:\/\/botoxclass.com\/&amp;sa=D&amp;source=editors&amp;ust=1779658012398353&amp;usg=AOvVaw3n3yvasvPiuoAxZGU7BICC\">Dr. Runels Online <\/a><\/span><span class=\"c15 c14\"><a class=\"c10\" href=\"https:\/\/www.google.com\/url?q=https:\/\/botoxclass.com\/&amp;sa=D&amp;source=editors&amp;ust=1779658012398461&amp;usg=AOvVaw1wlqRiOzw8GyFp6qxbiyCa\">Botulinum Blastoff Course<\/a><\/span><span class=\"c0\"> &lt;=<\/span><\/p>\n<p class=\"c1\">=&gt; <span class=\"c6\"><a class=\"c10\" href=\"https:\/\/www.google.com\/url?q=https:\/\/cellularmedicineassociation.org\/&amp;sa=D&amp;source=editors&amp;ust=1779658012398705&amp;usg=AOvVaw0Ju8pZSjCYgK8Pb2W-RpEO\">The Cellular Medicine Association (who we are<\/a><\/span><span class=\"c20\">) <\/span><span class=\"c0\">&lt;=<\/span><\/p>\n<p class=\"c1\">=&gt;<span class=\"c15\"><a class=\"c10\" href=\"https:\/\/www.google.com\/url?q=https:\/\/cellularmedicineassociation.org\/procedures\/&amp;sa=D&amp;source=editors&amp;ust=1779658012398914&amp;usg=AOvVaw1uYg9X3jBVYOHpN3XYsPTj\"> Apply for <\/a><\/span><span class=\"c15 c14\"><a class=\"c10\" href=\"https:\/\/www.google.com\/url?q=https:\/\/cellularmedicineassociation.org\/procedures\/&amp;sa=D&amp;source=editors&amp;ust=1779658012399061&amp;usg=AOvVaw1hJmZnhwjqWLt-sEd-ISIA\">Online Training for Multiple PRP Procedures<\/a><\/span><span class=\"c20\"> <\/span><span class=\"c0\">&lt;=<\/span><\/p>\n<p class=\"c1\">=&gt; <span class=\"c6\"><a class=\"c10\" href=\"https:\/\/www.google.com\/url?q=https:\/\/oshot.info\/fsfi-calculator&amp;sa=D&amp;source=editors&amp;ust=1779658012399331&amp;usg=AOvVaw2Elt9e0ZODO5fXVPadj_QR\">FSFI Online Administrator and Calculator<\/a><\/span><span class=\"c0\"> &lt;=<\/span><\/p>\n<p class=\"c1\">=&gt; <span class=\"c6\"><a class=\"c10\" href=\"https:\/\/www.google.com\/url?q=https:\/\/5notes.com\/&amp;sa=D&amp;source=editors&amp;ust=1779658012399555&amp;usg=AOvVaw3suFxYZIGzkWfISYNkmyHI\">5-Notes Expert System for Doctors<\/a><\/span><span class=\"c20\"> <\/span><span class=\"c0\">&lt;=<\/span><\/p>\n<p class=\"c1\">=&gt;<span class=\"c6\"><a class=\"c10\" href=\"https:\/\/www.google.com\/url?q=https:\/\/cellularmedicineassociation.org\/password\/&amp;sa=D&amp;source=editors&amp;ust=1779658012399770&amp;usg=AOvVaw325DgAOk3eOpVB84_4Us4c\"> Help with <\/a><\/span><span class=\"c6 c14\"><a class=\"c10\" href=\"https:\/\/www.google.com\/url?q=https:\/\/cellularmedicineassociation.org\/password\/&amp;sa=D&amp;source=editors&amp;ust=1779658012399904&amp;usg=AOvVaw1bKf-T8XQ-4POlYiypo8dW\">Logging into Membership Website<\/a><\/span><span class=\"c6\"><a class=\"c10\" href=\"https:\/\/www.google.com\/url?q=https:\/\/cellularmedicineassociation.org\/password\/&amp;sa=D&amp;source=editors&amp;ust=1779658012399982&amp;usg=AOvVaw3-JKbttr_Kl7Cfzh2mp4Ku\">s<\/a><\/span><span class=\"c20\"> <\/span><span class=\"c0\">&lt;=<\/span><\/p>\n<p class=\"c1\">=&gt; <span class=\"c6\"><a class=\"c10\" href=\"https:\/\/www.google.com\/url?q=https:\/\/ontraport.com\/Cellular-Medicine-Association-&amp;sa=D&amp;source=editors&amp;ust=1779658012400317&amp;usg=AOvVaw1U2slG2sGhiDTQ1tg0ieRt\">The software I use to send emails: ONTRAPORT (free trial)<\/a><\/span><span class=\"c20 c41\"> <\/span><span class=\"c33\">&lt;=<\/span><span class=\"c0\"> <\/span><\/p>\n<p class=\"c1\">=&gt; Sell O-Shot\u00ae products: You make 10% with links you place; shipped by the manufacturer), <span class=\"c6\"><a class=\"c10\" href=\"https:\/\/www.google.com\/url?q=https:\/\/www.loom.com\/share\/dcd9fe2284a746a199fd7d5cc42d5f61?sid%3Df5a33b4b-a3ee-4fb1-b13e-2273718dce9b&amp;sa=D&amp;source=editors&amp;ust=1779658012400756&amp;usg=AOvVaw3aNo8TQ8BYb_8bsuImaBUg\">this explains<\/a><\/span> and <span class=\"c6\"><a class=\"c10\" href=\"https:\/\/www.google.com\/url?q=https:\/\/oshotwomen.leaddyno.com\/&amp;sa=D&amp;source=editors&amp;ust=1779658012400911&amp;usg=AOvVaw2Np6Of2KFCyT3VFF2ywaIt\">here\u2019s where to apply<\/a><\/span><\/p>\n<div>\n<table class=\"c16\">\n<tbody>\n<tr class=\"c40\">\n<td class=\"c36\" colspan=\"1\" rowspan=\"1\">\n<p class=\"c1\"><span class=\"c15\"><a class=\"c10\" href=\"https:\/\/www.google.com\/url?q=https:\/\/runels.com\/&amp;sa=D&amp;source=editors&amp;ust=1779658012403009&amp;usg=AOvVaw3O50PqjZQh38LaxGopUUq4\">Charles Runels, MD<\/a><\/span>\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0888-920-5311 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0<span class=\"c15\"><a class=\"c10\" href=\"https:\/\/www.google.com\/url?q=https:\/\/cellularmedicineassociation.org\/&amp;sa=D&amp;source=editors&amp;ust=1779658012403239&amp;usg=AOvVaw36tXeHq7pKim3RXauN56n8\">CellularMedicineAssociation.org<\/a><\/span><\/p>\n<\/td>\n<td class=\"c37\" colspan=\"1\" rowspan=\"1\">\n<p class=\"c13\">Page\u00a0\u00a0of<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p class=\"c1 c21\">\n<\/div>\n<hr class=\"c45\" \/>\n<div>\n<p class=\"c1\"><a id=\"ftnt1\" href=\"#ftnt_ref1\">[1]<\/a><span class=\"c17\"> Trost et al., \u201cDefinitions, Classification, and Epidemiology of Sexual Dysfunction.\u201d<\/span><\/p>\n<\/div>\n<div>\n<p class=\"c1\"><a id=\"ftnt2\" href=\"#ftnt_ref2\">[2]<\/a><span class=\"c17\"> White and White, \u201cNitrous Oxide Abuse Prevalence, Mechanisms, Treatments and Prevention.\u201d<\/span><\/p>\n<\/div>\n<div>\n<p class=\"c1\"><a id=\"ftnt3\" href=\"#ftnt_ref3\">[3]<\/a><span class=\"c17\"> Torres et al., \u201c&lt;span Style=\"font-Variant.\u201d<\/span><\/p>\n<\/div>\n<div>\n<p class=\"c1\"><a id=\"ftnt4\" href=\"#ftnt_ref4\">[4]<\/a><span class=\"c17\"> Younan et al., \u201cRecombinant Platelet-Derived Growth Factor in Tissue Repair.\u201d<\/span><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>The following is an edited transcript of the Journal Club with Pearls &amp; Marketing (JCPM) of May 19, 2026, with Charles Runels, MD. \u00a0 -&gt; The PDF transcript of this live journal club can be seen here &lt;-&lt; Topics Covered It\u2019s All About Words: Redefining Female Sexual Dysfunction How the Definitions Relate to Our Procedures [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"jetpack_post_was_ever_published":false},"categories":[274,256],"tags":[134,311,2027,2001,264,316,2008,594,2010,2031,2014,2002,2029,1998,828,221,2009,280,2024,2003,2004,704,1809,2017,2018,2007,2005,2015,1942,2032,2030,2016,2033,2011,40,2036,2022,65,2019,2025,968,2023,249,306,2028,138,2000,973,2006,1999,2020,2034,2021,2026,2035,166,2013,2012,251,531],"class_list":["post-4983","post","type-post","status-publish","format-standard","hentry","category-clitoxin-r","category-pripaus-toxin-tm","tag-botox","tag-botulinum-toxin","tag-brandshield-com","tag-bremelanotide","tag-cellular-medicine-association","tag-charles-runels","tag-clitoris-injection","tag-clitoxin","tag-crossover-histology","tag-daxxify","tag-demyelination","tag-dhea-cream","tag-directory-listing","tag-distress-criteria","tag-dysport","tag-erectile-dysfunction","tag-erectile-tissue-urethra","tag-exosomes","tag-fda-approved-pdgf-protocols","tag-female-cognitive-arousal-disorder","tag-female-orgasm-illness-syndrome","tag-female-sexual-dysfunction","tag-flibanserin","tag-folate","tag-gait-disturbance","tag-genital-dysmorphophobia","tag-hard-flaccid-syndrome","tag-homocysteine","tag-jcpm","tag-ld50","tag-letybo","tag-methylmalonic-acid","tag-neurotoxin-dosing","tag-nitrous-oxide","tag-o-shot","tag-obesity","tag-off-label-iv-use","tag-p-shot","tag-paresthesias","tag-patient-education-marketing","tag-pde5-inhibitors","tag-pdgf","tag-platelet-rich-plasma","tag-priapus-toxin","tag-provider-training","tag-prp","tag-psychogenic-vs-biological","tag-regenerative-medicine","tag-restless-genital-syndrome","tag-sexual-dysfunction-prevalence","tag-stroke-risk","tag-testosterone-deficiency","tag-topical-only-products","tag-trademark-enforcement","tag-type-2-diabetes","tag-urinary-incontinence","tag-vitamin-b12-deficiency","tag-whippets","tag-wound-healing","tag-xeomin"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p6W8NG-1in","jetpack-related-posts":[{"id":2937,"url":"https:\/\/oshot.info\/members\/botox-for-female-sexual-dysfunction-a-review-iscg-2023\/","url_meta":{"origin":4983,"position":0},"title":"Botulinium Toxin for Female Sexual Dysfunction &#8211; A Review (ISCG 2023)","author":"Charles Runels, MD","date":"March 27, 2023","format":false,"excerpt":"The following was posted in 2023. A more up-to-date description (with the research) can be seen here (click)<-- Video of ISCG 2023 Lecture on Botox for Sexual Dysfunction Relevant Links References 1. Video of Lecture: a preview of Clitoxin\u2122 ...\u00a0 the use of botulinum toxin to improve sexual dysfunction in\u2026","rel":"","context":"In &quot;Clitoxin\u00ae&quot;","block_context":{"text":"Clitoxin\u00ae","link":"https:\/\/oshot.info\/members\/category\/clitoxin-r\/"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":4368,"url":"https:\/\/oshot.info\/members\/jcpm2025-09-16-alopecia-overview-female-sexual-function-p-shot-post-radiation\/","url_meta":{"origin":4983,"position":1},"title":"JCPM2025.09.16 | Alopecia | Overview Female Sexual Function | P-Shot\u00ae Post Radiation","author":"Charles Runels, MD","date":"September 22, 2025","format":false,"excerpt":"Journal Club with Pearls & Marketing 2025.09.16 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0\u00a0Cellular Medicine Association JCPM2025.09.16 The following is an edited transcript of the\u00a0Journal Club with Pearls & Marketing\u00a0(JCPM) of September 16, 2025, with Charles Runels, MD. \u00a0 >-> The PDF of this live journal club can\u2026","rel":"","context":"In &quot;alopeica&quot;","block_context":{"text":"alopeica","link":"https:\/\/oshot.info\/members\/category\/alopeica\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/cellularmedicineassociation.org\/wp-content\/uploads\/2025\/07\/image5-300x239.jpg?resize=350%2C200&ssl=1","width":350,"height":200},"classes":[]},{"id":4337,"url":"https:\/\/oshot.info\/members\/jcpm2025-09-02-scoping-reviews-of-gyn-uses-of-our-prp-for-multiple-gyn-uses-and-hair\/","url_meta":{"origin":4983,"position":2},"title":"JCPM2025.09.02 | Scoping Reviews of Gyn Uses of our PRP for Multiple Gyn Uses (and Hair)","author":"Charles Runels, MD","date":"September 21, 2025","format":false,"excerpt":"Journal Club with Pearls & Marketing 2025.09.02 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0\u00a0Cellular Medicine Association JCPM2025.09.02 The following is an edited transcript of the\u00a0Journal Club with Pearls & Marketing\u00a0(JCPM) of September 2, 2025, with Charles Runels, MD. \u00a0 >-> The PDF of this live journal club can\u2026","rel":"","context":"In \"Androgenic Alopecia\"","block_context":{"text":"Androgenic Alopecia","link":"https:\/\/oshot.info\/members\/tag\/androgenic-alopecia\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/cellularmedicineassociation.org\/wp-content\/uploads\/2025\/07\/image5.jpg?resize=350%2C200&ssl=1","width":350,"height":200},"classes":[]},{"id":3135,"url":"https:\/\/oshot.info\/members\/jcpm2023-12-05-peyronies-birth-control-pills-sexual-dysfunction-prp-devices-serious-warning\/","url_meta":{"origin":4983,"position":3},"title":"JCPM2023.12.05 Peyronie&#8217;s | Birth Control Pills &#038; Sexual Dysfunction | PRP Devices (serious warning)","author":"Charles Runels, MD","date":"December 10, 2023","format":false,"excerpt":"Topics Discussed Include the Following... Penile Rehabilitation after Prostate Surgery (new research supports the use of our P-Shot\u00ae procedure). Research on Platelet-Rich Plasma (PRP) in men in the bedroom The Role of Testosterone in Women's Sexual Function and the Impact of Birth Control Pills The Use of O-Shots\u00ae\u00a0in Improving Female\u2026","rel":"","context":"In &quot;warning&quot;","block_context":{"text":"warning","link":"https:\/\/oshot.info\/members\/category\/warning\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/vampirefacelift.com\/members\/wp-content\/uploads\/2021\/08\/O-Shot_Oil_bottle-300x300.jpeg?resize=350%2C200&ssl=1","width":350,"height":200},"classes":[]},{"id":4941,"url":"https:\/\/oshot.info\/members\/jcpm2026-04-21-o-shot-in-l-d-for-episiotomy-hair-and-skin-cancer-glp-1-and-bedroom\/","url_meta":{"origin":4983,"position":4},"title":"JCPM2026.04.21 | O-Shot\u00ae in L &#038; D for Episiotomy | Hair and Skin Cancer | GLP-1 and Bedroom","author":"Charles Runels, MD","date":"May 14, 2026","format":false,"excerpt":"The following is an edited transcript of the Journal Club with Pearls & Marketing\u00a0(JCPM) of April 21, 2026, with Charles Runels, MD.\u00a0\u00a0 -> The PDF of this live journal club can be seen here <-< =>The marketing kit for this journal club is here (pre-written emails)<= Topics Covered PRP Variability\u2026","rel":"","context":"In &quot;episiotomy&quot;","block_context":{"text":"episiotomy","link":"https:\/\/oshot.info\/members\/category\/episiotomy\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/cellularmedicineassociation.org\/wp-content\/uploads\/2025\/07\/image5-300x239.jpg?resize=350%2C200&ssl=1","width":350,"height":200},"classes":[]},{"id":3083,"url":"https:\/\/oshot.info\/members\/jcpm2023-09-12-genitalmutilation-priapustoxin-lichensclerosus-emailmarketing\/","url_meta":{"origin":4983,"position":5},"title":"JCPM2023.09.12 GenitalMutilation.PriapusToxin.LichenSclerosus.EMailMarketing","author":"Charles Runels, MD","date":"September 28, 2023","format":false,"excerpt":"Topics Discussed Include the Following... *Genital Mutilation *Lichen Sclerosus *Priapus Toxin\u00ae *Email marketing *Penis Pumps Video\/Recording of CMA Journal Club, Pearl Exchange, & Marketing Tips 1. Transcript, 2. Relevant Research 3. Relevant Link 1. Edited Transcript Welcome to the Journal Club. Tonight, we're covering a subject that needs to be\u2026","rel":"","context":"In &quot;female genital mutilation&quot;","block_context":{"text":"female genital mutilation","link":"https:\/\/oshot.info\/members\/category\/female-genital-mutilation\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/vampirefacelift.com\/members\/wp-content\/uploads\/2021\/08\/O-Shot_Oil_bottle-300x300.jpeg?resize=350%2C200&ssl=1","width":350,"height":200},"classes":[]}],"jetpack_likes_enabled":true,"_links":{"self":[{"href":"https:\/\/oshot.info\/members\/wp-json\/wp\/v2\/posts\/4983","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/oshot.info\/members\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/oshot.info\/members\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/oshot.info\/members\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/oshot.info\/members\/wp-json\/wp\/v2\/comments?post=4983"}],"version-history":[{"count":2,"href":"https:\/\/oshot.info\/members\/wp-json\/wp\/v2\/posts\/4983\/revisions"}],"predecessor-version":[{"id":4986,"href":"https:\/\/oshot.info\/members\/wp-json\/wp\/v2\/posts\/4983\/revisions\/4986"}],"wp:attachment":[{"href":"https:\/\/oshot.info\/members\/wp-json\/wp\/v2\/media?parent=4983"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/oshot.info\/members\/wp-json\/wp\/v2\/categories?post=4983"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/oshot.info\/members\/wp-json\/wp\/v2\/tags?post=4983"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}