{"id":5150,"date":"2026-07-01T18:15:07","date_gmt":"2026-07-01T18:15:07","guid":{"rendered":"https:\/\/oshot.info\/members\/?p=5150"},"modified":"2026-07-01T18:20:41","modified_gmt":"2026-07-01T18:20:41","slug":"clitoxin","status":"publish","type":"post","link":"https:\/\/oshot.info\/members\/clitoxin\/","title":{"rendered":"CLITOXIN\u00ae"},"content":{"rendered":"<style>\n.clitoxin-clean {\n  max-width: 980px;\n  margin: 0 auto;\n  line-height: 1.62;\n  font-size: 18px;\n}\n.clitoxin-clean h1,\n.clitoxin-clean h2,\n.clitoxin-clean h3,\n.clitoxin-clean h4,\n.clitoxin-clean h1 span,\n.clitoxin-clean h2 span,\n.clitoxin-clean h3 span,\n.clitoxin-clean h4 span,\n.clitoxin-clean .title,\n.clitoxin-clean .subtitle {\n  color: #5A2D6F !important;\n}\n.clitoxin-clean h1,\n.clitoxin-clean h2,\n.clitoxin-clean h3 {\n  line-height: 1.25;\n  margin-top: 34px;\n  margin-bottom: 14px;\n}\n.clitoxin-clean p {\n  margin: 0 0 17px;\n}\n.clitoxin-clean a {\n  color: #5A2D6F;\n}\n.clitoxin-clean img {\n  max-width: 50% !important;\n  height: auto !important;\n  display: block;\n  margin: 24px auto;\n}\n.clitoxin-clean img.alignleft,\n.clitoxin-clean img.alignright {\n  float: none !important;\n  margin-left: auto !important;\n  margin-right: auto !important;\n}\n.clitoxin-clean .clitoxin-video {\n  width: 50%;\n  aspect-ratio: 16 \/ 9;\n  position: relative;\n  margin: 0 auto 24px;\n}\n.clitoxin-clean .clitoxin-video iframe {\n  position: absolute;\n  inset: 0;\n  width: 100%;\n  height: 100%;\n}\n.clitoxin-clean blockquote {\n  border-left: 4px solid #5A2D6F;\n  margin: 28px auto;\n  padding: 14px 24px;\n  background: #faf8fc;\n  max-width: 760px;\n}\n.clitoxin-clean blockquote h3,\n.clitoxin-clean blockquote h4 {\n  margin: 0;\n}\n.clitoxin-clean ol,\n.clitoxin-clean ul {\n  padding-left: 1.5em;\n}\n.clitoxin-clean .wp-caption,\n.clitoxin-clean figure {\n  max-width: 50% !important;\n  margin: 24px auto !important;\n  text-align: center;\n}\n.clitoxin-clean .wp-caption img,\n.clitoxin-clean figure img {\n  max-width: 100% !important;\n  width: 100% !important;\n}\n@media (max-width: 760px) {\n  .clitoxin-clean img,\n  .clitoxin-clean .clitoxin-video,\n  .clitoxin-clean .wp-caption,\n  .clitoxin-clean figure {\n    width: 100% !important;\n    max-width: 100% !important;\n  }\n}\n<\/style>\n<div class=\"clitoxin-clean\">\n<div class=\"clitoxin-video\"><iframe title=\"Female Sexual Dysfunction &amp; the Clitoxin\u00ae Procedure\" src=\"https:\/\/player.vimeo.com\/video\/936641842?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<h3><a href=\"https:\/\/clitoxin.com\/wp-content\/uploads\/2024\/04\/Female-Sexual-Dysfunction-^0-the-Clitoxin-Procedure.pdf\" target=\"_blank\" rel=\"noopener\">--&gt;Click to read or download a PDF <span style=\"color: #800080;\">Transcript of the above video<\/span> that includes diagrams and <span style=\"color: #800080;\">scientific references<\/span>&lt;--<\/a><\/h3>\n<h3><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-192 size-medium\" src=\"https:\/\/clitoxin.com\/wp-content\/uploads\/2024\/04\/clitoxin-logo-1-300x69.jpeg\" alt=\"\" width=\"150\" height=\"34\" \/><span style=\"color: #800080;\">Important Legal Disclaimer:<\/span> <em><strong><span style=\"color: #800080;\">This is an off-label use of botulinum toxin; no results are ever guaranteed (no therapy works every time). If considered, it should only be done by a physician who has been properly trained and certified to do the procedure and only after considering all other options, including the option to do nothing, and only after a signed consent that includes the fact that results may vary and are unpredictable for new, off-label therapy and includes all the usual contraindications and possible side effects of botulinum toxin.<\/span><\/strong><\/em><\/h3>\n<h2><span style=\"color: #0000ff;\"><a style=\"color: #0000ff;\" href=\"https:\/\/clitoxin.com\/research\/\" target=\"_blank\" rel=\"noopener\"><i>See the Research&lt;--<\/i><\/a><\/span><\/h2>\n<h2><a href=\"https:\/\/oshot.info\/members\/directory\" target=\"_blank\" rel=\"noopener\"><span style=\"color: #0000ff;\"><em><strong>Find Provider&lt;--<\/strong><\/em><\/span><\/a><\/h2>\n<div>\n<h1 class=\"c19 title\"><span class=\"c3 c25\" style=\"color: #0000ff;\">Edited Transcript of Clitoxin\u00ae Procedure Video<\/span><\/h1>\n<p class=\"c19\"><em><span class=\"c11 c12\">By Charles Runels, MD<\/span><\/em><\/p>\n<h1 class=\"c17\"><span class=\"c21 c3 c16\" style=\"color: #800080;\">The Serious Problem: Sexual Dysfunction in Women<\/span><\/h1>\n<p class=\"c0\"><span class=\"c1\">Sex problems in women can take several forms.<\/span><span class=\"c1 c10\">1<\/span><span class=\"c1 c3\">\u00a0A woman can suffer pain (dyspareunia), she can have decreased lubrication, which can cause pain and other problems, decreased arousal, and decreased desire. She can also have trouble with orgasm, either a decrease in intensity or difficulty in having an orgasm. Any one or more of those problems can cause decreased satisfaction. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">These problems do not solely decrease sexual pleasure; by definition, for a woman to warrant the diagnosis by her physician of \u201csexual dysfunction,\u201d she must suffer psychological distress because of her symptoms. If she only complains of symptoms that decrease pleasure, without secondary psychological distress, she does not have sexual dysfunction. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1\">Even by that strictest of definitions, it is still estimated around 40% of women suffer from their sex, and surprisingly, the incidence is higher<\/span><span class=\"c33 c20 c5\">\u00a0in younger <\/span><span class=\"c1\">women.<\/span><span class=\"c1 c10\">2<\/span><span class=\"c1 c3\">\u00a0<\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">Why should younger women suffer more sex problems? <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">Some may guess that younger women would suffer less because they enjoy a younger body. The answer is in the definition. When a young woman (starting her family and making her first relationships) suffers dyspareunia, anorgasmia, and decreased arousal, that can be more distressing for her than for a woman who has already reared her children, or is widowed or divorced and has determined to take time to live alone.<\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">This definition of sexual dysfunction in women is unusual among the diagnosis criteria for the disease. For example, if your blood pressure is elevated and you are not psychologically bothered by it, you still have hypertension. Or if a male cannot have an erection, he has erectile dysfunction, regardless of his emotions about the condition. Since the definition of female sexual dysfunction requires that she be distressed by the problem, menopausal women may still suffer symptoms (perhaps more frequently than their younger siblings), but are not counted as having sexual dysfunction because they are less likely to be as upset. <\/span><\/p>\n<h3 class=\"c14 subtitle\"><span class=\"c8 c3\" style=\"color: #800080;\">Sexual dysfunction interferes with much more than pleasure.<\/span><\/h3>\n<p class=\"c19\"><span class=\"c24\">As a physician, I have cared for thousands of women over the past 36 years. Many of those women told me that when they enjoy good sex and good orgasms, it increases their creativity, but when they have sex problems, they have trouble focusing, and their family relations are strained. Women often tell me they use orgasm either with a lover or masturbating to help fall asleep and deal with depression and anxiety. Sex has far-reaching effects across <\/span><span class=\"c1\">all parts of a woman's life<\/span><span class=\"c20\">.<\/span><span class=\"c10 c20\">3<\/span><\/p>\n<h3 class=\"c14 subtitle\"><span class=\"c8 c3\" style=\"color: #800080;\">It is Not Just to Please a Man<\/span><\/h3>\n<p class=\"c0\"><span class=\"c1 c3\">Improving sex is not about women pleasing men. Women should love themselves. Sometimes, that self-love involves another person; sometimes, it does not.<\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">An elderly woman told me, \u201cI was sad when I had to put my wife in the nursing home because of her dementia. But I make love to myself. Why should men have all the fun? Orgasms make me happier.\u201d <\/span><\/p>\n<blockquote>\n<h4 class=\"c15\" style=\"text-align: center;\"><span style=\"color: #0000ff;\"><em><span class=\"c11 c5 c9\">Better sex helps a woman love herself.<\/span><\/em><\/span><\/h4>\n<\/blockquote>\n<p class=\"c0\"><span class=\"c1 c3\">Still, a woman can want to bring pleasure to her lover. Imagine a man completely content with his premature ejaculation and giving no thought to the frustration of his female lover. It can be good for him to want to bring her pleasure, and it can be good for the woman to want to bring pleasure to her husband, but it is also good for her to love herself. Sexual dysfunction can lessen all these pleasures.\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/clitoxin.com\/wp-content\/uploads\/2024\/04\/image8.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-208 size-full\" src=\"https:\/\/clitoxin.com\/wp-content\/uploads\/2024\/04\/image8.png\" alt=\"\" width=\"507\" height=\"660\" \/><\/a><\/p>\n<h1 class=\"c17\"><span class=\"c3 c16 c21\" style=\"color: #800080;\">Options for Treating Sexual Dysfunction in Women<\/span><\/h1>\n<p class=\"c0\"><span class=\"c1\">The options to treat sex problems in women include the FDA-approved drugs: flibanserin, bremelanotide, and topical DHEA.<\/span><span class=\"c1 c10\">4<\/span><\/p>\n<p class=\"c0\"><span class=\"c1\">Other drugs have been shown by research to help with sex, but the FDA does not approve their use to help with sex\u2014making them off-label, non-FDA-approved. For example, Wellbutrin and testosterone are commonly prescribed to help women with sex but are not FDA-approved for that purpose.<\/span><span class=\"c1 c10\">5<\/span><span class=\"c1\">\u00a0<\/span><span class=\"c1 c10\">6<\/span><span class=\"c1 c3\">\u00a0<\/span><\/p>\n<p class=\"c0\"><span class=\"c1\">Other options include lubrication, fantasy, sex counseling or family counseling, sex toys, and the O-Shot\u00ae procedure<\/span><span class=\"c1 c10\">7<\/span><span class=\"c1\">\u00a0<\/span><span class=\"c1 c10\">8<\/span><span class=\"c1\">. Options also include surgery (for phimosis and other pain problems), lasers, radiofrequency, and Kegel machines<\/span><span class=\"c1 c10\">9<\/span><span class=\"c1 c3\">. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">Lubricants do not solve most sex problems (only help with dyspareunia from dryness). <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">Family counseling or sex counseling is tremendously helpful and can make almost any problem better, but counseling to facilitate acceptance of a physical problem by learning how to cope better is not the same as making the problem go away (unless the problem is psychological or social with no physical etiology).<\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">None of those therapies are magic bullets. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">None.<\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">Not one.<\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">For comparison, if you suffer pain, you can take morphine, and most will have less pain\u2014almost guaranteed. You can take a sleeping pill, and you will likely feel sleepy.<\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">But we do not have a counterpart in the sexual medicine arena where most people can do one thing, and they are guaranteed to enjoy better sex.<\/span><\/p>\n<blockquote>\n<h4 class=\"c15\" style=\"text-align: center;\"><span style=\"color: #0000ff;\"><em><span class=\"c5 c9 c11\">There is nothing for female sex problems with a guaranteed restoration to good sex.<br \/>\nThere are no magic bullets.<\/span><\/em><\/span><\/h4>\n<\/blockquote>\n<p class=\"c0\"><span class=\"c1\">There are also significant side effects with our current options to help women with sex. For example, flibanserin should not be taken with alcohol because the combination can cause a dangerous drop in blood pressure.<\/span><span class=\"c1 c10\">10<\/span><span class=\"c1 c3\">\u00a0Also, flibanserin must be taken every day, even if you do not plan to have sex that day. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1\">In the studies of flibanserin, the reward (for taking the drug every day and not drinking any alcohol) was that the woman averaged enjoying sex <\/span><span class=\"c1 c5\">one more time per month\u2014one.<\/span><span class=\"c1 c10\">11<\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">Not 2.<\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">1 extra sex encounter per month.<\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">With bremelanotide, significant nausea, often with vomiting, is a common side effect. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">Vomiting usually mixes poorly with candlelight.<\/span><\/p>\n<h2 class=\"c14 subtitle\"><span class=\"c8 c3\" style=\"color: #800080;\">Nothing for Orgasm<\/span><\/h2>\n<p class=\"c0\"><span class=\"c1 c3\">Even though there are three FDA-approved drugs to help women with sex, none of them are indicated to help women enjoy more or better orgasms directly.<\/span><\/p>\n<h2 class=\"c14 subtitle\"><span class=\"c8 c3\" style=\"color: #800080;\">No Magic Bullets<\/span><\/h2>\n<p class=\"c0\"><span class=\"c1 c3\">So, we do not have an effective, universal treatment for female sex problems. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">We have only three FDA-approved drugs to help women with sex. Two of the three approved drugs are psychiatric drugs (they only affect the brain): flibanserin and bremelanotide. The only one designed to help the genitalia of the female is DHEA cream, which is only FDA-approved to help postmenopausal women with pain. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1\">That's it, <\/span><span style=\"color: #0000ff;\"><em><span class=\"c5 c9\">just three drugs approved by the FDA to help women with sex\u2014two are psychiatric drugs, and the other is only for postmenopausal women to relieve pain, while men enjoy the option of over twenty FDA-approved sex drugs; the drugs are for men of every age; and, most of the drugs for me directly target the improvement of the function and health of the male genitalia<\/span><span class=\"c1 c3\">. <\/span><\/em><\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">Judging by our FDA-approved menu of drugs, we are telling men that we can help the function of their genitalia to help them to better sex, but with women, we are telling them, \u201cYour sex problems are mostly in your head.\u201d<\/span><\/p>\n<h2 class=\"c17\"><span style=\"color: #800080;\"><span class=\"c16\">The Need for <\/span><span class=\"c5 c16\">Systems Analysis<\/span><span class=\"c21 c3 c16\">\u00a0to Understand Treatment Options<\/span><\/span><\/h2>\n<p class=\"c0\"><span class=\"c1\">Since there are no \u201cmagic bullets\u201d for treating sexual dysfunction in women, there must be a systems analysis to allow for optimal results (and to expand options to include additions to the psychiatric drugs).<\/span><span class=\"c1 c10\">12<\/span><span class=\"c1\">\u00a0<\/span><span class=\"c1 c10\">13<\/span><span class=\"c1\">\u00a0<\/span><span class=\"c1 c10\">14<\/span><span class=\"c1\">\u00a0<\/span><span class=\"c1 c10\">15<\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">The best way to think about systems analysis is to consider someone struggling to breathe: you would not give everyone suffering shortness of breath a bronchodilator because some may not have asthma (or bronchospasm). She may be a child who aspirated a foreign body into his trachea, aspirated a penny, or a small toy.<\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">Shortness of breath (dyspnea) can be caused by severe anemia (insufficient red blood cells are available to carry the oxygen). Dyspnea can be caused by cyanide poisoning, emphysema, a collapsed lung, or psychiatric problems (anxiety or fear). <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">So, you would not treat everyone suffering from dyspnea with a bronchodilator or give everyone a transfusion. Instead, you use systems analysis to diagnose which component (or components) need treatment; physicians use systems analysis daily and habitually to diagnose and treat every medical problem. <\/span><\/p>\n<blockquote>\n<h4 class=\"c15\" style=\"text-align: center;\"><em><span class=\"c11 c5 c9\" style=\"color: #0000ff;\">Physicians were taught to examine the penis, the foreskin, the testicles, and the prostate,<br \/>\nbut not the clitoris, the clitoral hood, or the labia minora.<\/span><\/em><\/h4>\n<\/blockquote>\n<p class=\"c0\"><span class=\"c1 c3\">I do not see systems analysis employed universally in treating sexual dysfunction as with other medical problems. I often see physicians, for example, buy a new device, and then almost everyone with a sex problem gets treated with that; maybe they buy a vaginal laser or something else on our list, a radiofrequency device, or a Kegel machine, or maybe they have just learned about flibanserin, and everybody gets that. Physicians are reckless most of the time; it is just that as part of their training, there has been less understanding and emphasis on systems analysis when treating female sexual problems. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">Historically, when it comes to female sexual dysfunction, there's much more research regarding male sexuality, and because of that, the understanding of the female orgasm system is less thorough, and the deployment of systems analysis is subsequently less frequent.<\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">It wasn't that long ago that the clitoris was not even drawn into the anatomy textbooks. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1\">As physicians, <\/span><span class=\"c11 c12\">we were all taught to examine the penis, the testicles, and the prostate, but not the clitoris. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">I've been teaching physicians in my hands-on workshops and online for 13 years, and when I teach, I like to ask, \"Were you ever taught to examine the clitoris when you were in medical school?\" <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">So far, no one has answered \u201cYes\u201d to that question. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">They always answer, \u201cNo.\u201d<\/span><\/p>\n<p class=\"c0\"><span class=\"c1\">Research has demonstrated that the thoroughness of teaching even the anatomy of female sexuality is much less for females than for males.<\/span><span class=\"c1 c10\">16<\/span><\/p>\n<h2 class=\"c14 subtitle\"><span class=\"c8 c3\" style=\"color: #800080;\">What is a System?<\/span><\/h2>\n<p class=\"c19\"><span class=\"c24\">Multiple components working together to accomplish a purpose make a system.<\/span><span class=\"c24 c10\">17<\/span><span class=\"c24\">\u00a0<\/span><span class=\"c24 c10\">18<\/span><span class=\"c24\">\u00a0<\/span><span class=\"c24 c10\">19<\/span><span class=\"c24\">\u00a0<\/span><span class=\"c10 c24\">20<\/span><span class=\"c24\">\u00a0And there can be systems within systems. There can be a solar system; within that solar system exists the earth-moon system, where the satellite (moon) orbits the earth. The circulatory system is a component of the body system. <\/span><\/p>\n<blockquote>\n<h4 class=\"c15\" style=\"text-align: center;\"><span style=\"color: #0000ff;\"><em><span class=\"c11 c5 c9\">A system is multiple components working together to accomplish a purpose. <\/span><\/em><\/span><\/h4>\n<\/blockquote>\n<p class=\"c0\"><span class=\"c1 c3\">One component of the female orgasm system is hormones, so at least part of the endocrine system is a component of the female orgasm system. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">There are also mechanical systems within the orgasm system (muscles and bones); for example, there must be a structure to the posterior vagina to push the penis against the anterior vaginal wall for stimulation of the woman. Making the vagina smaller in diameter is not just about stimulating the penis. The penis must have something supporting it, or else there's no pressure on the G-spot or the urethra or the mechanism of sensation (imagine a vagina with no posterior wall, there would be zero stimulation of the anterior vagina). So, there's a mechanical component to the female orgasm system.\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/clitoxin.com\/wp-content\/uploads\/2024\/05\/image14.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-217\" src=\"https:\/\/clitoxin.com\/wp-content\/uploads\/2024\/05\/image14.png\" alt=\"\" width=\"344\" height=\"330\" \/><\/a><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">Muscle contraction and relaxation are part of the pleasure of orgasm.<\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">Also, it is impossible to enjoy good sex without good blood flow and respiration because there is some exercise component and a blood flow component to sex. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">There is a psychological component. Maybe the woman was abused, or maybe she has depression. Maybe she has compulsions that are not for her best health.<\/span><\/p>\n<figure id=\"attachment_252\" aria-describedby=\"caption-attachment-252\" style=\"width: 792px\" class=\"wp-caption alignnone\"><a href=\"https:\/\/clitoxin.com\/wp-content\/uploads\/2024\/12\/Female-Orgasm-System-Poster.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-252\" src=\"https:\/\/clitoxin.com\/wp-content\/uploads\/2024\/12\/Female-Orgasm-System-Poster.jpg\" alt=\"\" width=\"792\" height=\"1024\" \/><\/a><figcaption id=\"caption-attachment-252\" class=\"wp-caption-text\">The Female Orgasm System<\/figcaption><\/figure>\n<p class=\"c0\"><span class=\"c1 c3\">There is a social component. Perhaps her relationship is not so good, or the structure of her household is so there's no privacy or intimacy. Or perhaps she enjoys a lover who demonstrates caring and understanding of her body and emotions.<\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">And, of course, there's a neurological component to the female orgasm system; a woman must be able to \u201cfeel\u201d and be aware of what she is feeling. \u00a0<\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">One might argue that the female orgasm system has been largely undefined because it is extremely complicated, but that offers no legitimate alibi for not defining the system and thinking deeply about how to treat the dysfunction of the system.<\/span><\/p>\n<h2 class=\"c0\"><span class=\"c8\" style=\"color: #800080;\">The Importance of the Autonomic Nervous System<\/span><\/h2>\n<p class=\"c0\"><span class=\"c1\">There are two <\/span><em><span class=\"c20 c5 c33\" style=\"color: #0000ff;\">subsystems<\/span><\/em><span class=\"c1\">\u00a0within the nervous system component of the female orgasm system.<\/span><\/p>\n<p class=\"c0\"><span class=\"c1\">First, there's a <\/span><span class=\"c1 c5\">somatic nervous system<\/span><span class=\"c1 c3\">: voluntary movement and conscious sensation. If you decide to move your left hand, that's a somatic movement; that is voluntary. If you touch something with your finger or if the clitoris is touched, that is a somatic sensation. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1\">Second is the autonomic nervous system: the part of your nervous system that tells your heart how fast to beat (without it, the heart would stop beating) and tells your bowels when to have peristalsis. <\/span><span class=\"c1 c5\">The autonomic nervous system tells you when to sweat or to shiver and when to feel aroused<\/span><span class=\"c1\">. The primary arousal center in the brain is within the hypothalamus. Of course, there is communication between the midbrain (autonomic) and the cerebrum; you are aware that you're aroused, just like you're aware that you feel hot or cold when you shiver, but <\/span><strong><em><span class=\"c33 c20\">it's the midbrain that is controlling that autonomic nervous system, and there are nerves corresponding to both parts (somatic and autonomic) of the neurological system<\/span><\/em><\/strong><span class=\"c1\">.<\/span><span class=\"c1 c10\">21<\/span><span class=\"c1\">\u00a0<\/span><span class=\"c1 c10\">22<\/span><span class=\"c1\">\u00a0<\/span><span class=\"c1 c10\">23<\/span><span class=\"c1\">\u00a0<\/span><span class=\"c1 c10\">24<\/span><\/p>\n<p class=\"c19\"><span class=\"c24\">There are the somatic nerves for conscious sensations. However, the autonomic nervous system input and output, even though less a part of consciousness, are just as powerful. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">Consider the pain when someone is having a heart attack. She may have left arm pain even though the arm is not being damaged, but because the innervation and the flow of the nerves from the heart are less granular, the brain cannot tell exactly what is being damaged. It can only tell something is hurting. If you have pain from a kidney stone, it feels like a severe backache with nausea; your brain does not tell you that there is swelling in your ureter. So, there's less granularity with the autonomic nervous system, but it is still very important, perhaps more important than the somatic nervous system in some ways, because it governs all body functions.\u00a0<\/span><\/p>\n<figure id=\"attachment_226\" aria-describedby=\"caption-attachment-226\" style=\"width: 373px\" class=\"wp-caption alignnone\"><a href=\"https:\/\/clitoxin.com\/wp-content\/uploads\/2024\/05\/image3.png\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-226 size-full\" src=\"https:\/\/clitoxin.com\/wp-content\/uploads\/2024\/05\/image3.png\" alt=\"\" width=\"373\" height=\"220\" \/><\/a><figcaption id=\"caption-attachment-226\" class=\"wp-caption-text\"><strong><em>Figure 1. The nervous system is one of the subcomponents of the female orgasm system. The nervous system contains the subcomponents of the autonomic and the somatic nervous system.<\/em><\/strong><\/figcaption><\/figure>\n<p class=\"c0\"><span class=\"c1 c3\">Shut off the somatic nerves to your hand\u2014that is disturbing. Shut off the autonomic nervous system\u2014you die. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">And you would lose all sexual desire.<\/span><span style=\"overflow: hidden; display: inline-block; margin: 0.00px 0.00px; border: 0.00px solid #000000; transform: rotate(0.00rad) translateZ(0px); -webkit-transform: rotate(0.00rad) translateZ(0px); width: 325.40px; height: 1.33px;\"><img decoding=\"async\" style=\"width: 325.40px; height: 1.33px; margin-left: 0.00px; margin-top: 0.00px; transform: rotate(0.00rad) translateZ(0px); -webkit-transform: rotate(0.00rad) translateZ(0px);\" title=\"\" src=\"images\/image5.png\" alt=\"\" \/><\/span><\/p>\n<p class=\"c0\"><span class=\"c1\">Considering the current body of research, the autonomic nervous system (sympathetic and parasympathetic) that controls and regulates the female sexual response has been relatively ignored.<\/span><span class=\"c1 c10\">23<\/span><span class=\"c1 c3\">\u00a0There is no malintent. It has not been discussed or studied as much as the male autonomic nervous system in relation to sex. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1\">For example, by the time most finish college and by the time everybody finishes medical school, people know that the parasympathetic part of the autonomic nervous system, which has to do with relaxation (versus the sympathetic part, which has to do with the fight-or-flight response) has the most to do with erection in men. But even most physicians have a vague understanding of the function of the autonomic nervous system in females during the sexual response. There have been, thankfully, some heroic efforts to correct that mismatch of research and understanding. One recent study showed, for example, what happens to the autonomic nerves when a mid-urethral sling is placed, which is a legitimate and needed surgical procedure.<\/span><span class=\"c1 c10\">25<\/span><span class=\"c1 c3\">\u00a0But if you're paying attention to the somatic nerves of the clitoris and not to the autonomic nerves, then harm becomes more likely.<\/span><\/p>\n<h2 class=\"c17\"><span class=\"c21 c3 c16\" style=\"color: #800080;\">The Obvious Uses of Botulinum Toxin in the Female Sexual Response<\/span><\/h2>\n<p class=\"c0\"><span class=\"c1\">Botulinum toxin (BoNT) has been injected for over a decade to decrease unwanted and painful muscle contraction, or spasms, of the vagina (vaginismus)<\/span><span class=\"c1 c10\">26<\/span><span class=\"c1\">\u00a0<\/span><span class=\"c1 c10\">27<\/span><span class=\"c1\">\u00a0and to relax bladder spasms.<\/span><span class=\"c1 c10\">28<\/span><span class=\"c1\">\u00a0<\/span><span class=\"c1 c10\">29<\/span><span class=\"c1\">\u00a0It's also been used to attempt to <\/span><span class=\"c1 c5\">decrease <\/span><span class=\"c1\">sensation, not quite as successfully, for the pain of vulvodynia<\/span><span class=\"c1 c10\">30<\/span><span class=\"c1\">\u00a0<\/span><span class=\"c1 c10\">31<\/span><span class=\"c1\">\u00a0and the misery of unwanted, <\/span><span class=\"c1 c5\">persistent genital arousal disorder<\/span><span class=\"c1\">.<\/span><span class=\"c1 c10\">32<\/span><span class=\"c1 c3\">\u00a0In both areas, decreasing muscle contraction and decreasing sensation, botulinum toxin strategies have involved mostly thinking about the somatic nervous system. That's also how it\u2019s used cosmetically: you inject it into the muscles of the face; it interferes with the motor end plate or the communication of the nerve with the muscle, and the muscle relaxes.<\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">That is a somatic nerve response. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">You can frown or smile, and the muscle moves. Botulinum toxin interferes with that communication and causes relaxation. In the same way, it's thought to work with vaginismus and bladder spasms. Again, there's been an attempt to decrease nerve signal transmission with persistent genital arousal disorder and vaginismus.\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/clitoxin.com\/wp-content\/uploads\/2024\/05\/image1.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-229\" src=\"https:\/\/clitoxin.com\/wp-content\/uploads\/2024\/05\/image1.png\" alt=\"\" width=\"474\" height=\"264\" \/><\/a><\/p>\n<h2 class=\"c17\"><span style=\"color: #800080;\"><span class=\"c16\">The <\/span><span class=\"c16 c5\">Not-Obvious<\/span><span class=\"c21 c3 c16\">\u00a0Effect of BoNT When Injected<\/span><\/span><\/h2>\n<p class=\"c0\"><span class=\"c1\">But if you go to the migraine arena, here's a clue to something not obvious about how botulinum toxin might help in the female with sex. It was thought at one time that botulinum toxin helped relieve migraines by just relaxing the muscles. Although that is true with bruxism, where there's a spasm of the masseter muscle that causes teeth to clench, relaxing the muscle does help the resultant headaches.<\/span><span class=\"c1 c10\">33<\/span><span class=\"c1\">\u00a0<\/span><span class=\"c1 c10\">34<\/span><span class=\"c1 c3\">\u00a0 But with true migraine headaches, it is now thought that relaxing the muscles of the face is not how botulinum toxin works to decrease the frequency and intensity of migraines.<\/span><\/p>\n<p class=\"c0\"><span class=\"c1\">It is now postulated, and research has demonstrated that botulinum toxin, when you inject the face (for example, in the procerus muscle between the eyes), migrates along the axon by being brought into the Schwann cell (endocytosis), and then the botulinum toxin travels along the nerve until it <\/span><span class=\"c1 c5\">reaches the ganglion<\/span><span class=\"c1\">.<\/span><span class=\"c1 c10\">35<\/span><span class=\"c1\">\u00a0<\/span><span class=\"c1 c10\">36<\/span><span class=\"c1\">\u00a0<\/span><span class=\"c1 c10\">37<\/span><\/p>\n<p class=\"c0\"><span class=\"c1\">I'll say that again: <\/span><span class=\"c1 c5\">You inject the muscle of the face, but the way it helps with migraines is not by relaxing the muscle. BoNT helps with migraines because it goes along the nerve to the switchboard mechanism called a ganglion, and the ganglion then connects to another nerve that goes to the brain. That ganglion, the trigeminal ganglion, is where the nerve connects from the procerus muscle. The trigeminal ganglion and the caudate nucleus are also shared by the same nerves that come from the pain fibers in the meninges, and that's where the pain starts with migraine<\/span><span class=\"c1 c3\">.<\/span><\/p>\n<blockquote>\n<h4 class=\"c15\" style=\"text-align: center;\"><em><span class=\"c11 c5 c9\" style=\"color: #0000ff;\">BoNT has been primarily used to treat the somatic nervous system component of the female orgasm system.<br \/>\nBecause it also affects the autonomic nervous system, BoNT effects when injected in the clitoris were not obvious.<\/span><\/em><\/h4>\n<\/blockquote>\n<p class=\"c0\"><span class=\"c5 c9 c30\">You're using the face muscle as a port to inject the ganglion switchboard, which is shared by the nerves coming from the meninges, and, therefore, blocking the pain of migraine<\/span><span class=\"c1 c3\">.<\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">You are not treating migraine by relaxing the muscle injected; that idea is a clue to how botulinum toxin might work in a very non-obvious way to help female sexuality. <\/span><\/p>\n<h2 class=\"c17\"><span class=\"c21 c3 c16\" style=\"color: #800080;\">The Unexpected Result When BoNT is Injected<\/span><\/h2>\n<p class=\"c0\"><span class=\"c1\">When you think about the somatic nervous system and the female sexual response, you think about the pudendal nerve, which goes to the dorsal nerve of the clitoris. In other words, that's where you consciously feel the sensation when the clitoris is stimulated or touched. It travels along the dorsal nerve, and that's a somatic response.<\/span><span class=\"c1 c10\">38<\/span><span class=\"c1 c3\">\u00a0One might postulate that putting botulinum toxin in the clitoris might worsen the sexual response by blocking nerve transmission.<\/span><\/p>\n<blockquote>\n<h4 class=\"c15\" style=\"text-align: center;\"><em><span class=\"c11 c5 c9\" style=\"color: #0000ff;\">Because BoNT injected into the clitoris primarily affects the autonomic nervous system (not the somatic nervous system), the results are opposite and unexpected from what previous uses of BoNT would predict.<\/span><\/em><\/h4>\n<\/blockquote>\n<p class=\"c0\"><span class=\"c1\">But when considering the non-obvious component, the autonomic nervous system, and how botulinum toxin could migrate along the nerves of the autonomic nervous system that connect to the midbrain, the hypothalamus (where the arousal center lies), then you have an understanding of the possibility of <\/span><span style=\"color: #800080;\"><strong><em><span class=\"c5 c9\">unexpected results: that botulinum toxin would not decrease the response, either sensation or muscle contraction, but rather increase arousal by heightening the baseline level of the arousal center<\/span><\/em><\/strong><\/span><span class=\"c1 c3\">. So, that mechanism is not obvious if you're thinking about the somatic nerves (which is what most have thought about regarding female sexual response), and if the results were to improve sex, that would be unexpected but would be explained by the autonomic response. <\/span><\/p>\n<h2 class=\"c17\"><span class=\"c21 c3 c16\" style=\"color: #800080;\">Clitoxin\u00ae: a Specific Method for Injecting the Clitoris with Botulinum Toxin to Improve Sex for Women.<\/span><\/h2>\n<p class=\"c0\"><span class=\"c1\">To test for the unexpected results of the non-obvious, my wife and I did a study where we looked at what happened when women wanted improvement in their sexuality and they had either failed or did not want the current therapies.<\/span><span class=\"c1 c10\">39<\/span><span class=\"c1 c3\">\u00a0<\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">When they chose to experience the injection of botulinum toxin into the clitoris, we postulated that it might work in three different ways: (1) by affecting the autonomic nervous system, as I described, (2) by increasing arterial blood flow by relaxing the muscles that control blood flow to the clitoris, and (3) by triggering the regeneration of healthier tissues. <\/span><\/p>\n<p class=\"c0\"><a href=\"https:\/\/clitoxin.com\/wp-content\/uploads\/2024\/05\/image10.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-220\" src=\"https:\/\/clitoxin.com\/wp-content\/uploads\/2024\/05\/image10.png\" alt=\"\" width=\"561\" height=\"311\" \/><\/a><\/p>\n<ol class=\"c22 lst-kix_list_1-0 start\" start=\"1\">\n<li class=\"c14 c36 subtitle li-bullet-0\">\n<h3><span class=\"c8 c3\" style=\"color: #800080;\">Activation of the Autonomic Nervous System<\/span><\/h3>\n<\/li>\n<\/ol>\n<p class=\"c0\"><span class=\"c1\">\u201cBoNT\u201d stands for botulinum neurotoxin, which could be any brand name. We used Xeomin\u00ae in our study for the reasons described in our research.<\/span><span class=\"c1 c10\">39<\/span><span class=\"c1 c3\">\u00a0<\/span><\/p>\n<p class=\"c0\"><span class=\"c1\">After injecting the clitoris with botulinum toxin, if it then behaved as it does with migraine treatment,<\/span><span class=\"c1 c10\">36<\/span><span class=\"c1 c3\">\u00a0traveling from the facial muscles to the trigeminal ganglion to the caudate nucleus to affect the autonomic nervous system, then, after injection into the clitoris, BoNT would travel to the ganglion in the lateral vaginal wall through the cavernous nerves\u2014which would then signal the arousal center.<\/span><\/p>\n<p class=\"c0\"><span class=\"c1\">With the dorsal nerve of the clitoris, a woman consciously feels her clitoris. However, there are nerves in the clitoris that are not sensation nerves.<\/span><span class=\"c1 c10\">40<\/span><span class=\"c1\">\u00a0<\/span><span class=\"c1 c10\">25<\/span><span class=\"c1 c3\"> In other words when you inject the clitoris, the brain is consciously aware of sensation through the dorsal nerve of the clitoris, but it's the midbrain, the non-conscious brain, the same brain that is keeping track of your bowels and your heart and your sweating and your shivering\u2014that brain is also connected to the clitoris through the cavernous nerves, which then go out of the clitoris into the lateral vaginal wall to the ganglia. That\u2019s the parasympathetic part of the autonomic nervous system.<\/span><\/p>\n<p><a href=\"https:\/\/clitoxin.com\/wp-content\/uploads\/2024\/05\/image7.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-223\" src=\"https:\/\/clitoxin.com\/wp-content\/uploads\/2024\/05\/image7.png\" alt=\"\" width=\"269\" height=\"288\" \/><\/a><\/p>\n<p class=\"c0\"><span class=\"c1\">The sympathetic nervous system takes a different route, but both (sympathetic and parasympathetic) connect to ganglia (switchboards), which, when affected by BoNT, change the set point of those ganglia.<\/span><span class=\"c1 c10\">41<\/span><span class=\"c1 c3\">\u00a0<\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">The signal from the ganglia then passes through the inferior hypogastric plexus or the splenic plexus to the spinal cord and then to the arousal center of the hypothalamus. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">And then you have feedback loops because when the hypothalamus, the arousal center says, \"Oh, there is a change...\" Just like with migraines, there's been a change; although the clitoris isn't being stimulated, the baseline arousal level is raised by the botulinum toxin affecting the ganglion. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">So, the arousal center in the hypothalamus says, \"Oh! We're at a more aroused state,\" and it may not be to persistent genital arousal (where she's just got to have sex right now), but it might make her more easily aroused.<\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">Then, the cerebrum becomes aware of that feeling and may seek pleasure, sexual relationships, or self-love because the arousal center is becoming more heightened, or because the arousal center is more heightened, there may be an easier transition from non-aroused to arousal. Then, when that feedback happens, the lateral hypothalamus tells the cerebrum to be more aroused but feeds back through the same autonomic nerves to the genitalia to increase pleasure. The signals go in both directions\u2014traveling through afferent nerves (going back to the brain) and efferent nerves (leaving the brain). When signals leave the brain, they might tell the vagina to lubricate, and when orgasm happens, it may tell the uterus and the vagina to contract. So, feedback loops are happening with this positive spiral that leads to better sex. At least, that's what we thought might happen.<\/span><\/p>\n<ol class=\"c22 lst-kix_list_1-0\" start=\"2\">\n<li class=\"c14 c36 subtitle li-bullet-0\">\n<h3><span class=\"c8 c3\" style=\"color: #800080;\">Botulinum toxin relaxes smooth muscle to increase blood flow to the clitoris.<\/span><\/h3>\n<\/li>\n<\/ol>\n<p class=\"c0\"><span class=\"c1\">Botulinum toxin also relaxes smooth muscle. This has been known for over a decade. That's why it's used to relax the bladder in women with bladder spasms to help with incontinence.<\/span><span class=\"c1 c10\">42<\/span><span class=\"c1\">\u00a0<\/span><span class=\"c1 c10\">43<\/span><span class=\"c1 c3\">Arterioles within the clitoris have smooth muscles that line the wall, making them smaller in diameter when those muscles contract. When they relax, the diameter is larger, so more blood can flow through. It could be that the botulinum toxin might relax the muscles of the arterioles, leading to more blood flow and increased engorgement of the clitoris, which could cause increased stimulation.\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/clitoxin.com\/wp-content\/uploads\/2024\/05\/image9.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-221\" src=\"https:\/\/clitoxin.com\/wp-content\/uploads\/2024\/05\/image9.png\" alt=\"\" width=\"532\" height=\"260\" \/><\/a><\/p>\n<ol class=\"c22 lst-kix_list_1-0\" start=\"3\">\n<li class=\"c0 c36 li-bullet-0\">\n<h3><span class=\"c8 c3\" style=\"color: #800080;\">Botulinum toxin triggers tissue regeneration.<\/span><\/h3>\n<\/li>\n<\/ol>\n<p class=\"c0\"><span class=\"c1\">Other effects of botulinum toxin that have been known since the 1950s are that it can stimulate the growth of new blood vessels, nerves, and collagen. A lot of this research happened in the study of healing surgical wounds.<\/span><span class=\"c1 c10\">44<\/span><span class=\"c1\">\u00a0<\/span><span class=\"c1 c10\">45<\/span><span class=\"c1\">\u00a0<\/span><span class=\"c1 c10\">46<\/span><span class=\"c1\">\u00a0<\/span><span class=\"c1 c10\">47<\/span><span class=\"c1\">\u00a0<\/span><span class=\"c1 c10\">48<\/span><span class=\"c1\">\u00a0<\/span><span class=\"c1 c10\">49<\/span><span class=\"c1\">\u00a0<\/span><span class=\"c1 c10\">50<\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">For example, injecting the tissue with botulinum toxin blocks the motor end plate, but then the Schwann cell adapts by growing new neurons or nerves to adapt to that blocking. So, you have new nerves, and in the same way, you can see neovascularization and collagenesis. So, there are three ways that botulinum toxin could help. It might help by affecting the autonomic nervous system, increasing arterial blood flow, and triggering the regeneration of healthier tissue. But all that was a postulate until we did the study that we'll talk about momentarily. <\/span><\/p>\n<h2 class=\"c17\"><span class=\"c21 c3 c16\" style=\"color: #800080;\">What Is Not Possible with the Clitoxin\u00ae Procedure?<\/span><\/h2>\n<p class=\"c0\"><span class=\"c1 c3\">\u00a0Before we talk about the results of our study, I want to re-emphasize that there are no magic shots. You can't fix a low testosterone level or a high prolactin level from a micro-adenoma with an injection of botulinum toxin into the clitoris, and an elevated prolactin level is very likely to cause decreased desire and possibly anorgasmia. If a woman suffers from a uterine fibroid that's causing pain, that's not going to get better with an injection of the clitoris, just like you can't make shortness of breath caused by anemia better by giving someone a bronchodilator.<\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">In other words, for the best diagnosis and treatment, you must think about the whole orgasm system and decide what might be helpful using that systems analysis, just like you would with the respiratory system, the cardiovascular system, the lymphatic system, the gastrointestinal system, or any other system. Those posters were put on the wall in your schoolroom in the fifth grade to help you understand how components work together, all at the same time, with positive and negative feedback loops, to create an outcome.<\/span><\/p>\n<blockquote>\n<h3 class=\"c15\" style=\"text-align: center;\"><em><span class=\"c11 c5 c9\" style=\"color: #0000ff;\">There are no magic shots.<\/span><\/em><\/h3>\n<\/blockquote>\n<p class=\"c0\"><span class=\"c1 c3\">So if the woman has suffered prior sexual abuse, if she's in a toxic relationship, has not dealt with those problems, or if she has a lover who doesn't understand her body and they are not matching in the bedroom, then she will be made all happy from just injecting botulinum toxin in her clitoris. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">And in our study, the treatment seemed less helpful for postmenopausal and not hormonally replaced. It was also not as helpful for pain, although we did see that it significantly increased lubrication, arousal, orgasm, and satisfaction. <\/span><\/p>\n<h2 class=\"c17\"><span class=\"c21 c3 c16\" style=\"color: #800080;\">What Is Possible with the Clitoxin\u00ae Procedure?<\/span><\/h2>\n<p class=\"c0\"><span class=\"c1\">One of the problems with doing studies with female sex is that there's not an objective way to measure the results.<\/span><span class=\"c1 c10\">39<\/span><span class=\"c1 c3\">\u00a0The female sexual function index is one proven way the sexual response is measured in women. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">For comparison, if you're doing a study of a man's Peyronie's disease (his bent erection), you can measure that with a 10-cent protractor from the office supply store. If you're measuring erectile firmness, that's measurable, but to measure a woman's satisfaction, you can't measure that objectively. So, surveys are done, and the female sexual function index is one of the two or three most relied upon measures of the results. It has scores for different domains and a total score.\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/clitoxin.com\/wp-content\/uploads\/2024\/05\/image12.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-219\" src=\"https:\/\/clitoxin.com\/wp-content\/uploads\/2024\/05\/image12.png\" alt=\"\" width=\"322\" height=\"220\" \/><\/a><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">Here's one of the charts demonstrating <a href=\"https:\/\/clitoxin.com\/wp-content\/uploads\/2024\/04\/Female-Sexual-Dysfunction-^0-the-Clitoxin-Procedure.pdf\" target=\"_blank\" rel=\"noopener\">our results.<\/a><\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">When we injected botulinum toxin into the clitoris, the mean female sexual function index improved by eight. When we added platelet-rich plasma (the primary part of the O-Shot\u00ae procedure) to the BoNT and injected the clitoris, the response went up to 12.<\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">So, what does that mean, increasing the score by 8 with botulinum toxin to the clitoris by itself and 12 when it was added to platelet-rich plasma? <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">Here is a comparison. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">A meta-analysis was done where the major treatments for sexual dysfunction in women were considered. Because the placebo effect is very strong in any study of female sexuality, the meta-analysis also looked at the average expected placebo effect for the treatment of female sexual dysfunction. Looking at Wellbutrin, flibanserin, and bremelanotide and what happened, the average placebo effect was 3.62. The average flibanserin effect improved by 5.3, and bremelanotide was 3.6 (about the average of the placebo in the other studies), but the placebo was less in the bremelanotide study.\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/clitoxin.com\/wp-content\/uploads\/2024\/05\/image11.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-230\" src=\"https:\/\/clitoxin.com\/wp-content\/uploads\/2024\/05\/image11.jpg\" alt=\"\" width=\"397\" height=\"220\" \/><\/a><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">To give you a reference of what those numbers mean, another number to remember is that you must raise the total score to above 26.5 for the women to be counted as not having a sexual dysfunction.<\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">Most women who complain of sexual problems (to the point that they're distressed) show an average female sexual function index total of 20. The average score for women who are not complaining and who say sex is great, their average score is 30. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">So, to get from the average presentation with sexual dysfunction that's disturbing (20), most women will have to go up by six or seven, and neither of the two main FDA-approved agents accomplishes that (they only raise the score by 3 or 5). <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">Neither of the FDA-approved, on-label drugs, flibanserin or bremelanotide, raises the score by the six or seven needed to suffer no dysfunction, and neither comes close to raising the score by the ten or more that would be required to go from the average of twenty in women with problems to the average of thirty with women with no problems. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1\">In our study, the clitoral botulinum toxin alone bumped it by eight (enough to go from dysfunction to normal function). When we added platelet-rich plasma (PRP) to the botulinum toxin, it raised the average score by twelve\u2014<\/span><span class=\"c5 c9\">enough to take a woman from the average score seen with those suffering sexual dysfunction to that seen in women who are loving sex<\/span><span class=\"c1 c3\">. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">That means it was such a robust response that you could use the other two, flibanserin or bremelanotide, as the placebo and still show a statistical benefit from the Clitoxin\u00ae procedure (if these numbers are borne out in future studies).<\/span><\/p>\n<p class=\"c0\"><span class=\"c11 c5 c9\">In some women, BoNT injected into the clitoris could, if combined with platelet-rich plasma, take them from the average of 20 to greater than 30; there is nothing else that has been shown in any study to raise the total female sexual function index by that much. <\/span><\/p>\n<p class=\"c0\"><span class=\"c2\">Part of the reason that multiple modalities are recommended in treating sexual dysfunction in women, even the shotgun approach where many things are used at the same time, sometimes without regard to the system's analysis, is that knowing there is not one therapy that has been shown to move people that far on the scale, there is the hope of an additive or synergistic effect by using multiple therapies that will bring women up the level of thirty.\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/clitoxin.com\/wp-content\/uploads\/2024\/05\/image6.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-224\" src=\"https:\/\/clitoxin.com\/wp-content\/uploads\/2024\/05\/image6.png\" alt=\"\" width=\"418\" height=\"572\" \/><\/a><\/p>\n<p class=\"c0\"><span class=\"c1\">This idea, <\/span><span class=\"c5 c9\">Clitoxin\u00ae (injecting botulinum toxin in a very specific way into the clitoris), will not work if performed incorrectly<\/span><span class=\"c1 c3\">. But if it's done in a specific way, then our study shows the possibility of successful monotherapy for some women suffering sexual dysfunction.<\/span><\/p>\n<h2 class=\"c17\"><span class=\"c21 c3 c16\" style=\"color: #800080;\">Clitoxin\u00ae is a Non-FDA Approved, Off-Label Treatment<\/span><\/h2>\n<p class=\"c0\"><span class=\"c1 c3\">This is an off-label, non-FDA-approved use of botulinum toxin. So, let's talk about what that means. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1\">The status of non-FDA-approved does not mean it's not supported by research and is not commonly used.<\/span><span class=\"c1 c10\">51<\/span><span class=\"c1\">\u00a0<\/span><span class=\"c1 c10\">52<\/span><span class=\"c1 c3\">There are many supportive ideas about using botulinum toxin to help the three ways we just talked about: the autonomic nervous system, help with wound healing, dating back to the 1950s, help with vasodilatation or relaxation of smooth muscle. That's well known. It just wasn't obvious that it might be used in the clitoris. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1\">But let's explore this further: 21 to 31% of all prescriptions are written for non-FDA-approved, off-label uses.<\/span><span class=\"c1 c10\">53<\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">That means around one in four prescriptions of the millions written daily are used off-label. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1\">In one study, 90% of the children in the hospital received at least one off-label prescription. That\u2019s 90%, 9 out of 10 children in the hospital received at least one prescription during the hospitalization that was an off-label, non-FDA-approved use of the drug.<\/span><span class=\"c1 c10\">54<\/span><\/p>\n<blockquote>\n<h4 class=\"c15\" style=\"text-align: center;\"><span class=\"c11 c5 c9\" style=\"color: #0000ff;\">21 to 31% of all prescriptions written<br \/>\nare written for non-FDA-approved, off-label uses.<\/span><\/h4>\n<\/blockquote>\n<h3 class=\"c14 subtitle\"><span class=\"c8 c3\" style=\"color: #800080;\">Why So Many Off-Label Prescriptions?<\/span><\/h3>\n<p class=\"c19\"><span class=\"c6 c3\">The FDA governs the approval of drugs and the advertisement of drugs by the manufacturer of the drug. They also govern devices, and we need the FDA. They help confirm that a drug is safe, the side effects are known, and the risks are understood.<\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">The FDA also limits the manufacturers, the pharmaceutical companies, to only advertising the use of a drug for what it was shown (to the satisfaction of the FDA) to help. But that does not mean the FDA governs every prescription written\u2014far from it.<\/span><\/p>\n<p class=\"c0\"><span class=\"c1\">They have nothing to do with the way surgeries are done. They have nothing to do with the way doctors practice medicine except regarding what I just told you.<\/span><span class=\"c1 c10\">55<\/span><span class=\"c1\">\u00a0<\/span><span class=\"c1 c10\">56<\/span><\/p>\n<h3 class=\"c14 subtitle\"><span class=\"c3 c8\" style=\"color: #800080;\">The Off-Label Use of Botulinum Toxin for the Past Two Decades<\/span><\/h3>\n<p class=\"c0\"><span class=\"c1 c3\">Back to botulinum toxin, it's used millions of times per year\u2014off-label. But why so many off-label prescriptions? <\/span><\/p>\n<p class=\"c0\"><span class=\"c1\">For example, botulinum toxin is used off-label for all these problems: smoker\u2019s lines, bruxism, crow's feet, gummy smile, platysma bands, down-turned corners of the mouth, and dimpled chin.<\/span><span class=\"c1 c10\">57<\/span><span class=\"c1 c3\"> Just think about the gummy smile and the bunny lines alone that it's used for or take smokers lines, millions of times per year, arguably less serious indications than using it to help sexual function, and all of these uses are completely and totally off-label and not approved for that use by the FDA.\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/clitoxin.com\/wp-content\/uploads\/2024\/05\/image4.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-227\" src=\"https:\/\/clitoxin.com\/wp-content\/uploads\/2024\/05\/image4.png\" alt=\"\" width=\"430\" height=\"330\" \/><\/a><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">Thankfully, because botulinum has been used millions of times yearly for two decades, we have a good safety record for its use in women of childbearing age.<\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">But forget botulinum toxin for now. Why are there so many off-label prescriptions? <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">Well, there are several. <\/span><\/p>\n<h3 class=\"c14 subtitle\"><span class=\"c8 c3\" style=\"color: #800080;\">Orphan Indications and Why Pharmaceutical Companies Choose NOT to Seek FDA Approval for a Drug\u2014Even When They Know It Works.<\/span><\/h3>\n<p class=\"c19\"><span class=\"c11 c12\">Some populations are difficult to study because of legal and risk problems. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">For example, children are developing. There is a huge risk in giving drugs to children for fear of what might happen to them in the future. Women of childbearing age must worry about what will happen if they get pregnant while taking the drug. Because of these worries, pharmaceutical companies realize the low possibility of profit from the drug because the massive expense and risk of doing the studies to reach on-label status make it impossible to reach FDA approval for the drug and remain in business. This situation does not signal malintent, only economic impossibility.<\/span><\/p>\n<p class=\"c0\"><span class=\"c1\">These are called an \u201c<\/span><span class=\"c5 c9\">orphan population<\/span><span class=\"c1\">\u201d since pharmaceutical companies avoid doing studies on drugs to help them.<\/span><span class=\"c1 c10\">52<\/span><\/p>\n<p class=\"c0\"><span class=\"c1\">The other factor that causes pharmaceutical companies to avoid research is problems with a hard-to-prove success goal. For example, with sexual dysfunction in women, for the drug to gain on-label, FDA-approved status by the FDA, the companies must prove that a drug improves satisfaction\u2014proving only improved arousal or orgasm is not sufficient.<\/span><span class=\"c1 c10\">52<\/span><\/p>\n<p class=\"c0\"><span class=\"c1\">Remember, there's no ruler to measure this objectively. So if she, for example, improves her libido, but her lover is unable to keep pace with her, and she becomes frustrated and less satisfied, maybe she still has orgasms, but she doesn't have as many as she wants, and she's less satisfied, in that case, if other women had the same response, that drug would not be approved because her satisfaction went down. That is a very high bar, a very high bar, so high it becomes an \u201c<\/span><span class=\"c5 c9\">orphan indication<\/span><span class=\"c1 c3\">.\u201d\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/clitoxin.com\/wp-content\/uploads\/2024\/05\/image13.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-218\" src=\"https:\/\/clitoxin.com\/wp-content\/uploads\/2024\/05\/image13.png\" alt=\"\" width=\"336\" height=\"606\" \/><\/a><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">What I just told you about orphan indications and populations is a fact. What I'm about to tell you is an opinion: I think that that is why you will probably never see an on-label use of testosterone in women, even though testosterone is prescribed millions of times per year to help women with their sexual function and other problems. But there is no FDA-approved formula for testosterone for women, and probably never will be.<\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">It's completely off-label the millions of times it's written every year, and men have multiple FDA-approved forms of testosterone because you only must prove that their penis gets hard (objective measure), which is much easier to do than to prove that a woman becomes more satisfied (a subjective psychological measure). That's objective versus subjective measurement. To push it even more into the orphan category, subjective measurement measures something that's so multifactorial it discourages the pharmaceutical companies from doing the studies. It was heroic and almost miraculous that flibanserin (Addyi\u00ae) was ever approved because of the problems we discussed. It was abandoned because of such problems by the first company that had the drug, and another company (Sprout Pharmaceuticals) took it up and eventually pushed it to approval. It's a useful drug. <\/span><\/p>\n<p class=\"c0\"><span class=\"c5 c9\">Both flibanserin (only on-label and FDA-approved for premenopausal women) and bremelanotide are useful, but remember, neither of those drugs directly affects the female genitalia<\/span><span class=\"c1 c3\">. They're psych drugs, and their effects don't, on average, increase female sexual function the six to seven needed (on average) to go from dysfunction to function. Remember, flibanserin (in the studies) only improved on the average of one extra sexual encounter per month\u2014not per week, per month. <\/span><\/p>\n<h3 class=\"c14 subtitle\"><span class=\"c8 c3\" style=\"color: #800080;\">How Do the Pharmaceutical Companies Deal with Orphans?<\/span><\/h3>\n<p class=\"c0\"><span class=\"c1 c3\">Pharmaceutical companies must make a profit, or they cannot make any of our drugs. They must do research, and that takes profit. Even government-funded research is funded by taxes on someone\u2019s profit. Charities are supported by donations from someone who made a profit. Businesses and governments must have a surplus to operate. Profit is surplus, and surplus keeps things rolling; deficits lead to collapse. So, the companies are not ill-intentioned; they must avoid collapse. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">So, when an orphan indication arises (where proving its usefulness is beyond possibility without losing so much money that it just can't even be brought to market), the company sometimes recognizes that the prescriptions are being written (based on research and common practice) but loses the motivation to do the research. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">For example, consider botulinum toxin for frown lines; the number elevens\u2014botulinum toxin is brought to market, and the company secures on-label approval by the FDA for that indication. \u00a0Now, it's approved but not for bruxism, but doctors have done studies that show it helps with headaches from bruxism. It's approved for migraine but not for grinding your teeth. But then doctors publish the research, show that it helps, and use it for bruxism. Now, the pharmaceutical company can be disincentivized to spend the money for FDA approval for bruxism. They have no further need to prove that indication because it's already on the market, the research is robust, and physicians are already writing prescriptions for it, so it remains an orphan, as in it never sustains the research dollars and effort that is required to make it FDA approved for that indication. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">So, you may ask, \u201cIf you're going to use botulinum toxin to help with sex in women, is it safe?\" <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">The same cautions and warnings that apply to the use of BoNT for cosmetic use, vaginismus, and bladder spasms would apply here: the woman should not be pregnant so that you don't have to worry about harming the unborn. It should not be used if the woman has a neurological disease like myasthenia gravis. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1\">However, BoNT has been used in women of childbearing age with a very low complication rate for two decades, and it has also been routinely used millions of times per year <\/span><span style=\"color: #800080;\"><em><span class=\"c11 c5 c9\">at three times the dosage (150 to 200 units for migraines) that we used in our study for the treatment of female sex problems (50 units).<\/span><\/em><\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">And it has been used for two decades, with few complications, in the female genitalia, in the vagina, around Hart's line, around the urethra for vulvodynia and bladder spasm. It's been used in the bladder using a scope, running fiber-optic light through the urethra to inside the bladder, and injecting the bladder wall (not a fun thing to receive). <\/span><\/p>\n<p class=\"c0\"><span class=\"c1\">Further, the actual toxic dose of botulinum toxin, given intravenously if you just wanted to intentionally poison somebody with the usual concentration of cosmetic botulinum toxin, then the toxic dose is about $150,000 worth.<\/span><span class=\"c1 c10\">58<\/span><span class=\"c1\">\u00a0<\/span><span class=\"c1 c10\">59<\/span><span class=\"c1 c3\">\u00a0A very tiny fraction of this toxic dose is used for common treatments like cosmetic use, bladder spasms, and bruxism. <\/span><\/p>\n<h3 class=\"c14 subtitle\"><span class=\"c8 c3\" style=\"color: #800080;\">Serious Warning<\/span><\/h3>\n<p class=\"c0\"><span class=\"c1\">People are using non-FDA-approved forms of counterfeit botulinum toxin that they buy from cheap suppliers in other countries. That is dangerous and unethical. If you look at the people who have been hurt with the dosages that we're discussing (50 to 150 units), with genuine botulinum toxin from reputable FDA-governed suppliers, the incidence of serious sequelae is 1 in <\/span><span class=\"c1 c5\">millions.<\/span><span class=\"c1 c3\">\u00a0BoNT is even used in children with cerebral palsy with muscle spasms of the back and legs at much higher doses with few complications. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">The number of people with serious problems is less than one in millions. But only when it's bought from FDA-governed manufacturers. Physicians in the US should come from legitimate suppliers (Merz for Xeomin). If your provider is buying it through the mail from overseas, you are at great risk. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">And it's even more disturbing because there is no medical board that governs the injection of BoNT. I know you'll see in the news, and you'll see online that botulinum toxin should only be done by a dermatologist or a plastic surgeon. But when you go to the dermatologist or the plastic surgeon's office, the nurse often injects the BoNT. Unless something has changed recently, there are no medical board tests on botulinum injections, cosmetic injections, or cosmetic fillers. It's surprising when you think about it since millions of doses are done yearly, but the last I checked, even with a plastic surgery residency, there is no testing on the cosmetic use of BoNT.<\/span><\/p>\n<h2 class=\"c17\"><span class=\"c21 c3 c16\" style=\"color: #800080;\">What to Do?<\/span><\/h2>\n<p class=\"c0\"><span class=\"c1 c3\">So, how do you find the right person to provide the Clitoxin\u00ae procedure? <\/span><\/p>\n<p class=\"c0\"><span class=\"c1\">The short answer is that only those providers listed on the following website are licensed to do the procedure: <\/span><span class=\"c18 c24 c34\"><a class=\"c7\" href=\"https:\/\/www.google.com\/url?q=https:\/\/clitoxin.com\/&amp;sa=D&amp;source=editors&amp;ust=1715786457876446&amp;usg=AOvVaw1B3EsuXFVCXSINFXLXE7lP\">Clitoxin.com<\/a><\/span><span class=\"c1 c3\">.<\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">But what determines who is listed there as a licensed provider?<\/span><\/p>\n<p class=\"c0\"><span class=\"c1\">First, someone should have the proper license to inject botulinum toxin, which varies considerably from state to state. Some states allow nurses to practice medicine independently without MD supervision (cardiology, endocrinology, cosmetic botulinum toxin, everything).<\/span><sup class=\"c1 c10\"><a id=\"ftnt_ref1\" href=\"#ftnt1\">[1]<\/a><\/sup><span class=\"c1\">\u00a0Some states demand an MD or a DO even to inject cosmetic BoNT<\/span><sup class=\"c10\"><a id=\"ftnt_ref2\" href=\"#ftnt2\">[2]<\/a><\/sup><span class=\"c1 c3\">; some require a nurse practitioner degree, and some require an RN. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">So, the requirements to inject BoNT generally differ widely. However, the injector should first be licensed in the state where treatment takes place to perform the injections.<\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">Also, and just as importantly, the injector should understand the anatomy of what they're injecting and the science of what they are treating. You've got RNs who give chemotherapy. You have RNs who do dialysis, which can cause death. RNs do home dialysis, and RNs do home chemotherapy. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">So, an RN can inject something, assuming she's licensed in her state if she understands the anatomy. If an RN can give chemotherapy and put in a Foley catheter, and she practices in a state that will license her, she can inject BoNT. A Foley catheter is much more dangerous than injecting botulinum toxin at the doses that we used in our study. But she should be licensed. She should have a license that allows her to inject botulinum toxin in her state, and she should be getting her botulinum toxin from her country.<\/span><\/p>\n<p class=\"c15\"><span class=\"c11 c5 c9\">Only those listed on the following website are licensed to do the procedure:<br \/>\n<\/span><span class=\"c18 c5 c28\"><a class=\"c7\" href=\"https:\/\/www.google.com\/url?q=https:\/\/clitoxin.com\/&amp;sa=D&amp;source=editors&amp;ust=1715786457877428&amp;usg=AOvVaw0dtfKGajdS_J_LXnFDPvi4\">Clitoxin.com<\/a><\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">So, when you see the news reports about something happening outside of an office, it's not the lack of an office that's to blame. Again, we commonly do home chemotherapy. It's just that oftentimes, if you have some fly-by-night person injecting BoNT, they're not even licensed to use botulinum toxin. Still, they bought it cheaply online from another country, and now they're having a clandestine party in somebody's house because they do not have the license to have an office. They inject corrupted, highly concentrated botulinum toxin the wrong way, and then somebody gets hurt. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">So, cosmetic BoNT can be done outside the office, but the Clitoxin\u00ae procedure should not be done outside the office\u2014it should be done in the office. The Clitoxin\u00ae procedure involves more than cosmetic BoNT and will require proper lighting and other supplies unavailable outside the office.<\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">So, if you want the Clitoxin\u00ae procedure done, you should ensure that the person performing it is listed as one of our providers.<\/span><\/p>\n<p><a href=\"https:\/\/clitoxin.com\/wp-content\/uploads\/2024\/05\/image2.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-228\" src=\"https:\/\/clitoxin.com\/wp-content\/uploads\/2024\/05\/image2.png\" alt=\"\" width=\"526\" height=\"276\" \/><\/a><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">I'm sure others will inject the clitoris with BoNT in their own way, better or worse. But before being listed on the Clitoxin\u00ae provider website, providers must have first demonstrated they understand how to do the O-Shot\u00ae procedure, understand the anatomy, and understanding how to use platelet-rich plasma in the vagina, and then they have to demonstrate they understand the use of botulinum toxin and that understanding is documented as well as their license. They may be added to our provider list. <\/span><\/p>\n<blockquote>\n<h4 class=\"c15\" style=\"text-align: center;\"><em><span class=\"c11 c5 c9\" style=\"color: #0000ff;\">There are no perfect procedures, and there's always the choice not to be treated at all or to be treated with something else or in another way.<\/span><\/em><\/h4>\n<\/blockquote>\n<p class=\"c0\"><span class=\"c5\">The complications from any procedure can be unexpected and severe. However, we think that the results of our study are promising. There is reassurance in the safety of two decades of using botulinum toxin millions of times in women of childbearing age and using it even in the female genitalia and the strong science showing that the autonomic nervous system does play a critical role in the sexual function in regards to the arousal center and the massive autonomic nervous system innervating the clitoris through the inferior hypogastric complex\u2014all of that together with the research showing that botulinum toxin relaxes the smooth muscle to increase blood flow to increase engorgement of the clitoris and can result in new nerves, neovascularization, collagenesis, and neurogenesis\u2014Clitoxin\u00ae could be a possible treatment for some women<\/span><span class=\"c1 c3\">.<\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">Also, even if your provider offers the Clitoxin\u00ae procedure, they should consider the whole female orgasm system (or have someone else in the office or another office think about the female orgasm system). All parts of the female orgasm system should be considered: for example, social, hormonal, neurological (autonomic and somatic), psychological, cardiovascular, and other drugs that may be affecting sexuality. <\/span><\/p>\n<blockquote>\n<h4 class=\"c15\" style=\"text-align: center;\"><em><span class=\"c11 c5 c9\" style=\"color: #0000ff;\">Giving every woman a clitoris shot to help sex<br \/>\nis not acceptable. <\/span><\/em><\/h4>\n<\/blockquote>\n<p class=\"c0\"><span class=\"c1 c3\">I hope that's helpful. I look forward to more research confirming (or disproving) our pilot study. So far, the word from our providers has been too remarkable to even talk about. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">Oftentimes, we hear that women find themselves more easily aroused and say, \"This must be what it's like to be a teenage boy.\" <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">Not that they're aroused all the time, they're not aroused all the time; but they find it easier to become aroused and to have orgasms. And if that helps any number of people without serious sequelae, that's a very good thing. <\/span><\/p>\n<p class=\"c0\"><span class=\"c1 c3\">If you think this may help you or someone you love, I hope you will discuss the possibility with your chosen provider and your current primary care physician or gynecologist.<\/span><\/p>\n<h2 class=\"c17\"><span class=\"c21 c3 c32\" style=\"color: #800080;\">References<\/span><\/h2>\n<p class=\"c4\"><span class=\"c11 c12\">1.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Clayton AH, Valladares Juarez EM. Female Sexual Dysfunction. <\/span><span class=\"c2\">Psychiatric Clinics of North America<\/span><span class=\"c11 c12\">. Published online 2017. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/28477652\/\" target=\"_blank\" rel=\"noopener\">doi:10.1016\/j.psc.2017.01.004<\/a><\/span><\/p>\n<p class=\"c4\"><span class=\"c11 c12\">2.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Laumann EO, Paik A, Rosen RC. Sexual Dysfunction in the United States. <\/span><span class=\"c2\">Never married<\/span><span class=\"c11 c12\">.<\/span><\/p>\n<p class=\"c4\"><span class=\"c11 c12\">3.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Clayton AH, Valladares Juarez EM. Female Sexual Dysfunction. <\/span><span class=\"c2\">Psychiatr Clin North Am<\/span><span class=\"c3 c6\">. 2017;40(2):267-284.<a href=\"10.1016\/j.psc.2017.01.004\" target=\"_blank\" rel=\"noopener\"> doi:10.1016\/j.psc.2017.01.004<\/a><\/span><\/p>\n<p class=\"c4\"><span class=\"c11 c12\">4.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Nappi RE, Tiranini L, Martini E, Bosoni D, Righi A, Cucinella L. Medical Treatment of Female Sexual Dysfunction. <\/span><span class=\"c2\">Urol Clin North Am<\/span><span class=\"c11 c12\">. 2022;49(2):299-307. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/35428435\/\" target=\"_blank\" rel=\"noopener\">doi:10.1016\/j.ucl.2022.02.001<\/a><\/span><\/p>\n<p class=\"c4\"><span class=\"c11 c12\">5.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Faubion SS, Rullo JE, Clinic M. Sexual Dysfunction in Women: A Practical Approach. 2015;92(4).<\/span><\/p>\n<p class=\"c4\"><span class=\"c11 c12\">6.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Segraves RT. Antidepressant-induced sexual dysfunction. <\/span><span class=\"c2\">J Clin Psychiatry<\/span><span class=\"c11 c12\">. 1998;59 Suppl 4:48-54.<\/span><\/p>\n<p class=\"c4\"><span class=\"c11 c12\">7.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Runels C. 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Botulinum toxin type A for the treatment and prevention of hypertrophic scars and keloids: Updated review. <\/span><span class=\"c2\">J Cosmet Dermatol<\/span><span class=\"c11 c12\">. 2019;18(1):10-15. doi:10.1111\/jocd.12828<\/span><\/p>\n<p class=\"c4\"><span class=\"c11 c12\">49.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Koo HS, Yoon MJ, Hong SH, et al. Non-invasive Intrauterine Administration of Botulinum Toxin A Enhances Endometrial Angiogenesis and Improves the Rates of Embryo Implantation. <\/span><span class=\"c2\">Reprod Sci<\/span><span class=\"c11 c12\">. 2021;28(6):1671-1687. doi:10.1007\/s43032-021-00496-4<\/span><\/p>\n<p class=\"c4\"><span class=\"c11 c12\">50.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Mastrorilli V, De Angelis F, Vacca V, Pavone F, Luvisetto S, Marinelli S. Xeomin\u00ae, a Commercial Formulation of Botulinum Neurotoxin Type A, Promotes Regeneration in a Preclinical Model of Spinal Cord Injury. <\/span><span class=\"c2\">Toxins<\/span><span class=\"c11 c12\">. 2023;15(4):248. doi:10.3390\/toxins15040248<\/span><\/p>\n<p class=\"c4\"><span class=\"c11 c12\">51.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u201cOff-Label\u201d and Investigational Use Of Marketed Drugs, Biologics, and Medical Devices Guidance for Institutional Review Boards and Clinical Investigators. Published January 1998. https:\/\/www.fda.gov\/regulatory-information\/search-fda-guidance-documents\/label-and-investigational-use-marketed-drugs-biologics-and-medical-devices<\/span><\/p>\n<p class=\"c4\"><span class=\"c11 c12\">52.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Van Norman GA. Off-Label Use vs Off-Label Marketing\u00a0of\u00a0Drugs. <\/span><span class=\"c2\">JACC Basic Transl Sci<\/span><span class=\"c11 c12\">. 2023;8(2):224-233. doi:10.1016\/j.jacbts.2022.12.011<\/span><\/p>\n<p class=\"c4\"><span class=\"c11 c12\">53.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Radley DC, Finkelstein SN, Stafford RS. Off-label Prescribing Among Office-Based Physicians. <\/span><span class=\"c2\">Arch Intern Med<\/span><span class=\"c11 c12\">. 2006;166(9):1021. doi:10.1001\/archinte.166.9.1021<\/span><\/p>\n<p class=\"c4\"><span class=\"c11 c12\">54.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Moulis F, Durrieu G, Lapeyre-Mestre M. Off-label and unlicensed drug use in children population. <\/span><span class=\"c2\">Therapies<\/span><span class=\"c11 c12\">. 2018;73(2):135-149. doi:10.1016\/j.therap.2018.02.002<\/span><\/p>\n<p class=\"c4\"><span class=\"c11 c12\">55.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Beitzel K, Allen D, Apostolakos J, et al. US Definitions, Current Use, and FDA Stance on Use of Platelet-Rich Plasma in Sports Medicine. <\/span><span class=\"c2\">J Knee Surg<\/span><span class=\"c11 c12\">. 2015;28(1):29-34. doi:10.1055\/s-0034-1390030<\/span><\/p>\n<p class=\"c4\"><span class=\"c11 c12\">56.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Commissioner O of the. Understanding Unapproved Use of Approved Drugs \u201cOff Label.\u201d FDA. Published April 18, 2019. Accessed February 11, 2024. https:\/\/www.fda.gov\/patients\/learn-about-expanded-access-and-other-treatment-options\/understanding-unapproved-use-approved-drugs-label<\/span><\/p>\n<p class=\"c4\"><span class=\"c11 c12\">57.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0FDA official recomendations regarding Botox. https:\/\/www.accessdata.fda.gov\/ drugsatfda_docs\/label\/2011\/103000s5236lbl.pdf<\/span><\/p>\n<p class=\"c4\"><span class=\"c11 c12\">58.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Naumann M, Jankovic J. Safety of botulinum toxin type A: a systematic review and meta-analysis. <\/span><span class=\"c2\">Current Medical Research and Opinion<\/span><span class=\"c11 c12\">. 2004;20(7):981-990. doi:10.1185\/030079904125003962<\/span><\/p>\n<p class=\"c4\"><span class=\"c11 c12\">59.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Stephens ML, Balls M. LD50 Testing of Botulinum Toxin for Use as a Cosmetic. 2005;(2):5.<\/span><\/p>\n<hr class=\"c35\" \/>\n<div>\n<p class=\"c19\"><a id=\"ftnt1\" href=\"#ftnt_ref1\">[1]<\/a><span class=\"c26 c3\">\u00a0The states that allow full practice authority for Nurse Practitioners\u2014meaning they can evaluate patients, diagnose, order and interpret diagnostic tests, and initiate and manage treatments, including prescribing medications, under the authority of the state board of nursing without requiring a supervising physician\u2014are as follows: Alaska, Arizona, Colorado, Connecticut, Delaware, Hawaii, Idaho, Maine, Maryland, Minnesota, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Dakota, Oregon, Rhode Island, South Dakota, Vermont, Washington, Wyoming.<\/span><\/p>\n<\/div>\n<div>\n<p class=\"c19\"><a id=\"ftnt2\" href=\"#ftnt_ref2\">[2]<\/a><span class=\"c3 c26\"> For example, Alabama does not allow a nurse or nurse practitioner to inject cosmetic botulinum toxin; the injector must have an MD or DO degree.<\/span><\/p>\n<\/div>\n<\/div>\n<div>\n<h2 class=\"c11\"><em style=\"color: #800080;\"><strong>Summary of Mechanism of Action...<\/strong><\/em><\/h2>\n<\/div>\n<h4 class=\"kHtcsd\"><span style=\"color: #0000ff;\"><em><strong>After Injecting botulinum neurotoxin (BoNT) into the clitoris, it is thought that (1) it is taken up by endocytosis and then migrates by axonal transport to the ganglion embedded in the wall of the vagina; (2) these ganglia then signal (through afferent autonomic nerves in the inferior hypogastric plexus) to trigger the hypothalamus (where the arousal center resides); (3) the activated hypothalamus triggers (through efferents going back to the genitalia and to the cerebral cortex) arousal, desire, and lubrication, and facilitate orgasm, combining to increase sexual satisfaction in the woman. This is in addition to the neovascularization, neurogenesis, and local vasodilation triggered by the BoNT. These effects can be amplified when the BoNT is combined with the regenerative properties of platelet-rich plasma. <a style=\"color: #0000ff;\" href=\"https:\/\/www.longdom.org\/open-access\/the-clitoral-injection-of-incobotulinumtoxina-for-the-improvement-of-arousal-orgasm--sexual-satisfaction-a-specific-meth.pdf\" target=\"_blank\" rel=\"noopener\">Here's the original research by Runels and Runnels supporting these ideas (click to read).<\/a><\/strong><\/em><\/span><\/h4>\n<div class=\"oGxHof keYx5e JRaMs\" data-cad=\"150\" data-hid=\"_IEv8ZeC7B5nUp84P64W2wAo_51\" data-mid=\"\/m\/0p9sf\" data-msat=\"130\" data-oad=\"400\" data-thd=\"300\" data-tsd=\"200\" data-tt=\"basal ganglia\" data-ukff=\"1\" data-uh=\"true\">\n<div id=\"_IEv8ZeC7B5nUp84P64W2wAo_51\" class=\"sWxfbf bgTrRc\" data-hid=\"_IEv8ZeC7B5nUp84P64W2wAo_51\" data-hveid=\"CAYQGQ\" data-ved=\"2ahUKEwjgy8uKz4WFAxUZ6skDHeuCDagQtrILegQIBhAZ\">\n<div class=\"jJAaRe\">\n<div class=\"EyBRub jUja0e\" data-ved=\"2ahUKEwjgy8uKz4WFAxUZ6skDHeuCDagQ68lIegQIBhAa\">\n<div class=\"Kwz0be JH9iGc\">\n<div class=\"yeyPlb\">\n<div class=\"rAzITb PZPZlf k0Jjg fCrZyc NQYJvc FR7ZSc eFSWxd gzV1t\" tabindex=\"0\" role=\"button\" data-key=\"Basal ganglia\" data-hveid=\"CAYQIQ\" data-ved=\"2ahUKEwjgy8uKz4WFAxUZ6skDHeuCDagQuLILKAB6BAgGECE\">\n<div class=\"niO4u\">\n<h5><\/h5>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>&#8211;&gt;Click to read or download a PDF Transcript of the above video that includes diagrams and scientific references&lt;&#8211; Important Legal Disclaimer: This is an off-label use of botulinum toxin; no results are ever guaranteed (no therapy works every time). If considered, it should only be done by a physician who has been properly trained and [&hellip;]<\/p>\n","protected":false},"author":5564,"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_feature_clip_id":0,"_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":[],"tags":[],"class_list":["post-5150","post","type-post","status-publish","format-standard","hentry"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/s6W8NG-clitoxin","jetpack-related-posts":[{"id":5153,"url":"https:\/\/oshot.info\/members\/jcpm2026-06-23-female-ejaculation-clitoxin-priapus-toxin-alopecia\/","url_meta":{"origin":5150,"position":0},"title":"JCPM2026.06.23 | Female Ejaculation | Clitoxin\u00ae | Priapus Toxin\u00ae | Alopecia","author":"Charles Runels, MD","date":"July 1, 2026","format":false,"excerpt":"Journal Club with Pearls & Marketing 2026.06.23 Cellular Medicine Association JCPM2026.06.23 The following is an edited transcript of the Journal Club with Pearls & Marketing (JCPM) of June 23, 2026, with Charles Runels, MD. >-> The PDF of this live journal club can be seen here <-< Topics Covered PRP\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":3271,"url":"https:\/\/oshot.info\/members\/jcpm2024-04-02-clitoxin-orphan-therapeutics\/","url_meta":{"origin":5150,"position":1},"title":"JCPM2024.04.02 | Clitoxin\u00ae | &#8220;Orphan Therapeutics&#8221;","author":"Charles Runels, MD","date":"April 7, 2024","format":false,"excerpt":"Journal Club with Pearls & Marketing 2024.04.02 \u00a0 \u00a0Cellular Medicine Association JCPM2024.04.02 The following is an edited transcript of the\u00a0Journal Club with Pearls & Marketing\u00a0(JCPM) of April 2, 2024, with Charles Runels, MD, and Alexandra Runnels, MD, FACOG. >-> The PDF Transcript of the Page Can be Downloaded or Read\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":"https:\/\/i0.wp.com\/cellularmedicineassociation.org\/wp-content\/uploads\/2024\/03\/image12-300x239.jpg?resize=350%2C200&ssl=1","width":350,"height":200},"classes":[]},{"id":3296,"url":"https:\/\/oshot.info\/members\/jcpm2024-04-09\/","url_meta":{"origin":5150,"position":2},"title":"JCPM2024.04.09","author":"Charles Runels, MD","date":"April 15, 2024","format":false,"excerpt":"Journal Club with Pearls & Marketing 2024.04.09 \u00a0 \u00a0Cellular Medicine Association JCPM2024.04.09 The following is an edited transcript of the\u00a0Journal Club with Pearls & Marketing\u00a0(JCPM) of April 9, 2024, with Charles Runels, MD. \u00a0 >-> The transcript as a PDF file can be read or downloaded here <-<[1] Topics Covered\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":"https:\/\/i0.wp.com\/cellularmedicineassociation.org\/wp-content\/uploads\/2024\/03\/image12-300x239.jpg?resize=350%2C200&ssl=1","width":350,"height":200},"classes":[]},{"id":3263,"url":"https:\/\/oshot.info\/members\/jcpm2024-02-26-clitoxin-procedure-history-pearls\/","url_meta":{"origin":5150,"position":3},"title":"JCPM2024.02.26  Clitoxin\u00ae Procedure History &#038; 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