Restore Confidence Comfort and Intimate Wellness Naturally
What Is the O-Shot® and How Does It Work?
The O-Shot® was developed by Charles Runels, MD, who also developed the P-Shot® for men. It applies the same regenerative biology of platelet-rich plasma (PRP) well-established in orthopedics, wound healing, and dermatology to the specific tissue and vascular anatomy of the female pelvic region.
What Is PRP?
How Does It Work in This Context?
When PRP is injected into the anterior vaginal wall and clitoral complex, the concentrated growth factors stimulate several regenerative processes in the local tissue:
- Angiogenesis Growth of new blood vessels improves circulation to the clitoris and vaginal walls, directly enhancing arousal, sensitivity, and natural lubrication
- Collagen remodeling New collagen production improves tissue tone, elasticity, and structural integrity contributing to a firmer, more responsive vaginal wall
- Nerve sensitization Improved vascular supply and tissue health supports the function of sensory nerves in the clitoral and vaginal region
- Urethral support When applied periumbrally, PRP strengthens periurethral tissue, providing mechanical support to reduce stress urinary incontinence
- Tissue regeneration in atrophic conditions Growth factors promote cellular repair and reduce inflammatory processes, making PRP particularly useful in conditions like vulvar lichen sclerosus and genitourinary syndrome of menopause
Conditions the O-Shot® May Address
Female Sexual Dysfunction (FSD)
An umbrella term covering disorders of sexual desire, arousal, orgasm, and genito-pelvic pain. Affects an estimated 40% of women at some point in their lives.
Hypoactive Sexual Desire Disorder (HSDD)
Persistent absence or deficiency of sexual desire causing personal distress the most common female sexual complaint. PRP may improve clitoral blood flow and restore arousal response.
Female Orgasmic Disorder
Persistent difficulty achieving orgasm despite adequate stimulation. Reduced clitoral sensitivity is a primary factor; PRP addresses this through angiogenesis and nerve support.
Stress Urinary Incontinence (SUI)
Involuntary urine leakage during coughing, sneezing, exercise, or laughter caused by weakened urethral support. Periurethral PRP injections may strengthen surrounding tissue.
Genitourinary Syndrome of Menopause (GSM)
Vaginal atrophy, dryness, irritation, and pain are caused by oestrogen decline during or after menopause. PRP promotes tissue regeneration as a non-hormonal option.
Dyspareunia (Painful Intercourse)
A chronic autoimmune skin condition causing vulvar itching, burning, pain, and scarring often inadequately controlled by topical corticosteroids. PRP shows promising regenerative and anti-inflammatory effects in peer-reviewed studies.
Vaginal Laxity
Loss of vaginal wall tone often following childbirth. PRP promotes collagen formation to improve tissue firmness and sexual function.
Vulvar Lichen Sclerosus (VLS)
A chronic autoimmune skin condition causing vulvar itching, burning, pain, and scarring often inadequately controlled by topical corticosteroids. PRP shows promising regenerative and anti-inflammatory effects in peer-reviewed studies.
Interstitial Cystitis / Bladder Pain Syndrome
Chronic bladder pain with urinary urgency and frequency. Emerging evidence suggests periurethral PRP may offer symptomatic relief.
What the Clinical Research Shows
A 2025 meta-analysis of 12 randomized controlled trials encompassing 882 men with vasculogenic ED found statistically significant improvements in the IIEF-EF (International Index of Erectile Function Erectile Function) domain score and Erection Hardness Score (EHS) following LiSWT compared to sham therapy. Participants achieving EHS ≥ 3 (suitable for intercourse) increased significantly in the treatment group. This represents the most comprehensive RCT-level analysis of LiSWT for ED currently available. PMID: Published online June 2025, Translational Andrology and Urology Honest note: Study specifically examined vasculogenic ED patients whose dysfunction is rooted in impaired penile blood flow. Results may be less applicable to patients with predominantly psychogenic, neurogenic, or hormonal ED. IIEF score improvements were statistically significant but individual results vary considerably.
Twenty women with stress urinary incontinence received autologous PRP injections at the anterior vaginal wall. At 1 month, 65% reported cure or improvement; at 6 months, improvements were maintained. No adverse events were recorded throughout the study period. This was among the first published trials of PRP specifically for SUI, demonstrating safety and a meaningful clinical response in a difficult-to-treat population.
Fifty-two women with sexual dysfunction and orgasmic disorder (FSFI score ≤26) received four sessions of PRP injections to the anterior vaginal wall. Following treatment, total FSFI score improved significantly (p<0.001), and orgasm subdomain scores nearly doubled from 2.11 to 4.48. Fifty percent of patients achieved clinically normal sexual function scores. Significant improvements were seen across all six FSFI domains. No adverse events were reported.
Li, Xu & Man (BMC Urology, 2024) conducted a systematic review of 7 controlled trials with 475 patients evaluating LiSWT for Peyronie's disease. Meta-analysis found LiSWT significantly increased the proportion of men experiencing plaque size reduction (RD 0.27, 95% CI: 0.04–0.50, p=0.02) and improvement in penile curvature (RD 0.13, p=0.05) versus placebo. Pain reduction and IIEF improvement were additional documented benefits. PMID: 39375617 CONFLICTING EVIDENCE (Peyronie's): Shockwave therapy for Peyronie's disease is the subject of ongoing debate in the urology literature. While this meta-analysis shows statistically significant plaque reduction, the effect sizes are modest and some trials showed no difference vs. placebo. LiSWT is generally considered most beneficial for pain reduction in Peyronie's disease, with plaque reduction and curvature improvement being less consistent. It is not a replacement for collagenase injections (Xiaflex) or surgical correction in patients with significant curvature. Dr. J discusses realistic expectations for Peyronie's patients during consultation.
Fifty women with vulvar lichen sclerosus who had not responded adequately to topical corticosteroid therapy received three PRP injections 4–6 weeks apart. At 6 months after the final injection, 100% of patients (95% CI 93–100%) were either satisfied or very satisfied with the treatment. Statistically significant reductions were observed in itching, burning, dyspareunia, and dysuria (all p<0.05). Sexual function, psychological wellbeing, and quality of life all improved significantly on validated scales.
A comprehensive scoping review searching MEDLINE, Web of Science, Scopus, CENTRAL, and EMBASE through February 2025 analysed 43 studies on PRP across five gynaecological conditions, including SUI, female sexual dysfunction, vulvar lichen sclerosus, vulvovaginal atrophy, and interstitial cystitis. The review found PRP improved symptoms and quality of life in multiple conditions, particularly VLS and sexual dysfunction – and was consistently well tolerated with only minor injection-site adverse effects (transient pain or swelling) across all included studies.
Honest Evidence Summary
94%
Patient satisfaction rate in vulvar lichen sclerosus PRP pilot study (Boero et al., Arch Gynecol Obstet 2024)
43
Studies in gynaecology reviewed in 2025 PRISMA scoping review confirming PRP safety profile
Zero
Serious adverse events across major PRP trials for female sexual dysfunction
Who Is a Good Candidate for the O-Shot®?
The O-Shot® may be appropriate for women who:
- Experience reduced sexual desire, arousal, or difficulty achieving orgasm
- Have dyspareunia (pain during intercourse) related to dryness, atrophy, or lichen sclerosus
- Have stress urinary incontinence (leakage with coughing, sneezing, exercise, or laughter)
- Are experiencing genitourinary syndrome of menopause vaginal dryness, irritation, or atrophy and prefer a non-hormonal approach
- Have vulvar lichen sclerosus and have not achieved full symptom control with topical corticosteroids
- Are generally in good health and have no active genital infections
- Want a non-surgical, minimally invasive treatment option with an excellent safety record
- Prefer a treatment made entirely from their own body — with no synthetic hormones, fillers, or foreign materials
The O-Shot® May Not Be Recommended If:
- You have active pelvic or vaginal infection
- You have a platelet disorder or are taking anticoagulant medications
- You are pregnant or breastfeeding
- You have a blood cancer or active systemic malignancy
Dr. J conducts a comprehensive medical evaluation before recommending the O-Shot® to ensure it is safe and appropriate for your individual health profile.
What to Expect: Your O-Shot® Appointment
Step 1: Private Consultation: Dr J reviews your complete medical history, sexual health concerns, symptoms, and treatment goals. He explains the procedure in full, discusses realistic expectations based on current evidence, and determines whether you are a suitable candidate. Every aspect of your consultation is held in strict confidence.
Step 2: Blood Draw: A small amount of blood (approximately 15–20 mL) is drawn from a vein in your arm – similar to a routine blood test. This is used to create your personalised PRP.
Step 3: PRP Preparation: Your blood sample is placed in a medical-grade centrifuge and spun to separate and concentrate the platelet-rich plasma. This process takes approximately 10–15 minutes and uses an FDA-cleared separation system.
Step 4: Topical Anaesthesia: A numbing cream is applied to the injection area and given adequate time to take full effect. Most patients describe the procedure as very well tolerated once the area is properly anaesthetised.
Step 5: PRP Injection: Using a very fine needle, Dr J administers the PRP to targeted locations, typically the anterior vaginal wall (including the G-spot area) and the clitoral complex. If urinary incontinence is being addressed, additional periurethral injection sites may be used. The injection portion of the procedure takes only a few minutes.
Step 6: Recovery: There is no required downtime. Most women resume normal daily activities immediately. Mild swelling or sensitivity at the injection site is normal and typically resolves within 24–48 hours. Sexual activity is generally resumed after 4 days.
Step 7: Results Timeline: Initial improvements in sensitivity and lubrication may be noticed within 2–4 weeks. Full results typically develop over 6–12 weeks as tissue regeneration progresses. Results generally last 12–18 months, with many women returning annually for maintenance.
Part of the FemiFresh™ Women's Wellness Program
The O-Shot® is offered as part of Dr. J’s FemiFresh™ women’s sexual wellness brand — a comprehensive, physician-designed program for women seeking evidence-based, non-surgical solutions to intimate health concerns.
Ask Dr. J about combining the O-Shot® with complementary FemiFresh™ treatments for a more comprehensive approach:
FemiFresh Shot™: Dr. J’s proprietary PRP protocol for women’s sexual rejuvenation.
FemiFresh Wave™: Low-intensity acoustic wave therapy to improve blood flow and tissue health in the vaginal region.
PRP Vaginal Rejuvenation: Comprehensive vulvovaginal PRP treatment targeting atrophy, dryness, and tissue restoration.
Vaginal Dryness Treatment: Non-hormonal treatment options for women experiencing dryness and discomfort due to menopause or other causes.
Female Sexual Dysfunction: Comprehensive evaluation and treatment planning for women experiencing a range of sexual health concerns.
Frequently Asked Questions O-Shot® Orlando
The O-Shot® is an injection of platelet-rich plasma (PRP) derived from your own blood administered to specific areas of the vaginal and clitoral tissue. The concentrated growth factors in PRP stimulate new blood vessel formation, collagen production, and tissue regeneration. Clinically, this translates to improved sensitivity, better natural lubrication, stronger orgasmic response, and when periurethral injections are included reduction in stress urinary leakage. Results develop gradually over 6–12 weeks as the regenerative process takes hold.
Most patients report minimal discomfort. A topical anesthetic cream is applied before any injection and given adequate time to work. The injection itself is brief. Some patients report a mild sensation of pressure. The clitoral area may feel more sensitive for 1–2 days after treatment, but this is temporary and resolves on its own.
Yes, stress urinary incontinence (SUI) is one of the most studied applications of PRP in gynaecology. A 2021 pilot study published in Scientific Reports (Long et al.) found meaningful improvement in SUI symptoms at both 1 and 6 months with no adverse effects. A 2023 randomised trial further explored PRP for SUI, and a 2025 scoping review of 43 studies confirmed PRP was generally well tolerated and associated with symptom improvement across urological applications. The evidence is promising; Dr J will assess whether your specific type and severity of incontinence is likely to respond.
Yes, vulvar lichen sclerosus (VLS) is one of the conditions where PRP shows some of the most compelling published results. A 2024 pilot study in Archives of Gynaecology and Obstetrics (Boero et al.) found 100% patient satisfaction at 6 months among women with VLS who had not responded fully to corticosteroid therapy. Itching, burning, dyspareunia, and dysuria all improved significantly. PRP appears to exert both regenerative and immunomodulatory effects that may address the underlying inflammatory process driving the condition.
Every O-Shot® at Dr J Anti-Ageing Clinic is performed by Dr J personally, a board-certified physician with over 25 years of clinical experience and 15+ years in regenerative medicine. You will not be seen by a nurse or a technician for this procedure. Dr J conducts both the consultation and the treatment, and remains available for questions throughout your care
The O-Shot® and FemiFresh Shot™ are both PRP-based injections for female sexual wellness, but the FemiFresh Shot™ refers specifically to Dr J’s proprietary protocol for this treatment, including preparation method, injection technique, and post-treatment guidance. Dr J will explain the distinctions during your consultation and recommend the most appropriate protocol for your goals.