I was recently sent YET ANOTHER puff piece on the “O shot®.” For those of you fortunate enough not to have space in your brain taken up rent free by the “O shot®” it is an injection of platelet rich plasma (PRP) into the vagina and clitoris that claims to bring rocking orgasms to women.

Honestly, these pieces enrage me. They read like a press release from the doctor offering the procedure with a cautionary note from the American Congress of OB/GYN (ACOG) tacked on at the end, so in the wasteland of the Internet, stating this is unsafe and untested. But hey orgasms, right! Page clicks! 

I’ve written on the lack of science behind the “O shot®” before, but this time I took a deeper dive into the back story and the background of Dr. Charles Runels, the “inventor.”

This is what I found.

First of all, there is STILL no science that supports the O shot

I need to get this information out front, because this most recent piece on the “O shot” starts off claiming it is backed by “medical science.” This is untrue. Fake news. A lie. Shoddy reporting. Take your pick. 

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To say something is backed or supported or can be achieved by medical science you would need at least one quality study to support it. There are no studies in indexed, peer-reviewed literature looking at injecting platelet rich plasma into the vagina or clitoris to improve sexual satisfaction. There are not even any studies in animals telling us what, if anything, PRP does to vaginal tissue.

There are three studies, one looking at biopsies in a lab, one with three women so not even a study, and the other on rabbits. All of these are looking at PRP to see if that could reduce mesh-related inflammation and are not about orgasms. Also, the proposed “hypothesis” behind the “O shot®” seems a bit of a stretch. 

There are a few low quality publications looking at it for lichen sclerosus with low quality results. Regardless, that indication is not orgasmic dysfunction.

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This is the supporting “study” offered by Runels when I questioned him via Twitter. It is in a non indexed journal and is a case series of 11 women with four different diagnoses (one cannot compared the sexual dysfunction of pain with sex with that of orgasmic dysfunction). Of the 11 women, 64% reported some kind of improvement, but I can’t tell if this is retrospective or prospective data. Also, no IRB was involved.

I would ask Runels more, but he blocked me.

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I will be forever stunningly amazed that he listed his office as “Medical School” and that he repeatedly misspelled dyspareunia in the paper.

 

So platelet rich plasma in the vagina and the clitoris is a shaky hypothesis not science.

Just a side note on platelet rich plasma in general. There is no good science to support it helps much of anything. This of course does not stop the press from suggesting that it is routine therapy.

How did the “O shot®” get it’s start?

It was apparently “invented” by Runels who registered the term “O shot®” as a trademark. Dr. Runels lists his medical specialty as internal medicine. Internal medicine training includes very little gynecology. Perhaps at most an internal medicine doctor spends a few months in residency in a gynecology clinic. As a Canadian-trained gynecologist I spent five years in residency learning about the reproductive tract. I spent another year in fellowship learning about infections and the female reproductive tract. I have operated in the vagina for over 25 years. An internal medicine doctor is not trained to operate on anything, never mind the vagina or clitoris. So how exactly did an internal medicine doctor decide he should inject the vagina and clitoris with PRP?

Dr. Runels apparently got interested in genital PRP because he was injecting his own penis. The first clitoris he injected was his sex partner’s

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Yes, you read that right. It is from The Guardian. It is the first paragraph in the piece.

When I heard that information I was shocked. Once you do a procedure on a person they become your patient. Doing non-emergent gynecologic procedures on sex partners, never mind completely experimental ones, is generally frowned upon. For example, I was taught if your sex partner gets pregnant and they want an abortion you refer them to another provider. It was drilled into me during my training that the power dynamics, bias, and objectivity are simply impossible to navigate with GYN procedures and sex partners.

This is what the AMA says:

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The FDA and Dr. Runels

In 2008 the Food and Drug Administration notified Runels that they were initiating disqualification proceedings against him. Among their concerns that he checked “no vulnerable populations” on the IRB application and then subjects were recruited from a center for the homeless.

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The eight page letter to Runels from the FDA also says he failed to promptly inform the IRB of serious adverse events and it goes on to describe many other concerns. 

Dr. Runels defended his actions to a reporter claiming, “he wasn’t aware that the volunteers in the vaccine trial were homeless, as addresses were being checked by the company running the trial” although he admitted he “was responsible for everything, which is why I got burned.”

It appears Runels was disqualified from being a clinical investigator in 2009.

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Getting disqualified by the FDA means a clinical investigator has “repeatedly or deliberately failed to comply with applicable regulatory requirements or the clinical investigator has repeatedly or deliberately submitted false information to the sponsor or, if applicable, to FDA, in any required report. A disqualified clinical investigator is not “eligible to conduct any clinical investigation that supports an application for a research or marketing permit for products regulated by FDA (including drugs, biologics, devices, new animal drugs, foods, including dietary supplements, that bear a nutrient content claim or a health claim, infant formulas, food and color additives, and tobacco products).” 

Dr. Runels and the Alabama State Board of Medical Examiners

The way Dr. Runels practiced medicine drew attention from the State Board of Medical Examiners of Alabama. In 2009 he was fined $5,000 for misuse of hormone replacement therapy. He “overdosed” two women with testosterone and was restricted from prescribing hormones. In 2011 the Board made an exception for thyroid hormone and testosterone in deficient patients.

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Here is what you need to know about the “O shot”

The hypothesis involves significant leaps of faith. This means it must be studied not promoted as legitimate therapy by doctors hoping to cash in on sexual difficulties.

There are no studies at all suggesting the “O shot” improves orgasm or sexual function. 

There is no animal or human data suggesting it is safe to inject in vaginal epithelium or into the clitoris. Who knows if this could spread the human papilloma virus or herpes to other areas of the lower genital tract? I can think of a thousand ways this could harm women, but then again I am an appropriately confident OB/GYN not an internal medicine doctor or a plastic surgeon. 

Dr. Runels started by injecting his own penis with an unproven therapy and then by injecting his sex partner’s clitoris and vagina. 

The way Dr. Runels prescribed hormones was apparently egregious enough to catch the eye of his state medical board. His license was restricted to stop him prescribing hormones from 2009-2011. He is apparently now allowed to prescribe thyroid hormone and testosterone in specific situations.

Dr. Runes was disqualified in 2009 by the FDA from being a clinical investigator.

And yes, the leading group of OB/GYNS says it is “deceptive” to suggest procedures like the “O shot®” are “accepted and routine surgical practices.”

Do doctors doing the “O shot” and reporters covering it not know or don’t they care?

That to me is really a million, or probably more, dollar question. It honestly makes me very sad. I found all this information in less than an hour. But hey orgasms, right? 

If a doctor recommended the “O shot” to anyone I know my advice would be to get up and walk out the door.

 

Join the Conversation

33 Comments

  1. The minute I saw him cite himself as a source, I knew this was going to be bad. The FDA debarment and ethical proceedings were just the icing on the cake. (Part of my day job involves post-market studies.) I remain dumbfounded that a) people fall for this crap and b) people come up with such utter bullshit to promote to said gullible dupes.

  2. Wouldn’t plasma or blood injected into the clitoris (or anywhere, for that matter) just be absorbed by the body and not stay where you put it? So it sounds like, even if it were safe, it would be useless.

  3. Wow, this sounds like an awful practice! Isn’t the medical community moving away from blood transfusions and other manipulations with blood, rather than finding new bodily openings to inject blood in?

  4. I could not have made a better case. As a Board certified OB/GYN for 27 years II always get the feeling that patients suspect ulterior motives when one debunks snake oil like the O Shot

  5. Good article, but if you’re going to go after his spelling…you need to have proper grammar. “How did the “O shot®” get it’s start?”

    1. His misspellings are in what he pretends to be professional papers while this is a blog meant for curious lay people. If I’m making a quilt for my kids to sleep under, I don’t worry about slightly cut off points, but if I’m making one for a quilt show, I make sure those points are as close to perfect as humanly possible.
      Your ellipsis shouldn’t be there either.

  6. Did you know that if one wanted to perform an injection of PRP into a clitoris and call it an O shot, one has to pay him a licensing fee! Seriously!

  7. Just wow…this is the first time I’m hearing of this, but unfortunately, I imagine a lot of orgasm-deprived women I know would jump at something like this if they knew about it. I realize there are medical reasons that some women can’t achieve orgasm, but for many, it comes down to lack of communication or attention from their sexual partner – not from some “quick fix” “medical procedure”. Thanks for sharing your knowledge and research on this topic! Your blog is a wonderful resource for debunking trends such as this one.

  8. Thanks for doing an expose of this ridiculous practice. If you have some free time, how about taking on Dr Matlock (you know, the Beverly Hills and Dubai cosmetic GYN surgeon who popularized “laser vaginal rejuvenation”, cosmetic labioplasty, etc)? He is also the inventor of the G shot (http://thegshot.com/) which claims 87% success in improving orgasmic function (with the ubiquitous caveat…”results my vary” of course). Dr Runnels is clearly a doofus who has no business practicing medicine, much less GYN surgery but Dr Matlock hides behind money, lawyers and his credentials to maintain an air of credibility.

    1. Dr. Runels,

      Can you not read? I mentioned that study (and that it is low quality) and provided a link. I checked and the link works. That study in no way supports the use of PRP for orgasmic dysfunction and it would, IMO, be unethical to say that it does. I do hope that was not your intention.

      I did a literature search. The screen shot is in my post. There are no studies supporting your hypothesis or the safety of your technique or your claimed outcomes. That is troubling.

      That doctors perform an untested biologically unsound therapy is only proof that snake oil sells not of efficacy.

      My career has been dedicated to helping women make evidence based choices. As a gynecologist who specializes in the lower reproductive tract it is well within my scope to comment on an internist’s claims about vaginal PRP.

      I have interviewed some urologists on your P shot, so do come back for that.

      Dr. Gunter

    2. I read it. 15 women took part in the testing of PRP. Only 12 of them completed the the testing. 7 of them reported the reducing of vaginal inflammation. That’s it! The results of this study have nothing to do with treatment of orgasmic function and are unconclusive.

  9. Hi – The o shot did nothing for me except cause an issue.. I am seeing a urogynecologist today to see if they can figure out now why I do pee on myself AFTER having the O shot..

    There has got to be a way to get this information out here as I did plenty of research and could find nothing but positive things before getting the shot.

    Had I been able to see something like this I would have not gone in the o shot direction.

    Thanks for exposing this idiot..

    Sincerely,

    Linda

  10. I wish i saw this before i went through with it.
    I haven’t had any luck since i had it done. Even my incoherence i bad. I think it made it worse.
    I still dont have orgasm and i am very frustrated, i spent alot of money on this and it hasn’t helped.

  11. Thank you for exposing, your research is well received. Women do need something to get that aging vagina to come out and play, but I don’t know what it is!

  12. There are some good, high quality studies on prp injections in oral surgery showing it has a benefit but this just sounds like nonsense. Why would you inject into an otherwise pathology free area?

  13. Thankyou so much for this information, Dr Jen Gunter! I was curious about the O shot, no way I am I going to go through with it after having read this. I do have a question: what is your opinion on Femilift? I am curious about this. Thanks again, Hoping for an answer!

  14. Thank you for you very well researched piece, I found it very useful. I am an Associate Professor of Plastic Surgery, in the UK, and will be suggesting that my trainees do not use this technique until FDA approved.

  15. Thanks for these updates. However I understand professional athletes have used PPR to regain and heal back to playing much more quickly than previous techniques. For example, baseball pitchers went to the Dominican Republic in the off season to visit doctors there giving PRP, to their shoulders, elbows and wrists injuries or just wear and tear from over using. This was a number of years ago, and perhaps they were also using some other ingredients such as growth hormones and peptides.
    Then I heard of Dr Barbara Sturm in Germany a number of years ago using your own blood to make a facial cream. She was friends with George Hamilton and I must say he looked pretty good, right?
    I tried it, just one, and it did not work. I was not aware of PRP then and she did not mention she did this technique. I understand today she has a few celebrities promoting her special face mask, although I am not sure if she is now using the PRP.
    Its not easy when conventional methods do not work. I have fibroids. No solutions offered from mainstream except surgical removal of them or the entire womb. Also tried hormonal work taking off main stream treatments, but no luck.

    When I put together what PRP does for athletes, it made sense, not for orgasm but for healing the area. Others suggestions were stem cell treatment but that is too expensive and not yet a proven technique due to poor application by the doctors. Its difficult to find honorable doctors. When you go near treatments with big money, the doctors are dishonest.
    I was checking the PRP. I wasn’t sure about this fellow.
    Thank you for your help.

  16. Greetings from Down-Under (no pun intended) – The O-shot is promoted in Australia which is very concerning – would the Trades and Goods Administration our version of the FDA have this listed as a procedure that is approved or not? I am not sure how to navigate the system to find out.

  17. Thanks for this post. I was researching ways to get my mojo back (post-menopause) and was intrigued by yet leery of the o-shot. After reading your post, I will most definitely skip it.

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