Incontinence Therapy for Women in Camas, WA

A Treatment for Incontinence, Low Libido, and Dysparenia

What is the O-Shot?

The numbers of women affected by decreased sexual arousal or pleasure are surprising, considering the discomfort many people have talking about sex.  Still, 30-50% of women admit to difficulty. The actual numbers are likely higher.

I was a Family Practice doctor for 8 years without a single woman bringing the subject up.  Men, on the other hand, asked for Viagra by name.  And yet, the incidence of low libido, pain with intercourse (dysparenia) and urinary incontinence is high among women, especially following pregnancy and during the pre- and post-menopausal years. At these times, women often develop a lower sense of well-being that can adversely affect their sexual relationships with unfortunate (and unnecessary!) consequences.

There are 4 types of sexual dysfunction: 

1.  Hypoactive Sexual Desire Disorder- In this case, the desire for sex is low, and at odds with what a woman wants.  Hypoactive Sexual Desire Disorder can affect both pre- and post-menopausal women, as well as women with surgical menopause (induced by hysterectomy and oopherectomy), especially in the period immediately following surgery.

2.  Female Sexual Arousal Disorder- This usually, but not always, accompanies Hypoactive Sexual Desire Disorder. Women with this Female Sexual Arousal Disorder want to have sex, and attempt to have sex, but have trouble finding pleasure in it.

3.  Female Orgasmic Disorder- In this disorder, women feel aroused but have difficulty with orgasm.  Frustration then leads to avoidance.

4.  Dyspareunia- Even with the best of partners, women with Dyspareunia find the experience of having sex painful. The pain is not from lack of lubrication or vaginal spasm.

Urinary Incontinence 

Urinary Incontinence is downright embarrassing, especially when leakage happens without warning. An estimated 35% of women over age 60 experience at least occasional incontinence.  The numbers are likely higher, as many women find the issue too embarrassing to talk about. Left untreated, urinary incontinence can lead to restrictions in activities, depression, and low self-esteem.  

Incontinence can occur at any age.  Typically it first occurs following pregnancy, and then worsens as women age. There are two main types of urinary incontinence: Urge Incontinence and Stress Incontinence.

Urge incontinence, or overactive bladder, occurs as a consequence of bladder muscle spasms.  With urge incontinence, there is not enough time to get to the bathroom, and a large quantity of urine is released.

Stress incontinence occurs when abdominal pressure increases, with a cough or a sneeze, for example. The extra pressure is problematic when a woman’s urethra has been weakened or injured during delivery.  The amount of urine leaked is less than in urge incontinence, but still significant and distressing.

Incontinence can interfere with the ability to exercise and may also lead to avoidance of social situations.  However, urine incontinence is treatable. Platelet Rich Plasma (PRP) offers a non-surgical approach that can quickly improve, if not eliminate, the need for pads.  Additional benefits are gained when PRP is combined with pelvic floor Physical Therapy, bio-identical hormones and supplements. 

Very few women, about 14%, ever talk to their physician about sex or incontinence.  In addition to taboos, this is likely related to a perceived lack of treatment options. While psychotherapy and hormone replacement have been available for years, the fear of taking hormones, despite numerous long-term benefits, has limited their use.  The benefit of psycho-social therapies has been proven but is not appealing or available for some women, and not enough for others.

But there is another option, the O-shot, introduced by Dr. Charles Runels. 

When I first heard of this non-surgical treatment for sexual dysfunction and urinary incontinence, I immediately signed up to learn about it.  The concept of using one’s own blood to heal and regenerate vaginal tissue was an extension of work I had long been doing.  Since 2013,I have been using purified blood, with all its wonderful growth factors, to heal and strengthen tendons, ligaments, fascia, and cartilage in my Sports Medicine practice.

Purified blood is called Platelet Rich Plasma (PRP).  Platelets are the body’s principle cells that rush to an injury, cause it to stop bleeding, releasing growth factors that stimulate “stem cells” causing healing, and encouraging new blood supply to the area, which can bring in other agents needed for healing and repair.  

The O-shot, using a woman’s own Platelet Rich Plasma, restores, rejuvenates and activates the Female Orgasm System.  The O-shot is an office-based procedure that takes less than an hour.  The benefits, seen within days or weeks, can be lasting, especially when combined with the use of bio-identical hormones, supplements, and pelvic floor exercises. 

After treatment, women have described:

· Greater arousal from clitoral stimulation

· Younger, smoother skin of the vulva (lips of the vagina)

· A tighter introitus (vaginal opening)

· Stronger orgasm

· More frequent orgasm

· Increased sexual desire

· Increased ability to have a vaginal orgasm

· Decreased pain

· Increased natural lubrication

· Decreased urinary incontinence

· Reducing episiotomy scar and vaginal tear pain 

This amazing, low risk, painless therapy is available for $1200. Please call to book an appointment.  

O-shot in the news

Nylon article on the reporters first hand experience with getting the O-shot https://nylon.com/articles/o-shot-experience

Technical Articles

Matz, EL: Safety and feasibility of platelet rich fibrin matrix injections for treatment of common urologic conditions Demonstrates O-Shot® methodology could be widely effective for stress incontinence in women 

 Neto JB, O-Shot®: O-Shot:  Platelet Rich Plasma in Intimate Female Treatment –  oshot-platelets-rich-plasma-in-intimate-female-treatment-2167-0420-1000395 

 Goldstein AT, King M, Runels C, Gloth M, Pfau R,  Intradermal injection of autologous platelet-rich plasma for the  treatment of vulvar lichen sclerosus. Journal of the American Academy of  Dermatology, 2017, 76(1), 158-160 (click to read)  


How does Platelet Rich Plasma (PRP) work?

PRP has a concentrated amount of platelets and growth factors that encourage blood vessel growth, which help bring in nutrients and attract other substances needed to repair and regrow the tissue. 

What is the risk of using PRP?

PRP is not associated with any risk or complication because it is your own blood, which is not foreign to your body.  The risk of treatment is a consequence of the actual injection technique. The risk of treatment with PRP includes allergy to the anesthetic and injury or puncture of a deeper structure or nerve. This shouldn’t happen, but because everyone’s anatomy is slightly different, it is a potential. Bruising to the injected area can be expected. There is a low risk of infection. 

Is there anything I need to avoid prior to treatment?

The use of anti-inflammatory medications, such as Motrin, Aleve, Advil and other prescription variations, will interfere with the platelet ability to activate healing. Fish oil, which at high doses can lead to more bleeding, should be stopped 3-5 days before. Low dose aspirin is ok. We should review your medication and supplement list prior to the procedure.

What can I expect during and after the treatment?

The treatment is preformed using topical anesthetic and ice.  In some offices Nitrous Oxide can be used.  This should help with any nervousness or anxiety you have about the procedure and further reduce your concern about pain. The injections are done with very small needles in specific locations.  It is takes about 20 min. After the procedure once the anesthesia has worn off, the vaginal area will feel bruised and slightly swollen.  This usually lasts a day.  In some people it may last 3-5.

When can I resume sexual intimacy?

The benefit can be immediate in some people, while in others, it may take 2 to 8 weeks. I suggest waiting until the anesthesia to wear off and the bruised sensation to go away before engaging in sexual activity. 

What are bio-identical hormones?

Bio-identical hormones are chemically identical to the hormones in your body. They can be described as the non- GMO equivalent of many pharmaceutical hormones. This makes them safe. Estrogen, Progesterone (not progestin), testosterone, DHEA, and melatonin are all examples of common hormones whose levels drop as we age, perhaps causing some of the aging that is normally expected. The use of bio-identical hormones with regular laboratory evaluation has optimized the healing benefit of the O-shot. 

What is the cost of the O-shot?

The cost is $1200, well worth the benefit it has on relationships with partners and the needless embarrassment of leaking urine.

Do you need another O-shot?

The benefit is variable, lasting months to years. Many women choose to repeat the O-shot yearly or every other year. There are women, who at the first evaluation may need 1 or more treatments because of scars from episiotomies or tearing during vaginal delivery. 

What else can I do to improve the benefit of the O-Shot?

Healthy nutrition with a diet low in manufactured carbohydrates (ie: food that is processed at a factory and comes in a box or bag).  Good carbohydrates are found in vegetables and fruits.  Be careful of how you cook or prepare these, as fats that are partially hydrogenated are not healthy. Butter (especially Ghee, which is clarified butter) or coconut oil are healthy choices.  Steaming is even better.  A fist sized portion of meat cooked at temperatures below 400 degrees may be OK a few days a week.  Be careful with the sauces and salad dressings, as they can add calories.  Avoid snacks.  Fast for 13 hours a day (overnight). 

Supplements can be beneficial in terms of healing. Fish Oil (restart 1 day after the procedure), Multiminerals. Vitamin D3.

Daily intake of ½ your body weight in water is great if you do not have heart disease or issues where you need to avoid too much fluid. 

Exercise daily.  20 minutes of vigorous exercise is recommended, however a day where you walk a lot (to go grocery shopping or to do errands) can be extremely valuable. 

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