It’s a confusing time to have a vagina. On the one hand, we’ve never had it better. Conversations about periods, menopause, and some of the less-glamorous aspects of childbirth are happening (though there’s plenty of room for improvement — especially when it comes to stigma and inclusivity). Sexual pleasure and orgasms (though not one and the same) are no longer strictly confined to punchlines about having to fake it. We’re also talking about masturbation, sex toys, and porn — including the fact that [gasp] moms like porn too.
But on the other hand, there is still a massive amount of misinformation out there. And because most of us never had the benefit of accurate, comprehensive, and inclusive sex ed, it can be hard to determine which products and procedures are helpful, harmful, or relatively safe, but completely unnecessary. And there are a lot of them.
One is called the “O-Shot,” and yes, the “O” is for orgasm. Though the procedure does involve an injection, it’s not of a manufactured drug or other substance, but instead, part of your own blood (more on that in a minute). Here’s what to know about the O-Shot, including what it is, how long it’s supposed to last, what it costs, the risks involved, and whether the claims made about the injection’s ability to improve your orgasm have the research to back it up.
What is the O-Shot?
Over the past several years, a treatment for sports-related injuries involving injections of platelet-rich plasma (PRP) has increased in popularity. The process is relatively straightforward, according to the American Academy of Orthopaedic Surgeons: “Blood must first be drawn from a patient. The platelets are separated from other blood cells and their concentration is increased during a process called centrifugation. These platelets are then injected into the injured site.” Except in the case of the O-Shot, instead of an “injured site,” the PRP is injected into the clitoris, labia, G-spot, and other vaginal tissue (after numbing cream is placed on the areas involved).
According to Monica Grover, D.O., a gynecologist at VSPOT Sexual Health Spa in New York City (which offers the procedure), the cost of the O-Shot can range from $1,500 to $3,000. And because it’s an out-of-pocket procedure, it’s not covered by insurance. “The type of centrifuge, and the doctor’s technique and expertise are the biggest price variables for the O-Shot,” Grover tells Scary Mommy.
So how long is an O-Shot supposed to last? Grover says that there have been consistent reports of the O-Shot lasting for two to three years — though it’s important to keep in mind that these are anecdotal, and not part of a clinical trial or other type of study. “Even after two to three years though, it increases the threshold of a heightened orgasm from the original baseline and then women will return to exceed the new threshold,” she explains.
What, exactly, is the O-Shot supposed to do?
If you browse through the websites of clinics that offer the O-Shot, you’ll find a wide range of claims, promising everything from earth-shattering orgasms, to increased clitoral sensitivity, to curing various forms of sexual dysfunction. For example, according to Grover, the O-Shot “utilizes your own blood to increase sexual arousal, orgasms, and natural lubrication,” because the PRP “contains cell regenerating growth factors that, when painlessly injected into specific areas of the vulva, clitoris and vagina, trigger growth factors to increase blood flow, generate healthy tissue growth, and help improve the vascularization of the area.”
But Jen Gunter, MD, an OB-GYN and pain medicine physician, doesn’t see how that process could work. “There is no biological reason that platelet rich plasma would help with orgasm as there is no diseased or damaged tissue to heal,” she wrote in a May 2021 article for The Vagenda. When PRP injections are used in sports medicine, the aim is to mimic the body’s healing substances released in response to injury. But, as Gunter points out, “we don’t see improvement in orgasms or sexual function after surgery around the clitoris or in the vagina.”
So, if stimulating growth factors and cytokines during surgery — which is exactly what the O-Shot claims to do — doesn’t result in better orgasms, it’s difficult to see how the injections would have better results. Not to mention that getting PRP injections into your shoulder after a sports injury is one thing, but it’s a bit of a stretch to generalize that to mean that they’re safe for your clitoris, vulva, and vagina — especially given what we know about the sensitivity and absorbency of vaginal tissue, and how much we still have to learn about the clitoris (which was only fully mapped for the first time in 2005).
“The O-Shot makes no sense biologically and is completely untested,” Gunter, who also discusses the O-Shot in her 2019 book The Vagina Bible, told Scary Mommy. “We already have an awful history of untested and undertested procedures and medications harming women, like DES and the Dalkon Shield. Women do not need more untested procedures that come with hefty price tags and unsubstantiated claims.”
Complicating matters further is the concept of “sexual dysfunction.” It’s been more than 20 years since commercials for Viagra hit the airwaves, followed by other pharmaceutical treatments for erectile dysfunction. So one might assume that if a droopy dick can be dealt with by taking a pill, similar therapies must be available for people with a vulva. But it’s far more complex than that.
For those with a vagina, “sexual dysfunction” is an umbrella term encompassing any “persistent, recurrent problems with sexual response, desire, orgasm or pain,” according to the Mayo Clinic. And not only are there a wide range of symptoms of sexual dysfunction, there are many different potential causes of it, too, including medical conditions (e.g cancer, kidney failure, multiple sclerosis, heart disease, and others), menopause and other changes in hormone levels, mental health, and the state of your relationship. That’s not even counting people with partners who think sex revolves around their own orgasm or those who are well-meaning but clitorally challenged.
What are the risks of an O-Shot?
Before getting any kind of procedure, it’s important to do your homework and look into both its potential risks and benefits. But with the O-Shot, that’s easier said than done. As Gunter explained in her recent article for The Vagenda, it’s close to impossible to find any negative reviews of the O-Shot, or accurate information on its risks (though there are glowing reviews galore). This is pretty unusual for any product or procedure — let alone one that involves getting an injection in your clitoris — but also makes sense, given the lack of clinical research on the O-Shot (more on that in a bit).
When asked about the potential risks of the O-Shot, doctors who offer (and therefore make money from) the procedure tend to point out that because the injection doesn’t involve a drug, it doesn’t cause serious side effects. “Because we are using the patient’s own blood to extract the growth factors, there should not be true adverse events associated with the O-Shot itself, such as an allergic reaction,” Grover says. “Sometimes there can be a tingling sensation post-procedure, which should subside within 24 hours.”
But in addition to Gunter, other OB-GYNs who don’t offer the O-Shot have expressed concern over the lack of studies, and, as a result, the fact that we don’t currently have a clear picture of the potential risks. For example, UK-based gynecologist Anne Henderson, MRCOG, describes it as an “untested and dubious procedure” and urges people to steer clear.
“There are potential risks of autologous [the collection and reinfusion of the patient’s own red blood cells] blood injections such as this, particularly into a very sensitive area such as the genital region, where there is a high density of blood vessels and nerve fibres which could potentially be traumatised or damaged,” Henderson said in a 2019 with Refinery29.
According to Henderson, the O-Shot could result in bleeding, bruising, and infection, which, she warned, “could have even more serious consequences, and the risk of nerve damage which could cause long-term problems with vaginal pain, including pain with intercourse.”
Similarly, Leila Frodsham, MbChB, MRCOG, a gynecologist and spokesperson for the Royal College of Obstetricians and Gynaecologists, is concerned that the O-Shot could end up harming a patient’s sexual function by creating a blood clot similar to the ones that would form after an injury or other trauma. “Women with blood clots in this area generally complain of increased pain or reduced sensation,” she said in an interview with Refinery29. “Blood clots do not increase sexual satisfaction. More of my time is spent with women saying they think they’ve got issues because of blood clots, rather than with women thinking about curing something with blood clots.”
Is the O-Shot FDA-approved?
In this case, it’s more complicated than whether the O-Shot is or isn’t FDA approved (but to answer the question, it’s not). “Because the sample is prepared using the person’s own blood, it is not considered a drug, which is typically what needs to be FDA-approved,” Grover explains. Instead, the FDA regulates PRP injections via the devices used to isolate and prepare the PRP — several of which were cleared for use in 2020 and 2017.
So what does that mean? “FDA clearance allows PRP to be used for a wide range of different orthopedic indications. However, clearance is not synonymous with approval for a specific indication,” according to a 2018 article published in the journal Current Reviews in Musculoskeletal Medicine.
The article focused on PRP injections for musculoskeletal conditions and injuries but makes an important point that also applies to O-Shots: Just because the devices used in some PRP treatments have been cleared by the FDA, that doesn’t automatically mean that they’re considered safe to use for any purpose — nor is it blanket approval for all procedures that use the devices. So while the equipment used for O-Shots has FDA clearance, that doesn’t mean that the FDA has given any kind of stamp of approval to PRP injections in the clitoris, vagina, or vulva.
What does the research on the O-Shot say?
In short: nothing. This is a pretty long, complicated story (which Gunter has detailed in multiple blog posts), but here’s the short version. Not only has Charles Runels, MD — the inventor of the O-Shot — been reprimanded by the FDA for unethical research practices in the past, he first developed the O-Shot by experimenting on his girlfriend (which comes with its own set of ethical problems), according to a blog post he wrote himself.
OK, back to research. The only thing resembling a study specifically on the O-Shot was conducted and authored by Runels, involved a total of 11 participants, and was “published” in 2014 by a known predatory publisher — where basically anyone can “publish” their research by paying a fee. (Gunter discusses this further in her Vagenda article).
To be clear: There are plenty of studies looking at PRP injections in general, but currently, no legitimate research has been done on the safety and effectiveness of O-Shots. Doctors who offer O-Shots tend to disagree, and cite two journal articles in particular:
- This 2018 article, which isn’t itself a study, but a review of the findings of other studies on the use of PRP for gynecological purposes published between 2000 and 2017. It does contain a section specifically on the O-Shot, and deems the procedure “revolutionary” and “effective” based on two articles: the study Runels published himself in 2014, and a 2015 review of PRP injections in general (with no mention of their use for treating sexual dysfunction).
- This 2019 retrospective study, which was conducted using participants who had already gotten the O-Shot from a private clinic. It’s better than nothing, but also doesn’t tell us much, considering the participants all sought out and opted to receive the treatment themselves. Plus, at least two of the four authors of the paper offer the O-Shot in their own practices, adding yet another level of bias to the research.
Ultimately, everyone’s bodies, preferences, and needs are different, so having a range of options when it comes to experiencing or improving sexual pleasure can be a great thing. It can also be very lucrative. We already knew that sex sells, but so does a message of “empowerment” — even if a particular product or service doesn’t have scientific evidence to back up its claims.
So when it comes to the O-Shot, your best bet is to talk to an OB-GYN (that doesn’t offer the procedure in their practice) about the specific sexual issue(s) you’re experiencing, and the different possibilities for dealing with it. Then, once there is data from legitimate clinical trials, you can always revisit the option.