Oboost

Oboost, ie PRP injected to the female genital area is a treatment for sexual wellbeing.

Sexual Wellbeing

Sexual wellbeing is a vital aspect of good general health and with 20-40% of the adult population experiencing sexual difficulties it is a subject that warrants more awareness and discussion.

Doctors and patients are equally reluctant to talk about sexuality and sexual concerns.  

People in same-sex relationships can be even more hesitant to bring up the subject, especially if they sense doctor discomfort.

There is an increase of sexual difficulties associated with illness/medications/personal and relationship difficulties.

Sexual symptoms can also result from biological, psychological, and sociocultural factors.

Female sexual difficulties include:

  • Painful intercourse 1/10 females (Dyspareunia)
  • Lack of libido 4/10 females (Hyposexual desire disorder / Arousal disorder)
  • Anorgasmia 1/3 females (Orgasmic disorder)
  • Concerns about the physical appearance of their genitalia

Patients can be reluctant to discuss these issues with their doctor

  • Due to shame/embarrassment
  • Belief that the problem is a part of their age/medical condition/medications
  • Patient can be distressed/disgusted by their own bodies
  • Patients often don’t know that these conditions can be due to medical prescriptions

Main factors affecting sexuality

  1. Long term partner
  2. Psychosomatic disorders (mind-body) painful emotions/ memories and feelings about sex can inhibit arousal and sexual pleasure
  3. Medications: including anti-hypertensives, anti-depressants, anti-histamines and         anti-psychotics
  4. Cigarettes, alcohol, and methadone are also causes of sexual difficulties
  5. Sexual abuse: Patients with a history of sexual abuse, especially those who have not had therapy may present with sexual difficulties.  They experience guilt/fear/intense pain or disgust with sex. These patients have difficulties becoming aroused even when they’re in a good relationship with a loving partner.  People may dissociate with their bodies during sex or may have multiple partners and let their body be used as in the past.
  6. Life changes: Major life changes can also impact our sexual experiences. A new partner/baby/marriage/divorce/menopause, to name a few.
  7. Our sexuality is reflected by the way you feel about the rest of your life.

Other factors to consider

  • Response to your periods starting/menstruation/pregnancy/menopause/tampon use
  • Sexual beliefs and religion
  • Painful labour/episiotomy/infertility/still births/miscarriages/and termination of pregnancy
  • Acceptance of self-stimulation
  • Prior surgeries i.e. mastectomy/colostomy
  • Suitable contraception
  • Physical set up – kids sleeping in your bed
  • Coming out history for same sex couples

Painful Sex

Deep pain with intercourse warrants gynaecological investigation and review to exclude pelvic pathology.

Women with vaginismus experience pain with penetration and on examination they have vaginal spasm.

Anorgasmia

Associated with difficulty in relaxing or letting go sexually.  Many women who don’t orgasm still enjoy the sexual experience and become orgasmic in their 30’s or 40’s as they become more comfortable with themselves and their bodies.

Lack of Libido

Sexual interest can be affected by:

  • Illness
  • Medication
  • Hormone imbalance
  • Fatigue

However, more commonly it is affected by relationship issues. Unconscious anger/resentment might be underlying culprits. Women often feel this way if a partner is not interested in non-sexual intimacy.

Existing treatment modalities:

  • Psychological Psychotherapy
  • Behavioural Psychotherapeutic meds
  • Hormonal Short term testosterone
  • Psychopharmacological Flibanserin

The physical components that play a role in achieving an orgasm

We’ve already alluded to the fact that our mental health, past experience and memories can affect our ability to orgasm but how does this relate to the science of our psychology?

  1. You need to be able to let go … this is easier said than done and you need to stop worrying about other things
    – where are the kids?
    – what are all the things I have to do today?
    – that meeting in the morning…
    All these thoughts can inhibit your ability to become aroused.

  2. Positive and negative feedback loops
    Let’s say you’ve had a good sexual experience, then the next time you’re looking forward to it and you enjoy it more.  However, overcoming a bad experience is more difficult. Next time you might dread having sex which makes arousal and enjoyment more difficult.  If this becomes a repeating cycle for you it is very difficult to break out and establish a positive loop.

The Brain

Nothing happens without the brain.  It controls every part and every aspect of the female orgasm

  • The left hemisphere (awareness of immediate environment) must become deactivated. Left temporal lobe and central prefrontal cortex.
  • The areas that control micturition is the same areas responsible for orgasm.  The ventrolateral periaqueductal area is activated in women who ejaculate/orgasm successfully and is also responsible for the pelvic/vaginal contractions in women.
  • Pelvic organ stimulating center (via projections of the sacral perineurial motor neurons).  control pelvic organs involved in voiding.
  • You might wonder how the “voiding” fits into the orgasm but that will become clear soon.
  • The important message here is that some areas of your brain need to deactivated in order for others to become active!
  • Another little important part of the brain is the pituitary gland; our emotions and physical condition affect our pituitary gland which controls all the other glands in our body including our adrenal glands and ovaries.

Hormones

Hormones are chemical messengers that travel through our bodies and signal other organs and systems. Hormones play a huge role in our ability to achieve orgasm and proper hormone balance requires careful attention to both the blood levels and the woman’s symptoms.  A woman will struggle to have a sex drive/orgasm without proper hormone balance. Contrary to popular belief E2x does very little for sex drive. Testosterone plays the biggest role.

Relevant hormones for our sexual health include:

Testosterone

Plays a vital role in both arousal and orgasm in women.  The higher your testosterone levels the higher your drive.  It is important to test both the total and the free testosterone levels. The free testosterone levels can be increased to the upper 25% of what’s normal.  The best testosterone replacement method is by injection. Birth control pills drop your levels of testosterone.

Thyroid

High normal levels – healthier body and high sex drive.

Low levels – weight gain/depression.

Growth Hormone

Profoundly affects the sense of wellbeing and if its low, people tend to feel depressed and tired, which in turn affects emotions of arousal, libido and orgasm.

The IGF-1 should definitely be measured.

Prolactin

Mainly responsible for breast milk production.  If prolactin levels are too high it can lead to a lack of arousal, lowered libido and difficulty with orgasm.   This is one of the hormones that you want to keep on the low side.

E2x

Does not contribute to sex drive and orgasm. Lower end of normal is better.

Progesterone

It plays a small role with libido, more than E2x but less than progesterone.

Oxytocin

Lower levels of oxytocin are found in women who experience fewer emotions of love and tenderness with orgasm.

The physical components:

Blood vessels and blood flow

High blood flow to the penis forms the basis of an erection, in the exact same way high blood flow to the clitoris, urethra and vagina raises arousal and facilitates orgasm.

Nerve tissue

The peripheral nerves of the orgasm system detect sensation and control musculature of the vaginal wall.

The Skene’s glands (female equivalent of prostate gland)

Women can ejaculate during sex and they secrete fluid from small glands near the opening of the urethra called the periurethral glands or Skene’s glands.  This fluid contains PSA, the same chemical component found in prostate fluid. These glands can be found near the opening of the urethra.

Urethra

Dr Gräfenberg (who described the G-spot) thought the urethra was the most erotic part of a woman’s body.  Stimulating the G-spot means simply pushing on the urethra against the roof of the vagina – the urethra lies just on the other side of the anterior vaginal wall.

The vagina

This is actually the least sensitive part!  The vaginal wall senses touch and pressure much less than the urethra, clitoris or even the anus.  Compared to the male genitalia it is the equivalent of the scrotum – it does not lack sensation it is just not the most sensitive part!

The clitoris

The bulk of a woman’s clitoral tissue is mostly inside the body.  We can however only see a very small part there of. The visible part correlates to the head of the penis but the rest (which correlates to the shaft), can not be seen or touched.  A clitoris on average is 5-6 inches long! This inner part comes close to the roof of the vagina with stimulation.

The O-Boost Treatment

What happens on the treatment day

  • Consultation and consent
  • Specially compounded numbing cream is applied by the doctor to the clitoris area underneath the urethra and entrance to the anterior vaginal wall.
  • We take blood from your arm which goes into a Regen PRP ® tube and spin the blood in a centrifuge @ 3000 RPM’s.  At this speed the heavier cells go to the bottom of the tube whilst the lighter cells are left at the top. We collect the platelets into a syringe.
  • The doctor injects a tiny amount of local anaesthetic at the base of the clitoral hood.
  • We activate the platelets immediately prior to injection.  A small amount (approximately 10% of the injected platelets) of calcium or calcium gluconate when added to the platelets – trigger them to release their growth factors.  It also signals the clothing cascade so the PRP becomes thicker and is now known as PRFM platelet rich fibrin maxtrix.
    – Essentially the growth factors are now trapped in the matrix which holds the growth factors in place.
    – The GF stimulate and recruit multipotent stem cells to grow new and healthier tissue.
  • Next, 1ml of PRP is injected into the clitoris, 1ml immediately below the urethra (to stimulate Skene’s glands and to improve urinary incontinence) and the rest (approx) 4ml is injected into the anterior vaginal wall. (The injected PRFM travels through the clitoris and into the corpi cavernosa).

Is it painful?

Pain is truly minimal: discomfort, pressure and an urge to urinate is more commonly experienced.

After effects

  • Raised sensitivity of the clitoris – you can have sex but waiting 24 hours is recommended.
  • Spotting is normal (from needle entry points) and we will provide a panty liner.
  • The urge to urinate is very common, this is due to the fluid deposit under the urethra.  this sensation disappears within the next 24 hours.
  • Increased vaginal wetness, occasionally up to a week.
  • Initial period of increased libido/hypersexuality.
  • Swelling.
  • Bruising.

Side effects

Side effects are very rare.  PRP is from your own body and side effects are usually procedure related, i.e.,

  • Haematoma or bruising
  • Swelling
  • Local discomfort
  • Allergy to local anaesthetic
  • Infection (UTI)
  • Urinary retention
  • Blood in urine
  • Urethral injury (Rarely, no response is being reported.  In these instances the procedure can be repeated with varied results.

Aftercare

The clitoris is very sensitive for the first 12-24 hours so we recommend no intercourse or direct stimulation for 24 hours. You can shower as normal, although if a bath can wait 24 hours that is ideal.

We provide a panty liner in case of spotting which can occur in the first couple of hours.

No prophylactic antibiotics are necessary.

Credit: Dr Charles Runels: O-Shot Pioneer.

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