Does the O-Shot Work? An Honest Look at the Evidence for Women

Ashley Harwyn, PA-C, ABAAHP  |  Published March 20, 2025  |  Last updated October 6, 2026  |  18 min read

One pilot trial, a handful of small studies, and a list of promises that mostly have not been shown in a controlled study. Here is what is known about PRP for women's sexual health.

That is a smaller claim than the one this page used to make. An older version of this article said the shot “transforms” sexual health, and the evidence does not support that word. We still offer the O-Shot at Solcara, and we would rather you hear the real numbers from us before you decide. Below you will find what the procedure is, what each study actually measured, which of the familiar promises hold up, and which proven treatments may fit your symptom better.

• “O-Shot” is a name used for injecting platelet-rich plasma (PRP), made from your own blood, into genital tissue; studies have used sites that include the anterior vaginal wall and the clitoris. Protocols for dose, site, and number of sessions are not standardized.[2]
• A 2023 systematic review pooled 327 women across 12 studies and rated the overall evidence low, mainly because the studies were small and most had no comparison group.[2]
• In a 2026 randomized trial of 52 premenopausal women, 69.2 percent on PRP reported improvement at six months versus 34.6 percent on saline, but the individual sexual function subscales did not differ significantly.[1] Two small 2025 trials in postmenopausal women with vaginal atrophy reported sexual function gains with PRP, and their authors call for larger or longer studies.[9][10]
• For stress urinary incontinence, the one small randomized comparison in the 2023 review found a midurethral sling worked better than PRP.[2]
• Serious harm has been rare in the published reports: fewer than 1 percent had any adverse event, and all resolved.[2]
• Proven options exist for the most common complaints: vaginal moisturizers, low-dose vaginal estrogen, and related therapies for menopausal dryness and pain, pelvic floor muscle training for leaks, and two FDA-approved medicines for low desire in premenopausal women.[4][5][6][7]

What is the O-Shot, in plain terms?

“O-Shot” is a name used for an in-office procedure that uses platelet-rich plasma. A small amount of your blood is drawn and spun in a centrifuge, which separates out the platelet-rich plasma, and that concentrate is injected into the genital area.[3] The 2023 review describes PRP as rich in growth factors, and notes that preclinical studies (laboratory and animal research, not trials in women) have linked it to new blood vessel growth, nerve protection and regeneration, and wound healing.[2] The studies on women have injected sites that include the anterior vaginal wall, the clitoris, the area around the urethra, and the vulva.[2]

Two practical details matter more than the brand name. First, there is no single recipe. The 2023 review found such wide variation in how PRP was prepared, how much was given, where it went, and how often, that the authors could not combine the results into one pooled estimate.[2] When two clinics both say “O-Shot,” they may not be doing the same thing.

Second, the regulatory picture is narrow. The systems that prepare PRP are medical devices. One FDA 510(k) clearance for such a system, for example, describes PRP that is “mixed with autograft and/or allograft bone” to improve how bone graft handles.[3] That clearance is about the device that makes PRP, not about any effect of injecting it into vaginal or clitoral tissue. Solcara's own O-Shot page states that this use is not an FDA-approved indication, and that for this reason it is not covered by insurance.

What did the early O-Shot studies find?

The first wave of research on PRP for female sexual function was encouraging on paper and weak in design. The 2023 systematic review in Biomedicines identified five studies of PRP for sexual dysfunction, four prospective and one retrospective, and every one of them was single-arm.[2] In other words, each study treated a group of women and compared them with themselves before treatment. None had a group that received a placebo or a different treatment.

The sizes were small. The earliest included study, by Runels and colleagues in 2014, enrolled 11 women and reported an average rise of 5.5 points on the Female Sexual Function Index (FSFI), a standard questionnaire.[2] Other studies enrolled 20, 37, and 52 women, with follow-up ranging from about one month to six months.[2] Across the full review, which also covered incontinence, there were 327 women with an average age of 51.[2]

Why does the missing comparison group matter so much? Without one, a study cannot separate the effect of PRP from improvement that would have happened anyway. The 2026 randomized trial described below shows how large that can be: at six months, 34.6 percent of the women who received only saline also said they felt better.[1] The review authors put their overall judgment in their own words: despite promising initial results, “the level of current evidence is low due to methodological issues.”[2]

What did the randomized trials show?

In 2026, Obstetrics and Gynecology published a randomized controlled trial of vaginal PRP for sexual function.[1] It was a single-center pilot study. Fifty-two premenopausal women aged 18 to 50, without severe sexual dysfunction, were randomly assigned 26 to each group: one group received a one-time PRP injection into the anterior vaginal wall and the other received saline. The trial was single-blind, and women were followed for six months.[1]

The main question was how much the FSFI score changed at six weeks. The median rise was 2.2 points with PRP and 0.3 points with saline. At six months the median changes were 1.6 and 0.8 points. The abstract reports these comparisons at P = .05, right at the usual line for statistical significance.[1] When the researchers looked at each piece of sexual function separately (desire, arousal, lubrication, and orgasm), the PRP group moved in the right direction, but the abstract states these changes “were not statistically significantly different compared with control.”[1]

The clearest signal came from a global question: overall, do you feel better? At six weeks, 69.2 percent of the PRP group said yes versus 42.3 percent of the saline group. At six months it was 69.2 percent versus 34.6 percent, with P = .01.[1] No serious adverse events were reported.[1]

How should you read that? It is a genuine positive result, and it deserves respect. It is also one pilot trial of 52 women, with borderline results on its main measure, and it only enrolled premenopausal women without severe symptoms. On its own it tells us little about women after menopause, women with severe sexual dysfunction, or women whose main concern is leaking. Notice, too, that about a third of the women who received only saline also said they felt better.[1] A comparison group is what makes that kind of response visible, and the earlier single-arm studies did not have one.[2]

What about women after menopause? A PubMed search for randomized trials of PRP and female sexual function, run for this update in October 2026, returned three other small trials, all published in 2025 and all in postmenopausal women with vaginal atrophy. Two used a standard comparison. In an Egyptian trial described as double-blinded, 60 women received PRP or saline injections into the vaginal mucosa; at four months, total FSFI scores were higher with PRP (19.0 versus 9.7), with gains in lubrication, satisfaction, and pain, but no differences in desire, arousal, or orgasm.[9] In a Romanian trial of 90 women aged 50 to 65, three monthly PRP sessions were compared with 12 weeks of vaginal estriol; both groups improved, and the PRP group's slightly larger FSFI gain (10.1 versus 9.3 points) was not statistically significant.[10] Both author groups called for further, larger or longer studies.[9][10]

Which O-Shot promises hold up?

The earlier version of this post made a list of confident promises. We went back through each one and checked it against the trial and the systematic review. Some survive in a smaller form. Several do not survive at all. The table shows where each claim stands as of October 2026.

The pattern is consistent. The safety claim holds up best, the specific promises about orgasm and leaks hold up worst, and lubrication is mixed. That is close to the opposite of how the older version of this page presented it.

It also explains why we rewrote this page instead of trimming it. A promise of “more intense orgasms” or “restored lubrication” sounds like a measured result. In the 2026 trial, those exact outcomes were measured, and they were not significantly different from placebo.[1] In the 2025 saline-controlled trial in postmenopausal women, orgasm again did not differ, though lubrication did.[9] A woman deciding whether to spend her own money deserves to know that before the appointment, not after.

What helps the symptom you actually have?

If you are asking about the O-Shot, it helps to name the specific problem you want to improve: sex that hurts, dryness, leaking, a desire that has faded, or difficulty reaching orgasm. Each of those has a different set of causes, and several have treatments backed by position statements, Cochrane evidence, or FDA approval, as the sections below show.[4][5][6][7]

Dryness, burning, or painful sex after menopause. These are among the symptoms of genitourinary syndrome of menopause (GSM), which The North American Menopause Society describes as resulting from the effect of estrogen deficiency on the genitourinary tract.[4] The North American Menopause Society estimates GSM affects roughly 27 to 84 percent of postmenopausal women.[4] Its 2020 position statement lists over-the-counter lubricants and moisturizers as first-line for milder symptoms, and calls low-dose vaginal estrogen, vaginal DHEA, systemic estrogen therapy, and ospemifene effective treatments for moderate to severe symptoms.[4] Our guide on whether vaginal estrogen is safe covers the most common worries about that option.

Leaking with a cough, sneeze, or workout. That is stress urinary incontinence. A Cochrane review found women with stress incontinence who did pelvic floor muscle training were about eight times more likely to report cure than those without treatment (56 versus 6 percent, high-quality evidence).[7] The authors concluded this training belongs in first-line conservative care.[7] For PRP, the only randomized comparison in the 2023 review found a midurethral sling performed better.[2] Our post on urinary incontinence and vaginal laxity walks through the different types of leaking.

Low desire that bothers you. When low sexual desire causes distress and is not explained by another medical condition, a medication, or relationship problems, it may be hypoactive sexual desire disorder (HSDD). For premenopausal women, the FDA has approved two prescription medicines. Flibanserin (Addyi) is a nightly tablet, and its label warns that drinking alcohol close to a dose raises the risk of severe low blood pressure and fainting.[6] Bremelanotide (Vyleesi) is an injection used before sex; nausea was reported by 40 percent of users in trials.[5] Neither is approved for postmenopausal women, and both labels say to stop after eight weeks if there is no improvement.[5][6]

Everything else, including trouble with arousal or orgasm. Sexual problems can have more than one contributor. The FDA labels above, for example, require that low desire not be due to a co-existing medical or psychiatric condition, problems with the relationship, or the effects of a medication or drug substance before those medicines are used.[5][6] Solcara's sexual dysfunction therapy page describes the first step as an evaluation, not a procedure, and the hormone therapy page covers hormone options around perimenopause and menopause.

Not sure which of these fits you? Call 843-981-0870. Bring what has changed and when, and ask how the better-studied options for your symptom compare with the O-Shot, so you can choose with the facts.

Is the O-Shot safe, and what are the side effects?

Safety is the strongest part of the record so far. Across the studies in the 2023 review, fewer than 1 percent of women had any adverse event: two reported extreme sexual arousal and one had temporary urinary retention, and all three resolved.[2] The 2026 randomized trial reported no serious adverse events.[1] Because the material comes from your own blood, there is no donor tissue involved.

Low risk is not the same as no risk, and it is not the same as proven benefit. The published studies are small, so an uncommon problem could go unseen. For the blood draw itself, MedlinePlus says you may feel slight pain or a sting as the needle goes in, and some throbbing at the site afterward.[8] An older version of this page called the whole experience “virtually pain-free”; that line did not cite any study.

A second safety question is what an elective procedure can distract from. If you have pain with sex, new bleeding, unusual discharge, a lump, skin changes on the vulva, or leaking that started suddenly, raise it at your visit before any elective injection is discussed. Solcara also offers Pap smears if you are due for cervical screening.

How we approach the O-Shot in Charleston and Mount Pleasant

Solcara's O-Shot page says the conversation comes before any procedure is booked, and starts with what you are experiencing and for how long, where you are in the menopause transition, what medications you take, whether pain or incontinence is part of the picture, and what has already been tried. Solcara Health has offices in Mount Pleasant on Bramson Court and at The Longevity Club on Rutledge Avenue in downtown Charleston. Ashley Harwyn, PA-C, is board certified in anti-aging and functional medicine through A4M, and you can read more about Ashley.

The same page says that if the O-Shot is not the right starting point, you will be told that. If you have tried the established options, or your goal is something they do not address, and you still want the O-Shot, ask to go through the evidence summarized here at your visit: one encouraging pilot trial, an overall improvement that outpaced placebo, and specific promises that have not been demonstrated. For the wider topic, the guide to whether vaginal rejuvenation really works applies the same standard to lasers and other devices, and the platelet-rich plasma page covers how PRP is used elsewhere in the body.

Ashley Harwyn, PA-C PA-C, ABAAHP · Founder, Solcara Health Online

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About the author

Ashley Harwyn, PA-C, ABAAHP

Founder, Solcara Health · Diplomate, American Board of Anti-Aging Health Practitioners (ABAAHP)

Ashley has practiced medicine for more than fifteen years. Her path into it began at home, with a family member born with a congenital heart defect and a childhood spent watching how much the quality of a clinician's attention could change the shape of a life. She has since practiced across a range of settings, including medical mission work in Uganda, before founding Solcara to build the kind of practice she kept wishing existed, one that treats patients as whole people and tells them the truth about what the evidence does and does not support.

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