O-Shot®

O-Shot® in Charleston and Mt. Pleasant, SC

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Most pages about this procedure tell you it is safe, natural and effective. Two of those three are defensible. This page will show you the actual evidence, including the part that argues against it, because you are being asked to pay for something out of pocket and you deserve to make that decision with the real numbers in front of you.

The short version. A 2026 randomized controlled trial in premenopausal women was published in Obstetrics and Gynecology, and two 2025 trials studied postmenopausal women with vaginal atrophy. In the 2026 trial, at six months, 69.2 percent of women who received platelet-rich plasma reported improved sexual function, against 34.6 percent who received a saline placebo [1]. That is a real difference from a 52-person pilot study. It is not the same thing as settled science, and this page will not treat it as such.

Hear from Ashley

Ashley Harwyn, PA-C on what the O-Shot is and who asks about it. 53 seconds.

What the randomized trial actually found

Reported improvement at six months Randomized controlled trial, 52 women. Clarke et al, Obstetrics and Gynecology, 2026. PLATELET-RICH PLASMA 69.2% SALINE PLACEBO 34.6% A real difference, from one 52-person pilot trial. The individual subscales did not reach significance. Studied in premenopausal women 18 to 50.
The strongest single piece of evidence that exists for this procedure, shown in full.

Fifty-two women were randomized, half to a single PRP injection into the anterior vaginal wall and half to saline, then followed for six months. In this single-blind design, the participants did not know which they had received [1].

The headline result is the one in the chart above. On the Patient Global Impression of Improvement, 69.2 percent of the PRP group reported improvement at six months against 34.6 percent of the placebo group, and that difference was statistically significant [1].

The part that is usually left out

When the researchers looked at the components of sexual function separately, desire, arousal, lubrication and orgasm, every one of them moved in the right direction and not one of them reached statistical significance against placebo on its own [1].

That distinction matters when you are being sold something. The overall improvement was significant. The specific components were not. If a clinic quotes you a figure for how much your lubrication or your orgasm will improve, they are quoting something this trial did not establish.

Were women like you actually studied?

The trial enrolled sexually active premenopausal women between 18 and 50, without severe sexual dysfunction [1]. That is a narrower group than the women this treatment is usually marketed to.

If you are postmenopausal, or your symptoms are severe, the honest position is that the evidence for you is weaker rather than stronger. It may still be a reasonable thing to try. It is not a thing anyone can promise you, and the hormonal picture usually deserves attention first through hormone therapy or local estrogen.

Interactive  ·  60 seconds

Is the O-Shot the Right Starting Point?

Choose what you are hoping the O-Shot would address. The tool shows where each goal stands on the evidence; it is not an exam or a diagnosis. Nothing is stored or sent anywhere.

Tap all that apply

Educational only. Not a diagnosis or a substitute for clinical evaluation.

Will the O-Shot help urinary incontinence?

If leaking is what brought you here, this section matters more than any other on the page, and it is where we part ways with most O-Shot marketing in Charleston.

A systematic review examined PRP for both female sexual dysfunction and stress urinary incontinence across 12 studies and 327 women. In the one randomized comparison it identified, the midurethral sling performed significantly better than PRP injections for stress incontinence, on both of the measures used [2].

If leaking is your main complaint, the current evidence points toward a sling rather than toward this injection. The O-Shot is worth discussing if you want to avoid surgery, or if incontinence sits alongside other goals. It should not be presented to you as the better option for that symptom, and it will not be here.

How strong is the evidence, honestly?

The same systematic review pooled 12 studies covering 327 women, with a mean age of 51. Improvements were consistent across the scales used: the Female Sexual Function Index rose from 14 to 28, and the Vaginal Health Index from 11 to 19 [2].

Then it states its own conclusion plainly, and it is worth quoting rather than paraphrasing: the level of current evidence is low, because of methodological problems in the available studies [2]. Small samples, inconsistent preparation methods, short follow-up. Eleven of the twelve studies were observational rather than randomized.

That is the true state of it. Promising early results, one good randomized trial, and not yet the body of evidence that would let anyone responsibly promise you an outcome.

What the evidence supports

Improved overall sexual function in one randomized trial: 69.2 percent reported improvement against 34.6 percent on placebo at six months. A strong safety record, with under one percent adverse events across 327 women, all minor and all resolved.

What the evidence does not support

A promised improvement in any single thing. Desire, arousal, lubrication and orgasm each moved the right way but none reached significance alone. And for stress urinary incontinence the midurethral sling outperformed PRP in the one randomized comparison available.

What is the safety record?

This is the strongest part of the picture and it is genuinely reassuring. Across 327 women in the systematic review, fewer than one percent experienced any adverse event: three patients in total, two who reported extreme arousal and one with temporary urinary retention. All three resolved without further treatment [2]. The randomized trial reported no serious adverse events [1].

Because the preparation uses your own platelets, drawn from your own blood on the day, there is no donor material and no risk of an allergic reaction to a foreign substance.

Why the subscale result is the part to hold on to

It is tempting to read one strong headline number and stop there, and most pages about this procedure do exactly that. The more useful reading is that the overall impression of improvement moved clearly while the individual components did not reach significance on their own. That pattern is common in small trials and it has a specific meaning: the finding is real enough to take seriously and too coarse to promise you a particular outcome.

So if someone tells you this will fix desire specifically, or lubrication specifically, they are describing something the trial did not show. The honest version is that women in the treated group were more likely to say they were better overall, which is a genuine result and a smaller claim than the one usually made.

How the assessment works in Mount Pleasant and Charleston

A conversation comes before any procedure is booked. What you are actually 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.

A good deal of what brings women to this page is better addressed by treating vaginal atrophy, reviewing hormones, or referring for pelvic floor therapy. Where that is true you will be told, and the relevant laboratory work comes before any decision.

Solcara Health sees patients at two locations. In Mount Pleasant we are at 496 Bramson Ct, Ste 120, a short drive from Old Village, I'On, Park West and Daniel Island. The downtown practice is at The Longevity Club, 163 Rutledge Ave, Ste 202, in the medical district near MUSC and easy to reach from Harleston Village, West Ashley, Sullivan's Island and Isle of Palms.

Ashley Harwyn, PA-C holds board certification through the American Academy of Anti-Aging Medicine. This procedure is assessed here against the published evidence rather than against a brochure, which sometimes means the answer is that something else should come first.

If dryness or discomfort is the main problem

Local estrogen is better established for vaginal atrophy and is often the right first step. Read whether vaginal estrogen is safe after the 2026 FDA label change.

If leaking is the main problem

Stress incontinence deserves its own assessment before any procedure is chosen. See treatment for urinary stress incontinence and understanding urinary incontinence and vaginal laxity.

If the wider hormonal picture is unclear

Symptoms that arrive together usually share a cause worth measuring. See bioidentical hormone therapy and full panel lab testing.

What it costs, and what it does not cover

This is not covered by insurance and cannot be billed to it, because it is not an FDA-approved indication. Any clinic telling you otherwise is mistaken. Pricing is discussed openly before you commit to anything.

To book an assessment, call 843-981-0870 or ask for an O-Shot consultation through the form on this page. If incontinence is the main reason you are calling, say so when you book, because that changes which assessment you need.

Questions women actually ask

Ashley Harwyn, PA-C Ashley Harwyn, PA-C A4M Board Certified · Founder, Solcara Health Online

Tap a question to ask

About the author
Ashley Harwyn, PA-C, founder of Solcara Health in Charleston, South Carolina.

Ashley Harwyn, PA-C

Founder, Solcara Health · Board Certified in Anti-Aging and Functional Medicine (A4M)

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 women as whole people and tells them the truth about what the evidence does and does not support.

Full bio →

Why women choose Solcara for an O-Shot consultation

Ashley Harwyn, PA-C, offers the O-Shot® at Solcara Health and trained in the procedure with Dr. Charles Runels, who developed it and holds the trademark on the name. Because O-Shot® and Orgasm Shot® are protected names, any clinic offering them under those names should be able to show that training.

Most women who ask about it are dealing with something specific: dryness or pain after menopause, lower arousal, or leaking. Ashley's background is in family medicine and women's health, so the first visit looks at the whole picture, including hormones, vaginal tissue changes, pelvic floor strength and medications, before PRP comes up. For leaking in particular, pelvic floor therapy is the proven first step, and she will say so. If you decide the O-Shot is worth trying after that conversation, it is prepared from your own blood, with a plan for how you will judge the result.

References

U.S. Food and Drug Administration, HHS, and The Menopause Society sources.

  1. Clarke B, Gaddam N, Garcia B, Iglesia CB, Podolsky R, Dieter AA. Vaginal Injection of Platelet-Rich Plasma for Sexual Function: A Randomized Controlled Trial. Obstetrics and Gynecology. 2026;147(5):627-635. Read the study on PubMed
  2. Dankova I, Pyrgidis N, Tishukov M, et al. Efficacy and Safety of Platelet-Rich Plasma Injections for the Treatment of Female Sexual Dysfunction and Stress Urinary Incontinence: A Systematic Review. Biomedicines. 2023;11(11):2919. Read the study on PubMed

Be taken seriously, and told the truth

Book an evaluation at The Longevity Club, 163 Rutledge Avenue downtown, or our Mount Pleasant office.

BOOK A CONSULTATION →

Or call 843-981-0870

Medical Disclaimer: This page is for educational and informational purposes only and does not constitute medical advice, and reading it does not create a patient-provider relationship. It describes general medical information and categories of care, not a recommendation that any individual start, stop, or change any test, treatment, or medication. Any diagnosis or treatment decision requires evaluation by a qualified, licensed clinician who knows your personal and family history. Consult a qualified healthcare provider before making medical decisions. Information reflects sources available as of August 20, 2026.

Ashley Harwyn, PA-C, is Board Certified in Anti-Aging and Functional Medicine (A4M) and the founder of Solcara Health. Solcara serves South Carolina from Downtown Charleston (163 Rutledge Ave, Ste 202, The Longevity Club) and Mt. Pleasant (496 Bramson Ct, Ste 120).

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O-Shot® FAQ's

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