The O-Shot (Orgasm Shot): Evidence and Recommendations
The O-Shot, which involves platelet-rich plasma (PRP) injections into the vaginal and clitoral tissues for female sexual dysfunction, is not recommended for routine clinical use as it lacks FDA approval, robust clinical trial evidence, and endorsement from major medical societies. 1
What the O-Shot Claims to Be
The O-Shot procedure involves injecting autologous platelet-rich plasma into specific genital areas—typically the clitoral glans, G-spot area (distal anterior vaginal wall), and periurethral tissues—with the purported goal of improving sexual function, arousal, and orgasm in women. 2, 3
Current Evidence Status
Guideline Position on Regenerative Therapies
The National Comprehensive Cancer Network explicitly warns against "restorative or regenerative" therapies for sexual dysfunction, stating these treatments are not FDA-approved and are being administered in cash-only practices without robust clinical trial support. 1 The Sexual Medicine Society of North America similarly recommends against using restorative therapy in routine clinical practice due to absence of adequate evidence. 1
Research Evidence Quality
The available research on PRP injections for female sexual dysfunction consists primarily of:
- Small, uncontrolled studies with significant methodological limitations 4
- One systematic review identified only 5 studies (4 prospective, 1 retrospective) totaling 327 women, with the single randomized controlled trial having high risk of bias 4
- Studies show improvements in Female Sexual Function Index (FSFI) scores, but lack proper control groups, standardized protocols, and long-term follow-up 2, 4
Specific Study Findings
One Turkish study of 52 women receiving 4 PRP sessions showed FSFI score improvements from below 26 to 27.88±4.80, with orgasm subdomain scores increasing from 2.11±1.20 to 4.48±1.14. 2 However, this lacked a control group and blinding. A 2025 study on platelet-derived exosomes showed FSFI improvements but was retrospective and uncontrolled. 3
A systematic review concluded that despite "promising initial results," the level of current evidence is low due to methodological issues, and there is an emerging need for high-quality research. 4
Evidence-Based Alternatives That ARE Recommended
First-Line Pharmacological Options
- Flibanserin (100 mg daily at bedtime) for premenopausal women with hypoactive sexual desire disorder, FDA-approved with modest efficacy of approximately 1 additional satisfying sexual event every 2 months 5, 6
- Bremelanotide (subcutaneous injection as needed) for premenopausal women with hypoactive sexual desire disorder 5, 6
Non-Pharmacological Evidence-Based Treatments
- Pelvic floor physical therapy improves sexual pain, arousal, lubrication, orgasm, and satisfaction 1, 5
- Mechanical devices including vibrators or clitoral stimulatory devices for orgasm difficulties 5, 6
- Cognitive behavioral therapy has demonstrated effectiveness for sexual dysfunction 5, 6
- Vaginal lubricants and moisturizers (water-, oil-, or silicone-based) for vaginal dryness 1, 5
- Vaginal estrogen (pills, rings, creams) for postmenopausal vaginal dryness and dyspareunia 1, 5
Lifestyle Modifications
- Increased physical activity, smoking cessation, weight loss if overweight, and limiting alcohol consumption 1, 5
Critical Pitfalls to Avoid
- Do not recommend unproven regenerative therapies like PRP injections when evidence-based alternatives exist 1
- Recognize the financial exploitation risk as these procedures are offered in cash-only practices without insurance coverage or regulatory oversight 1
- Screen for reversible causes including medications (SSRIs, narcotics, hormonal therapies), psychological factors (anxiety, depression, relationship issues), and medical comorbidities (cardiovascular disease, diabetes) before considering any intervention 1, 5
- Perform proper evaluation including the Brief Sexual Symptom Checklist for Women as primary screening and Female Sexual Function Index for in-depth assessment 1
What NOT to Use
Phosphodiesterase type 5 inhibitors (like sildenafil) are not recommended for female sexual dysfunction due to contradictory results in clinical trials and lack of effectiveness data in women. 1, 5, 6, 7