When board-certified ob-gyn Courtenay Poucher, MD, uses platelet-rich plasma (PRP) for vaginal repair, it’s usually to treat atrophy and dryness, stress urinary incontinence, or lichen sclerosus. (The last in that list is a chronic inflammatory condition, most likely to occur during and after menopause, that causes itchy skin patches to form around the genitals.) She says that usually patients have already tried other remedies—lubricants, steroids, hormones, pelvic floor exercises, physical therapy, or surgery—yet their conditions remain unresolved.
According to Poucher, vaginal PRP injections—also known as the O-Shot, which was named by its founder, Charles Runels, MD—can be an effective alternative for most women. “Typically my patients report a vast improvement in their symptoms,” she says. That is: enhanced sexual pleasure during intimacy, the ability to work out without bladder leakage, and relief from the intolerable itching that occurs with lichen.
This noninvasive treatment has been used in various medical fields for decades. For example, in sports medicine, orthopedics, and dentistry and for hair growth and skin care. PRP uses your own plasma to try to restore the cells and tissues in your body. It’s not completely clear how it works, but research shows that the concentrated level of repair cells that are found in plasma—platelets, growth factors, and cytokines—is involved in the rejuvenation process. The cells enhance the formation of collagen and new blood vessels.
For most vaginal treatments, Poucher says the process takes less than a half hour—from blood draw to injection—and the results can last up to a year. She walked me through the basic steps of the procedure and its potential effects.
- Collect blood. It starts with a blood draw. “Typically one vial is drawn,” says Poucher. The blood is spun in a centrifuge to separate the plasma—the liquid-like part of the blood—from the rest (red and white blood cells). “I’m usually able to get approximately six ccs [cubic centimeters] of platelet-rich plasma that’s used for injection.”
- Inject plasma. Poucher says she takes precautions to ensure the injection is as painless as possible: “I use a super teeny, teeny, teeny-tiny needle.” And she applies a numbing cream at the injection site—vulva, clitoris, G-spot, or elsewhere, depending on the treatment protocol—to help ease the pain. Most of her patients feel some sensation, but nothing too painful, she says. After a quick postinjection cleanup, you’re free to go. There may be some spotting afterward, and if so, Poucher recommends avoiding a bath for 24 hours (showers are okay). “Most patients will start noticing an improvement within two weeks—max improvement is usually at six.”
- Use a cotreatment, if needed. Poucher says she often pairs PRP therapy with other treatments to enhance its benefits, especially in more severe cases. “Depending on the degree of atrophy that they have, I use multiple modalities, which could include PRP injection as well as a vaginal laser treatment,” she says. “The [radiofrequency] energy being delivered to the epithelium of the vagina allows the cells, in conjunction with the PRP injection, to increase collagen production and blood flow.” According to Poucher, the combination of therapies can produce transformational results: from pale, fragile, thinning vaginal walls to vibrant, pink, textured ones (with supple, healthy undulations called rugae) that can withstand the friction that comes with sex.
- Repeat. “One PRP injection along with one laser treatment and they’re typically good for a year,” says Poucher. “I have some patients that prefer to come back more often, almost like a Botox schedule—every four to six months—because it does decline over time.” Ultimately, she says it depends on the patient, but waiting too long (i.e., more than a year) can cause the condition to return to its original state. If you’re looking to explore PRP vaginal treatment, finding an ob-gyn who is certified in PRP injections is best; the official O-Shot website is a good place to start.
For foundational vaginal health, Poucher recommends pelvic floor exercises to all her patients. And she says using a device can help remind you to do them and perform them correctly. “There are so many wonderful devices out there. My personal favorite—the one I use—is called Elvie.” The device pairs with an app and sends daily prompts. And Poucher likes that it has a gamelike feel to it—one exercise lets you contract your pelvic floor muscles to the beat of jewels as they appear on the screen. “It’s amazing the difference [a toned pelvic floor] can make, not only with helping with a leaky bladder but also with tightening the vaginal walls.”
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This article is for informational purposes only, even if and regardless of whether it features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice. The views expressed in this article are the views of the expert and do not necessarily represent the views of goop.