Doctor Behind the O‑Shot Explains the Science — and Sparks Fresh Questions About the ‘Revenge Vagina’ Pitch

A public talk that mixed lab talk with a buzzword — and left many doctors uneasy

At a recent international medical conference, Dr. Charles Runels — the physician often credited with creating the O‑Shot — presented his view of why platelet‑rich plasma (PRP) injections into the vaginal area can restore sexual sensation and treat some pelvic symptoms. He told a packed room how concentrated platelets from a patient’s own blood are meant to release growth factors that encourage tissue repair.

The presentation grabbed attention not because it introduced a brand‑new treatment, but because of the phrase Dr. Runels used in slides and examples: the provocative marketing term sometimes called the “revenge vagina.” That line, and the way the treatment was framed, has renewed a long‑running debate: is this a promising medical therapy, or a cosmetic procedure dressed up with clinical language and sold on hope?

Where the O‑Shot came from and why it went viral

The O‑Shot grew out of a broader trend: taking platelet‑rich plasma, a portion of the patient’s own blood that is richer in platelets, and injecting it into injured tissues to speed healing. Doctors have used PRP in sports medicine and dermatology. In the early 2010s, Dr. Runels popularized using PRP injections in the vaginal area to treat sexual pain, urinary symptoms, and low libido.

What made the treatment famous — and controversial — was how it was marketed. Clinics and some practitioners embraced eye‑catching names and quick testimonials. A few viral social posts and celebrity mentions turned a medical procedure into a buzzword, and phrases like “vaginal rejuvenation” and “revenge vagina” began circulating in pop culture.

That mix of medical language and marketing helped the procedure spread quickly into aesthetic clinics and private practices. But it also drew scrutiny from physicians and women who wondered whether the evidence matched the claims.

What was presented as the therapy’s science — and where the evidence falls short

In his talk, Dr. Runels walked through the biological idea: platelets release growth factors and signaling molecules that can encourage new cells to form and improve blood flow in treated tissue. The claim is that, in the vaginal region, these effects could improve sensitivity, reduce discomfort, and in some cases help with mild urinary symptoms.

Supporters often point to small studies and patient surveys that report improvements in symptoms after PRP injections. But the scientific record has limits. Most published studies are small, not randomized, or rely on patient‑reported outcomes that are vulnerable to placebo effects. There are few large, high‑quality trials comparing PRP to a sham treatment or to standard therapies.

Dr. Runels cited clinical experiences and early data during the lecture. That kind of evidence can hint at a real effect, but it is not the same as a strong, reproducible trial that shows benefit beyond placebo and measures long‑term results.

Safety data are similarly thin. Because PRP uses the patient’s own blood, the risk of allergic reaction is low. But injections carry other risks: infection, pain, tissue damage, and scar tissue. Few studies have tracked long‑term outcomes, so questions remain about how durable any benefit is and whether repeated injections bring cumulative risks.

How the medical community is reacting — caution and calls for hard data

Many physicians who heard the presentation welcomed a clear explanation of the proposed mechanism. But they also stressed that mechanism alone does not prove benefit. In clinical care, experts say, promising biology must be matched by evidence from well‑designed trials.

Several clinicians and researchers told colleagues this week that they are concerned about the gap between promotional language and the science. Their worry: patients are being sold an expensive procedure on the basis of anecdote and compelling stories rather than solid proof.

Regulatory and professional bodies have not broadly endorsed PRP for sexual or aesthetic uses in the same way they approve drugs or medical devices with robust trials. That leaves a patchwork of practice standards, and critics say that increases the chance of uneven quality, inconsistent dosing, and unclear consent conversations.

Marketing, gender norms and what the conversation reveals

The controversy is about more than data. Calling a medical procedure a “revenge vagina” or using similar marketing plays on social pressures and personal insecurities. It signals that procedures promising enhanced sexual appeal can become products aimed more at cultural anxieties than clinical needs.

That matters because it shapes who seeks treatment and why. When procedures are sold with bold promises and scant evidence, some patients may pay significant sums for outcomes that are not guaranteed. The language also risks trivializing real medical conditions — like pelvic pain or urinary dysfunction — that need careful diagnosis and, in many cases, proven therapies.

The lecture served as a reminder that medicine and marketing often collide. Clinics and practitioners who offer PRP injections will continue to find patients who want the treatment. But the broader medical community is pushing for clearer studies, better outcome measures, and stronger safeguards so patients understand what is known and what is still experimental.

At a minimum, the talk reopened an important conversation: should a procedure be widely offered because it sounds plausible and feels low‑risk, or should broader adoption wait until stronger evidence proves it actually helps and is safe over time?