for…..Arousal, Desire, Orgasm, & Sexual Satisfaction
A specific method of use of Botulinum Toxin in the clitoris with or without PRP for improvement of Female Sexual Function
Improves female sexual function more significantly than any FDA-approved treatment option currently available
How Clitoxin® Works to Improve Female Sexual Function-Explained by Dr. Charles Runels
Original Research Article Published March, 2024:
The Clitoral Injection of IncobotulinumtoxinA for the Improvement
of Arousal, Orgasm & Sexual Satisfaction- A Specific Method and the
Effects on Women
Charles Runels and Alexandra Runnels
Journal of Women’s Health Care, Vol. 13 Iss. 3 No: 715
Who should have the Clitoxin® procedure?
- Any woman seeking to improve her sexual function and intimate relationship/s
- Best when done as a part of a holistic and comprehensive approach with evalutaion and treatment of the entire Female Orgasm System
- Does not significantly help certain genito-pelvic pain conditions (ex. clitorodynia, vulvodynia)
- Best results seen in women (both pre and post-menopausal) with adequate hormone levels either naturally or with replacement
What results can be expected after having the Clitoxin® procedure?
- Sexual arousal is most significantly improved domain of the female sexual function scale……(many report they feel more like when they were teenagers, but with better control)
- Marked improvements of vaginal lubrication, orgasmic function, sexual desire and sexual satisfaction are the other most commonly seen effects
- Improvement in urge incontinence symptoms seen in many women as welcome and unexpected side effect
- Labia minora and labia majora plumping resulting in more youthful feeling and looking vagina was noted in many women
- We have not seen any negative side effects with the Clitoxin® procedure in more than a year of patients treated in our offices
When can most women expect to see results?
- Rapid onset of action with effects beginning within the first few days and full effect at two weeks
How long do the effects last in most women?
- Improvements of arousal, lubrication, orgasm, and satisfaction last 5 – 6 months
- Equivalent and often more robust effects seen with 2nd and 3rd procedures as with first, when spaced 4 -6 months apart
- Can be combined with a traditional O-Shot® for increased and longer-lasting enhancement of sexual function
Does the Clitoxin® procedure hurt?
- The Clitoxin® procedure is not painful and done in very comfortable way (we utilize a uniquely-powerful numbing cream for a pain-free treatment)
- Extremely important for the procedure to only be done by a licensed provider who is trained and certified by the CMA (Cellular Medicine Association)
- Imposters pretending to be part of the CMA or pretending to know how to do the procedure without appropriate training are dangerous and should be reported to the CMA
How long does the procedure take to have done?
- Clitoxin® is a quick procedure and can typically be done in a 30 min appointment
Is there any downtime or are there any post-procedure restrictions?
- No downtime
- Sexual activity can be resumed the same day
- Minimal post-procedure restrictions
Charles Runels and Alexandra Runnels presenting original research of Clitoxin® at International Society of Cosmetic Gynecologist annual meeting 3/2024
Original Research Published March, 2024:
The Clitoral Injection of IncobotulinumtoxinA for the Improvement
of Arousal, Orgasm & Sexual Satisfaction- A Specific Method and the
Effects on Women
Charles Runels and Alexandra Runnels
Journal of Women’s Health Care, Vol. 13 Iss. 3 No: 715
Summary of Mechanism of Action of Botulinum Toxin (BoNT) Injected in the Clitoris:
(1) Local neuromuscular blockade of the smooth muscle cells in the vasculature accounts for a portion of the vasodilatory effects of BoNT injected into the clitoris.
*What follows is unexpected by most and unknown to many:
(2) After injection in the corpora cavernosa of the clitoris, BoNT is taken up via endocytosis by the neurons and then migrates by retrograde axonal transport to the ganglion embedded in the wall of the vagina.
(3) Ganglia in the lateral vaginal wall function as switchboard operators and play an important role in the physiologic response of the erectile tissue within the “clitorourethrovaginal complex”.
(4) Through neuromodulatory effects of BoNT on the ganglia, the balance of sympathetic/parasympathetic tone is “reset” or “rebooted”.
(5) Signals are then sent via afferent autonomic nerves via the inferior hypogastric plexus which then triggers the hypothalamus in the brain (where the arousal center resides).
(Afferent nerves send messages from structures of the body to the central nervous system (spinal cord and brain) to be processed, followed by efferent nerves triggering an action or effect.)
(6) The hypothalamus sends signals via efferent autonomic nerves to the genitalia and the cerebral cortex leading to both physiologic and emotional arousal.
(Efferent nerves send messages from the central nervous system (spinal cord and brain) to peripheral structures to “do things” either voluntarily or involuntarily (the action or effect).
(7) BoNT’s ability to block acetylcholine transmission in different types of nerves result in both local and central neuromodulation of both efferent and afferent nerves in the somatic and autonomic nervous systems.
(8) Neuromodulation in this manner leads to physiologic changes of vasodilation in the erectile tissue of the clitoris, urethra and vagina (clitorourethrovaginal complex). This is experienced by the woman as engorgement of the labia and clitoris, increased vaginal lubrication, enhanced sensation accompanied by a desire for the vagina to be penetrated and behavior that increases the liklihood of a sexual encounter. The domains of the Female Sexual Function Index (FSFI) representive of these changes are arousal, desire, lubrication, orgasm and satisfaction.
(9) Emotional or psychologic changes of increased sexual thoughts, a craving for sexual activity and motivation/drive to have sex occurs when the limbic system in the brain is signaled by the pelvic autonomic nervous system. The brain’s reward center is triggered when increased pleasure is felt and a positive feedback loop is created. The physiologic arousal response becomes quicker and easier to achieve with subsequent sexual activity as a result of this positive feedback loop.
(10) Improvement in arousal is naturally followed by improvement in the other domains of the female sexual function; lubrication, desire, orgasm and satisfaction.
(11) Pain is the only domain that is not as likely to improve as much as the others.
(12) Additionally, BoNT has known regenerative effects of neovascularization, neurogenesis, and local vasodilation effects, which are amplified when combined with platelet-rich plasma (like in the O-Shot® Procedure).
Timeline of the History of the Clitoris:
400BC: Hippocrates describes the clitoris as a protrusion that protects the vagina and names it the “columella” or “little pillar”
150BC: Claudius Galen, an Ancient Greek physician, acknowledges the clitoris, saying, “In women, the parts are within, whereas in men, they are outside.” He described the clitoris as the “female body’s failed attempt at a penis.”
Approximately 1500 years goes by without significant clitoral history.
1486: A treatise on the persecution of witches, called Malleus Maleficarum, or The Witches’ Hammer, identifies the clitoris as “the devil’s teat”. If the clitoris becomes engorged with tactile stimulation and arousal occurs, it is said to be associated with dealings with the devil or witchcraft.
1452-1519: Leonardo da Vinci illustrated the human body in great detail and is responsible for many advances in human anatomy. His knowledge was the result of human cadaveric dissection; however, there was an apparent lack of female specimens, and several of his drawings of the female reproductive system are inaccurate and more closely resemble animals than humans.
1545: Charles Estienne does one of the earliest known dissections of the clitoris. However, he thought the clitoris had a urinary function and referred to it as a woman’s “shameful member.”
1559: Realdo Colombo, anatomist, claims to have discovered the clitoris, which he calls “the love or sweetness of Venus” and identifies it as “the seat of women’s delight,” casting doubt on the long-held belief that women took no pleasure in sexual intercourse.
1671: Jane Sharp was an English midwife. In her book, Midwifery Mastered, she dubs the clitoris “the female penis” and says that it “makes women lustful and take delight in copulation.”
1672: Regnier de Graf, Dutch physician and anatomist, crafts the most comprehensive report on the clitoral anatomy ever published. He writes: “We are extremely surprised that some anatomists make no more mention of this part than if it did not exist at all in the universe of nature… In every cadaver we have so far dissected we have found it quite perceptible to sight and touch.” He also discovered the Graafian follicles in the ovaries, for which he is remembered.
1844: George Ludwig Kobelt, a German anatomist, conducts a study of the clitoris, drawing the first detailed anatomy of both the internal and external clitoris.
1858: Henry Gray publishes the first edition of Gray’s Anatomy, considered the seminal work on human anatomy, including the clitoris.
1904: Sigmund Freud, among other things, asserts that the clitorial orgasm is “immature”, while the vaginal orgasm, which women should begin to have once they have reached puberty, is “mature”. Though this has since been debunked, Freud’s theories on sex are thought to have been responsible for the culture of sex and sexuality that persists in the western world today.
1924: Psychoanalyst Princess Marie Bonaparte (Napoleon’s great grand-niece) conducts a study that measures the distance between the clitoris and vagina of 243 different women, concluding that those whose clitorises are further from their vaginas have a more difficult time orgasming during vaginal penetration, while those whose clitorises are closer have a much easier time.
1948: Charles Mayo Gos, editor of the 25th edition of Gray’s Anatomy is released, in which the clitoris is entirely erased.
1950: Ernst Grafenberg a german-born gynecologist, describes what has been termed the “G-Spot”, describes the length of the female urethral to be the most erogenous zone on a woman’s body. He is also known for inventing the IUD (Intrauterine Device).
1953: Alfred Kinsey publishes Sexual Behavior in the Human Female, a companion book to his 1948 publication, Sexual Behavior in the Human Male. He asserts that “the clitoris is the center of female pleasure”.
1966: William Masters and Virgina Johnson conduct research in their laboratory, where they scandalously observe sex acts in the flesh. They conclude that the vaginal orgasm is, in fact, comparable to the clitoral orgasm in terms of sexual response, debunking Freud’s ideas about “maturity”.
1998: Australian urologist Helen O’Connell conducts the first full autopsy of the female clitoris, mapping out both the internal and external clitoris, demonstrating that the clitoris has two to three times more nerve endings than the penis.
2005: Helen O’Connell publishes landmark article on clitoral anatomy.
2009: Surgeon Pierre Foldes does the first 3D ultrasound of the clitoris, later conducting the first successful female genital mutilation reversal surgery to remove scar tissue from the vulva and expose some of the internal clitoris in order to return sensation.
2010: Charles Runels, an American Internist, becomes the first to inject a living clitoris with any substance. He harnessed the regenerative potential of autologous platelet rich plasma, as had been done in dentistry and orthopedics, to improve orgasmic function through enhancement of clitoral anatomy in form and function. It was extremely successful and became known and performed around the globe as the O-Shot® Procedure.
2014: Italian research team Puppo+ Puppo publish a study in The Journal of Clinical Anatomy asserting, controversially, that both the vaginal orgasm and the G-spot are, in fact, myths.
2024: Charles Runels and his wife Alexandra Runnels, an American Obstetrician and Gynecologist, co-authored the first study published of the clitoral injection of botulinum toxin with and without PRP for improvement of sexual satisfaction. Their study found the results to be 2-4 times better than any currently available FDA approved treatments in regards to improvement in the Female Sexual Function Index. The results were unexpected to most experts in the field with a good understanding of the mechanism of action of botulinum toxin. He named it Clitoxin®.
MD’s, RN’s, NNP’s interested in learning the Clitoxin® method:
Online Certification through the CMA (Cellular Medicine Associates)
Hands-on Training with Alexandra Runnels, MD in San Antonio, TX, date TBA
Women who think this may help and would like to schedule the Clitoxin® procedure:
With Alexandra Runnels, MD in San Antonio, TX or Fairhope, AL, call (210) 483-6255 to schedule or book an appointment online below
With a Provider on the CMA Directory, go to www.clitoxin.com
