Sexual health and intimate wellness in Salinas and Carmel

Sexual health is health

Desire, arousal, comfort, and satisfaction depend on hormones, blood flow, nerves, sleep, medications, stress, and the relationship you're in, which is why a two-minute conversation rarely fixes them. Here the visit starts with listening. Because sexual health is so often tied to hormone health, Dr. Monarrez treats both, and looks at the whole picture before recommending anything.

For women

• Low desire, difficulty with arousal or orgasm, and changes after childbirth or menopause
• Dryness, irritation, or pain with intimacy, often helped by local vaginal estrogen and moisturizers
• FDA-approved prescription options for low desire and arousal when appropriate
• Hormone evaluation, since low estrogen or testosterone is a frequent, fixable contributor
• The O-Shot®, a platelet-rich plasma treatment described below

For men

• Erectile and performance concerns, with options that include FDA-approved prescriptions and testosterone therapy when indicated
• The P-Shot®, for erectile function, sensation, and penile health
• Botox for erectile function, on its own or combined with the P-Shot, described below
• Testosterone therapy, on the men's health page

The O-Shot® and the P-Shot®

Both use platelet-rich plasma prepared from your own blood, injected with numbing into the tissue involved in arousal and sensation. Dr. Monarrez trained in the O-Shot® and P-Shot® procedures through the Cellular Medicine Association, with the physician who developed them. Plan on 45 minutes to an hour for the visit.

The O-Shot is used for low arousal and sensitivity, difficulty with orgasm, dryness, pain with intimacy, and mild urinary leakage. Many women report improved sensation, arousal, and lubrication.

The P-Shot is about more than size. It is used to support erectile function and firmness, sensation, blood flow, and overall penile tissue health, including in men whose prescription medications have stopped working as well.

These are regenerative treatments with developing evidence, results vary, and we'll tell you honestly whether one is a reasonable option for you before you spend a dollar. Independent information from the Cellular Medicine Association: the O-Shot and the P-Shot.

Botox for erectile function

A newer option, standardized by the Cellular Medicine Association, uses a neuromodulator injected into the erectile tissue to relax the smooth muscle that limits blood flow. In published trials it improved erections for a portion of men, including some who no longer responded to pills, with effects lasting up to about six months. It can be done on its own or combined with the P-Shot in the same visit. This is an off-label use of an FDA-approved product; we'll explain what is known and what isn't before you decide.

When we refer

Dr. Monarrez is not a gynecologist or a urologist. When pelvic floor therapy, a specialist's procedure, or a surgical opinion is the right next step, she will say so and help you get there quickly.