Sexual wellness

Before a PRP appointment, three days ahead

• Stop over-the-counter anti-inflammatories. Ibuprofen, naproxen, fish oil, vitamin E and flaxseed oil. They reduce platelet activity and work against the treatment.
• Stop alcohol. It affects platelet function and increases bruising.
• Do not stop prescribed blood thinners or anticoagulants. Contact us instead so treatment can be planned around them.
• Hydrate and eat before you come. Hydration affects the quality of the plasma drawn.

Before botulinum toxin, seven days ahead

• Stop over-the-counter anti-inflammatories, fish oil, vitamin E and high-dose vitamin C, all of which increase bruising.
• Stop alcohol.

Tell us before your appointment

• Every medication you take, including anything for erectile function, blood pressure or mood, and any nitrate. Nitrates matter.
• Any bleeding or clotting disorder.
• Any neuromuscular condition, such as myasthenia gravis, which changes whether botulinum toxin is safe.
• Any active infection, skin breakdown, or lesion in the area to be treated.
• For anal sphincter treatment: your bowel history, any known fissure, hemorrhoids, inflammatory bowel disease, or previous anal surgery.
• Any history of blood cancer or active cancer, which rules out PRP.
• Any previous treatment of this kind, what was used and how it went.

The day itself

• Shower beforehand. No topical products on the area.
• Trimming the area is helpful but not required.
• Wear loose, comfortable clothing. Supportive underwear is useful after scrotal treatment.
• Plan for a quiet evening rather than the gym.

The first 48 hours

• Swelling and bruising are expected and settle over several days.
• No anti-inflammatories for three days. The inflammatory response is part of how PRP works, and suppressing it reduces the result. Ask us what to take instead if you need something.
• No ice directly on the skin, for the same reason. A cool compress over clothing is fine.
• No strenuous exercise, cycling or heavy lifting for 48 hours.
• Avoid heat: saunas, steam rooms and very hot baths.
• No alcohol for 24 hours.

Sexual activity

• No sexual activity, including masturbation, for one week. The tissue needs to be left undisturbed while the platelets do their work.
• Resume normally after that. There is no need to be cautious once the week has passed.

The following weeks

• Change is reported over six to twelve weeks, not days.
• A series of three sessions is the usual protocol, spaced four to six weeks apart.
• Anything else being treated for erectile function continues unless you are told otherwise. This is not a replacement for it.

The first 48 hours

• Mild swelling, small bumps and bruising at the injection points are normal and settle within a few days.
• Supportive underwear helps with comfort.
• No strenuous exercise, cycling or hot baths for 48 hours.
• Do not massage or rub the area.
• No sexual activity for 48 hours.

The timeline

• The effect appears gradually over two to four weeks, not immediately. Do not judge it in the first week.
• Full effect lasts about three to four months, then returns to baseline.
• Cold, exercise and anxiety will still cause some contraction. The muscle is relaxed, not disabled.
• Repeat treatment is scheduled once the effect has clearly worn off rather than on a fixed date.

The first week

• Soreness at the injection sites for a few days is normal.
• Temporary difficulty controlling gas is the most common effect, and it resolves as the botulinum toxin wears off. Temporary leakage of stool is less common but possible. Both are expected findings rather than complications, and dosing here is deliberately conservative.
• Keep stool soft. Fiber, fluid, and a stool softener if needed. Straining works directly against the treatment.
• Warm baths help with soreness.
• No receptive anal sex for two weeks.

The timeline

• The effect builds over two to four weeks and lasts about three to four months.
• Where this is being used for a fissure, healing is assessed at follow-up. Keeping stool soft over the following weeks is what determines whether it stays healed.
• Repeat treatment is possible where the benefit was clear and has worn off.