
Located in Columbia, Maryland, we offer expert-led Sexual Health, Hormone Therapy, and Facial Rebalancing services—including PRP, Shockwave Therapy, Penile Filler, Botox, and Dermal Fillers—to help you look, feel, and perform your best.
Climax Aesthetic Surgery in Columbia, Maryland, combines advanced sexual wellness, hormone therapy, and aesthetic medicine with medical expertise to deliver the ultimate in confidence-focused care for both men and women.
Our treatments—including O-Shot, P-Shot, Penile Filler, Shockwave Therapy, Hormone Therapy, Botox, and Dermal Fillers—are performed by experienced providers using the latest technology and evidence-based techniques. Each treatment plan is tailored to your unique anatomy, health, and aesthetic goals, with flexible payment plans available.
Climax Aesthetic Surgery is led by expert, board-certified providers, giving you peace of mind that you are always in trusted hands. We proudly serve patients at three convenient locations: New York City, NY, Virginia Beach, VA, and Columbia, MD.

Select the consultation option that works best for you. Meet with our team in person at
one of our locations or connect with us virtually from the comfort of your home.
Select the consultation option that works best for you. Meet with our team in person at one of our locations or connect with us virtually from the comfort of your home.
Support stronger arousal, improved sensitivity, enhanced pleasure, and intimate confidence for both women and men with advanced regenerative care designed to improve blood flow, tissue health, and sexual performance.
O-Shot & P-Shot
Penile Filler (UroFill)
Support stronger arousal, improved sensitivity, enhanced pleasure, and intimate confidence for both women and men with advanced regenerative care designed to improve blood flow, tissue health, and sexual performance.
O-Shot & P-Shot
Penile Filler (UroFill)
Relieve menopause symptoms, hormonal imbalance, low libido, and fatigue with hormone therapy or shockwave care designed to support circulation, sensitivity, and overall sexual wellness.
Hormone Therapy
Shockwave Therapy
Smooth wrinkles, restore volume, enhance facial balance, and boost confidence for women and men with advanced aesthetic care designed to lift, contour, and rejuvenate your skin and features.
Botulinum Toxin
Dermal Fillers
Smooth wrinkles, restore volume, enhance facial balance, and boost confidence for women and men with advanced aesthetic care designed to lift, contour, and rejuvenate your skin and features.
Botulinum Toxin
Dermal Fillers
Relieve menopause symptoms, hormonal imbalance, low libido, and fatigue with hormone therapy or shockwave care designed to support circulation, sensitivity, and overall sexual wellness.
Hormone Therapy
Shockwave Therapy
Our Virginia Beach, Virginia office is located at 700 Independence Cir, Virginia Beach, VA 23455, and this is our main office location. We are proud to be the only practice in Hampton Roads offering a true one-stop-shop experience that combines advanced sexual wellness, aesthetic services, and overall wellness treatments under one roof.
Schedule a private consultation to learn more about UroFill®, a non-surgical approach to penile girth enhancement. Discuss your goals, ask questions, and learn what to expect from the treatment, including the process, available options, and next steps.
Our Virginia Beach, Virginia office is located at 700 Independence Cir, Virginia Beach, VA 23455, and this is our main office location. We are proud to be the only practice in Hampton Roads offering a true one-stop-shop experience that combines advanced sexual wellness, aesthetic services, and overall wellness treatments under one roof.
Expert guidance.
Personalized care.
This consultation is ideal for patients interested in services such as P-Shot®, Testosterone Therapy, Botox, Dermal Fillers, and other eligible treatments. Ask questions, explore your options, and receive guidance on the next steps based on your individual needs.
Our Virginia Beach, Virginia office is located at 700 Independence Cir, Virginia Beach, VA 23455, and this is our main office location. We are proud to be the only practice in Hampton Roads offering a true one-stop-shop experience that combines advanced sexual wellness, aesthetic services, and overall wellness treatments under one roof.
Our Virginia Beach, Virginia office is located at 700 Independence Cir, Virginia Beach, VA 23455, and this is our main office location. We are proud to be the only practice in Hampton Roads offering a true one-stop-shop experience that combines advanced sexual wellness, aesthetic services, and overall wellness treatments under one roof.
Our Virtual Consultations are designed to give you direct access to one of our experienced medical providers at no cost. During your virtual visit, your provider will answer your main questions, explain what to expect from your desired treatment, and pre-screen whether you may be a good candidate.
After your virtual consultation, we recommend an in-person visit for a complete medical evaluation, where your provider will assess your needs and create a personalized treatment plan. The in-person consultation has a $250 fee, which is applied toward your treatment when you proceed.
O-Shot
A regenerative treatment for women that uses platelet-rich plasma to enhance sensitivity, improve intimacy, and support vaginal health.
P-Shot
A natural, PRP-based treatment for men that improves erectile function, boosts sensation,
and supports overall sexual wellness.
Penile Filler (UroFill)
A medical, filler-based treatment for men that adds supportive volume, improves firmness, and enhances sexual confidence.
Botulinum Toxin
A medical, neurotoxin-based treatment that relaxes overactive facial muscles,
smooths fine lines, and refreshes your appearance.
Dermal Fillers
A medical, gel-based treatment for facial
rebalancing that restores volume, contour, and natural-looking symmetry.
Hormone Therapy
A medical, hormone-based treatment that restores balance, boosts energy, supports libido, and improves overall wellness.
Shockwave Therapy
A non-invasive, wave-based treatment that improves blood flow, enhances sensitivity, and supports sexual performance.
ALL WE OFFER
Looking for something else? Visit our main website to discover all of our services.
Penile Filler - Before & After
Natural-looking results that feel just as natural. Every treatment is personalized to your anatomy and goals, creating balanced and renewed confidence.
Facial Rebalancing - Before & After
Natural-looking Botox and Dermal Filler results designed to enhance facial balance, soften lines, and refresh your appearance while preserving your natural expressions.

Mary Ojo-Carons, MD
Dr. Mary is a board-certified Cosmetic Gynecological Surgeon and Sexual Medicine Physician with over 15 years of experience. She is the founder of Climax Aesthetic Surgery and a recognized expert in sexual medicine, hormone therapy, menopausal care, gynecology, and reproductive science.

Akin Ojo-Carons, MD
Dr. Akinwunmi Ojo-Carons is Chief Financial Officer and Men’s Wellness Expert at Climax Aesthetic Surgery. A board-certified urologist and UroFill-certified provider, he specializes in advanced treatments for sexual health, confidence, and performance.

Pamela Ikem, RN
Pamela Ikem is the Chief Operations Officer, Facial Rebalancing Specialist, and Nurse Injector at Climax Aesthetic Surgery. With a BSN, RN licensure, and an MBA, she blends clinical skill and leadership to deliver compassionate, patient-centered care.
Yes. All treatments are medically guided and performed using evidence-based protocols and FDA-cleared technology in a clinical setting.
Results vary by treatment and individual, but many patients begin noticing improvements within weeks, with continued enhancement over time.
Yes. We offer flexible payment plans to make treatment more accessible.

When people think about sexual health, they often focus on desire, hormones, contraception, sexually transmitted infections, or physical comfort. What receives far less attention is the microscopic environment inside the vagina and the way sexual activity can temporarily influence it.
The vagina is home to an entire community of microorganisms known collectively as the vaginal microbiome. Far from being passive, this ecosystem plays an important role in maintaining vaginal health, supporting an appropriately acidic environment, and helping protect against the overgrowth of potentially problematic organisms.
Sex can influence this environment. Semen, a partner's microbiome, sexual practices, lubricants, condoms, hormonal changes, and even the frequency of intercourse can all interact with vaginal conditions in different ways. That does not mean sex is inherently harmful to the vaginal microbiome, nor does every change indicate that something is wrong. The more interesting question is how the vaginal ecosystem responds to these changes and why some women's microbiomes appear to return to their usual state easily while others experience recurring symptoms.
At Climax Aesthetic Surgery, conversations about women's intimate health often involve looking beyond a single symptom. Dr. Mary Ojo-Carons emphasizes the importance of considering the broader vaginal environment, hormonal health, sexual activity, symptoms, and individual medical history when evaluating changes in intimate wellness.
Understanding what happens to the vaginal microbiome during and after sex can make many seemingly mysterious changes easier to understand.
The vaginal microbiome refers to the microorganisms that naturally live within the vaginal environment. In many healthy reproductive-age women, bacteria belonging to the genus Lactobacillus are particularly important.
These bacteria help produce lactic acid, which contributes to the vagina's naturally acidic environment. During the reproductive years, vaginal pH is commonly around 3.8 to 4.5, although what is considered normal can vary depending on factors such as age, menstruation, hormonal status, pregnancy, and menopause.
This acidity is not accidental. It is part of the vagina's natural defense system and can make conditions less favorable for the excessive growth of certain organisms.
The vaginal microbiome, however, should not be imagined as a fixed collection of bacteria that remains identical every day. It is a dynamic ecosystem.
Hormones can change it. Menstruation can change it. Antibiotics can change it. Pregnancy and menopause can change it. Hygiene practices and vaginal products can influence it as well.
Sexual activity is another factor capable of temporarily altering this environment.
Yes, sexual activity can influence both the composition and the conditions surrounding the vaginal microbiome.
What matters is understanding the word change.
A change does not automatically mean infection, disease, or damage. The vaginal environment naturally fluctuates, and exposure to semen, friction, lubricants, condoms, menstrual blood, or microorganisms from another person's skin and genital area can temporarily alter vaginal conditions.
Researchers have also found associations between sexual activity and differences in vaginal bacterial communities. The relationship is complex because sexual behavior does not occur in isolation. Hormonal contraception, condom use, frequency of intercourse, new sexual partners, menstrual timing, and many other factors may influence what researchers observe.
For many women, these fluctuations are temporary and the vaginal ecosystem returns toward its usual state without producing noticeable symptoms.
For others, particularly those already susceptible to vaginal imbalance, sexual activity may be one of several factors associated with recurrent changes.
This distinction matters because the goal is not to make the vagina microbiologically identical every day. The goal is to understand whether its ecosystem remains resilient enough to recover from normal disturbances.
One of the clearest ways vaginal intercourse can affect the vaginal environment involves semen.
The healthy vagina during the reproductive years is generally acidic, while semen is more alkaline. This difference serves a biological purpose because sperm would otherwise face a very acidic environment.
After unprotected vaginal intercourse involving ejaculation, semen can therefore temporarily raise vaginal pH.
That does not mean semen is "bad" for the vagina. It means two biological environments with different chemical characteristics have temporarily interacted.
For many women, the vaginal environment gradually returns toward its usual acidity afterward. Lactobacilli and other biological mechanisms contribute to maintaining and restoring vaginal conditions.
The situation becomes more interesting when the vaginal microbiome is already less stable.
If protective Lactobacillus populations are reduced or the vaginal environment is already susceptible to disruption, a temporary increase in pH may create conditions that make it easier for certain other bacteria to become more abundant. This is one reason sexual activity is sometimes discussed in relation to bacterial vaginosis (BV).
Importantly, BV is not simply the result of semen entering the vagina, and it should not be reduced to a hygiene problem or blamed on a partner. It is a complex vaginal dysbiosis involving changes in the bacterial community.
Sex involves more than the interaction between semen and vaginal pH. It also involves contact between two different microbial environments.
Human skin, the mouth, penis, vulva, vagina, rectum, and other body surfaces all contain their own microbial communities. During sexual contact, microorganisms can be exchanged between partners and between different areas of the body.
Researchers are continuing to investigate how sexual partners may share genital bacteria and how those bacterial communities change over time.
This becomes especially interesting when someone has a new sexual partner.
A woman's body is encountering a different microbial environment, potentially alongside changes in sexual frequency, condom use, lubricant use, and other behaviors. Some women notice vaginal changes after beginning a new sexual relationship even when STI testing is negative.
That does not automatically mean the new partner "gave" her an infection. The vaginal ecosystem may simply be responding to several new biological exposures simultaneously.
Persistent odor, unusual discharge, burning, itching, pain, or irritation, however, should not automatically be attributed to microbiome adjustment. Those symptoms deserve appropriate evaluation because BV, yeast infections, sexually transmitted infections, urinary conditions, hormonal changes, dermatologic conditions, and other problems can produce overlapping symptoms.
Because semen can temporarily raise vaginal pH, condom use can change what the vaginal environment encounters during intercourse.
A condom that prevents semen from entering the vagina removes that particular alkaline exposure, although sex itself can still influence vaginal conditions through friction, microorganisms, lubricant ingredients, and other factors.
This is why vaginal health is rarely explained by one variable.
Two women may have similar sexual frequency and completely different vaginal experiences because their microbiomes, hormonal environments, partners, contraceptive methods, products, and baseline susceptibility are different.
Even the same woman may respond differently at different stages of her life.
Lubricant is often discussed primarily in terms of comfort, but from a vaginal-health perspective, formulation matters.
Different lubricants vary considerably in pH, osmolality, preservatives, fragrances, and other ingredients. Some products may be more irritating to sensitive vaginal or vulvar tissue than others, particularly with frequent use.
That does not mean women should avoid lubricant. In fact, appropriate lubrication can reduce uncomfortable friction during intercourse and may be particularly helpful when natural lubrication is reduced.
The better question is whether a product is appropriate for intimate tissue.
If someone repeatedly experiences burning or irritation after sex, it may be useful to consider not only the sexual activity itself but also everything used during it. Lubricants, spermicides, condoms, scented products, wipes, and cleansing products can all become part of the investigation.
Sometimes the most relevant clue is not simply, "This happens after sex," but rather, "This happens after sex when we use this particular product."
Sexual practices can expose the vaginal area to microorganisms from different parts of the body.
The mouth has its own complex microbiome, while the gastrointestinal tract contains an enormous and very different bacterial population. Moving directly from anal contact to vaginal penetration with the same penis, finger, or sex toy can transfer intestinal bacteria toward the vaginal and urinary areas.
Basic sexual hygiene can therefore matter without turning intimacy into a sterilization ritual.
Changing condoms between anal and vaginal penetration, cleaning sex toys appropriately, and avoiding the transfer of fecal bacteria toward the vagina are practical ways of reducing unnecessary microbial exposure.
The vagina needs balance, not sterility.
In fact, trying to "disinfect" the vagina after sex can create an entirely different problem.
Some women feel compelled to clean internally after intercourse, particularly when they notice semen or changes in odor afterward.
The vagina, however, is a self-cleaning organ. Internal washing and douching can interfere with its natural environment rather than improve it.
Douching may alter vaginal pH and disrupt beneficial bacteria, potentially making imbalance more likely instead of preventing it.
External vulvar hygiene is different from internal vaginal cleansing. Gentle washing of the external area is generally sufficient; there is no need to scrub or flush the vaginal canal to remove semen or make the vagina "clean."
The idea that a healthy vagina should have no bacteria, no discharge, and no natural scent is biologically unrealistic.
A healthy vagina is an ecosystem, not a sterile environment.
This is one of the most common sources of confusion surrounding sex and the vaginal microbiome.
BV involves a shift away from a Lactobacillus-dominant vaginal environment toward a more diverse bacterial community involving other organisms. Sexual activity is associated with BV, and factors such as a new sexual partner, multiple partners, and lack of condom use have been associated with increased risk.
Yet BV is not classified in exactly the same way as classic sexually transmitted infections such as chlamydia or gonorrhea.
This distinction helps explain why women can feel frustrated when BV seems connected to sex but does not fit neatly into the usual STI framework.
For someone experiencing recurrent BV-like symptoms after intercourse, repeatedly self-treating without confirming the diagnosis may make the situation even more confusing. Vaginal odor or discharge can have several causes, and treatment depends on identifying what is actually happening.
Another common misconception is that every vaginal symptom after sex represents a yeast infection.
Yeast infections and bacterial vaginosis are different conditions.
A yeast infection generally involves excessive growth of Candida, which is a fungus rather than a bacterium. Vaginal pH often remains within the normal acidic range during uncomplicated yeast infections, whereas BV is commonly associated with an elevated pH.
This is one reason symptoms alone do not always provide a reliable diagnosis.
Someone may experience irritation after sex and assume yeast, when the cause could instead involve BV, friction, a reaction to a product, hormonal dryness, an STI, or another vulvovaginal condition.
Sex does not affect the vaginal microbiome in a hormonal vacuum.
Estrogen plays an important role in vaginal tissue and in supporting conditions that favor Lactobacillus species. During reproductive years, estrogen supports glycogen accumulation in vaginal epithelial cells, indirectly helping create an environment favorable to Lactobacillus activity.
When estrogen declines, particularly during perimenopause and menopause, the vaginal environment can change substantially.
Lactobacillus populations may decrease, vaginal pH may rise, and vaginal tissue can become thinner, drier, or more sensitive. These changes are part of what clinicians now describe as genitourinary syndrome of menopause (GSM).
Now imagine adding sexual intercourse to tissue that is already drier and more sensitive.
Friction may become more noticeable, small amounts of irritation may occur more easily, and symptoms after intercourse may suddenly appear even though the woman's sexual habits have not changed.
This is why Dr. Mary Ojo-Carons encourages women to look at intimate symptoms within the broader context of hormonal and vaginal health. What appears to be a problem caused exclusively by sex may actually involve hormonal changes affecting how vaginal tissue and its microbial environment respond to sex.
Perhaps the most useful way to understand the relationship between sex and the vaginal microbiome is through the idea of resilience.
A healthy ecosystem does not necessarily avoid every disturbance. Instead, it can respond to change and return toward equilibrium.
Sex may temporarily introduce semen, microorganisms, friction, moisture, lubricant, and changes in pH. Menstruation creates another shift. Hormonal fluctuations create another. Antibiotics may create an even larger one.
The vaginal microbiome is constantly responding to these influences.
For many women, those changes happen quietly. They have sex, vaginal conditions fluctuate temporarily, and the ecosystem stabilizes again without symptoms.
When symptoms repeatedly appear after intercourse, however, the pattern itself becomes useful medical information.
Rather than assuming sex is the problem, the better question may be: Why is the vaginal environment having difficulty recovering after this particular trigger?
That question can lead to a much more productive conversation about vaginal health.
A temporary difference in scent or discharge immediately following intercourse, particularly when semen is present, does not necessarily indicate a medical problem. Persistent or recurrent symptoms are different.
Strong or unusual odor, significant changes in discharge, itching, burning, pelvic discomfort, painful intercourse, urinary symptoms, bleeding, or symptoms that consistently return after sex should be properly evaluated.
The timing matters too.
Does it happen only after unprotected intercourse? After intercourse with condoms? After using a certain lubricant? Around menstruation? Since starting a new relationship? Since entering perimenopause? After taking antibiotics?
These details can help a clinician understand the larger pattern.
At Climax Aesthetic Surgery, Dr. Mary Ojo-Carons approaches intimate wellness by considering the interconnected factors that can influence a woman's experience rather than viewing vaginal symptoms in isolation. Sexual activity, vaginal microbiome changes, hormones, tissue health, personal products, medications, and life stage can all contribute useful pieces of information.
The relationship between sex and the vaginal microbiome is a great example of why women's intimate health deserves more nuanced conversations.
Yes, sex can influence vaginal pH and microbial conditions. Semen can temporarily make the environment less acidic. Partners can exchange microorganisms. Sexual practices and products can introduce additional variables, while hormones can affect how easily the vaginal ecosystem adapts afterward.
None of that means sex is inherently disruptive or unhealthy.
The vagina is designed to exist in a changing biological environment, and a healthy vaginal microbiome is dynamic rather than perfectly static.
The more important distinction is between normal temporary fluctuation and a recurring imbalance that produces symptoms.
Understanding that difference can help women move away from unnecessary cleaning, repeated self-treatment, or the assumption that something is inherently wrong with their bodies. It can also make conversations with healthcare professionals much more productive.
If changes in odor, discharge, comfort, or vaginal symptoms consistently appear after intercourse, there may be more to investigate than the sexual encounter itself. Looking at the vaginal microbiome, hormonal environment, tissue health, sexual practices, and other contributing factors together can provide a much clearer picture of what is happening—and what the vagina may need to restore its natural balance.

