Skip to content

Most of us have heard of Botox for aesthetic use (it can also be used for migraines). But, did you know it also can be used to treat vaginismus?

And, it can be life-changing. Some of our patients with vaginismus who were never able to have penetrative sex with their partners before treatment are now having (great) sex!

What is it?

Botox is widely used in the United States for cosmetic purposes and for the treatment of migraines. At HerMD, we use vaginal botox primarily to treat the symptoms associated with vaginismus.

How many women have vaginismus?

It is not known within the general population how many women are impacted by vaginismus. In the clinical setting, it is estimated that between 5 to 17% of women have vaginismus. At HerMD, we have successfully treated many patients with vaginal botox for vaginismus. And the results are life-changing. They can now have penetrative intercourse, they can use tampons and they feel empowered by reclaiming their sexual health.

What are the symptoms

Women may experience symptoms of vaginismus for years without receiving proper information on the condition or their treatment options.

Some of the most common symptoms of vaginismus include:

  • Inability to insert a tampon, have penetrative intercourse, or tolerate a pelvic exam
  • Fear or Intense pain during these activities
  • Low sexual desire
  • Feelings of shame, sadness, worry, or fear

How does vaginal botox work?

The primary goals of vaginal botox are to alleviate the pain associated with vaginal penetration and to promote intercourse, and eliminate involuntary contractions/spasms of the muscles surrounding the vaginal opening.

About two weeks after treatment with vaginal botox, the botox takes full effect, completely paralyzing the pelvic floor muscles, and patients then begin a strict dilator protocol. By the time the effects of the Botox wear off, usually about 3-4 months later, most patients are able to engage in painless intercourse and experience typical penetration.

All patients treated with vaginal botox at HerMD have responded well to treatment so far, and are able to use larger dilators and tampons. Most of these patients have reported a return to sexual intercourse at about two weeks out, and those who are not yet sexually active have not passed our typical four-month results period.

Vaginal botox should be used for vaginismus after conservative approaches to treatment (medications, dilators, therapy) have failed.

What to expect on your visit

During your visit, you can expect your care team to listen to and address all of your concerns in a safe and trusted space. A consultation for vaginismus and vaginal botox may include:

  • A history and physical examination
  • Labs
  • Evaluation to determine candidacy for vaginal botox
If I pursue treatment with vaginal botox for vaginismus, will I be awake during the botox administration?

To make our patients comfortable, and in an effort to prevent any additional pain or trauma, we use anesthesia to put patients to sleep during the administration of vaginal botox.

Is vaginal botox on-label?

No, vaginal botox is not considered an “on-label” treatment for vaginismus. However, there is data that supports the use of vaginal botox in this setting. Additionally, in our experience at HerMD, we have a very high treatment success rate with vaginal botox.

How much botox are you going to use?

Generally, we will use 50 to 100 units of botox.

Will I ever need vaginal botox again?

Rarely, but some patients may need a second treatment in their lifetime.

The HerMD Difference

  • 10 minute appointments
  •  20 – 60 minute appointments
  • Fragmented
  • In-person only
  • Hybrid: in-person and virtual
  • Sterile environment
  • Patient-centric, beautiful and warm
  • Focus on obstetrics, annuals, and STI care
  • Gynecology, sexual health and menopause focused with ISSWSH and NAMS trained providers

HerMD Trailblazers and Changemakers

Meet Your Women’s Healthcare Leadership Team

We’re Revolutionizing Women’s Health Care

But don’t just take our word for it…

  • Patty Penuell

    I would recommend this practice/office to anyone. The people are friendly and attentive. The office is new, bright and pretty and Teri is amazing! I felt at ease and important from the time I walked in, to the time I left. Top-notch!

  • Stephanie Norris

    The whole experience with HerMD in Franklin TN from start to finish has been amazing. I was a new patient and met with Terri Greer. She was fantastic! She listened to all of my concerns and helped me sort through which options would be best for me. She spent over an hour with me and never once did I feel rushed or that she needed to get to the next appointment. She talked with me like a friend and never down to me if I had questions. I am so happy that I chose to go with HerMD and cannot recommend them enough!

  • Madison Hair

    I had my first ever Botox experience here and all the employees made me feel so comfortable. They are very informative and always have your best interest in mind. I can’t wait for my gyno appointment!

  • Shelby Southerland

    The office is so inviting and the staff is so knowledgeable. I really felt heard and understood when visiting the Carmel location. The women here take the time to listen to the needs of their patients and not rush them along. Hannah was my Botox injector and I’m so pleased with my results!!!Gynecological care and esthetic services all in one place, thank you for such great care.

  • Julie Virag

    Such a great experience. I was very nervous about my appointment due to some abnormal test results I received from my primary doctor. Teri Greer made me feel heard. She told me all of the possible scenarios, but was very calming and helped me not stress about my condition. She really put me at ease. Terri is amazing and I would highly recommend!!!

  • Elizabeth Mercer

    I just love everything about HerMD! The office is so girly, pretty and welcoming. Terri Greer NP is warm and caring. She always makes me feel comfortable and is extremely knowledgeable in anything and everything female! Karen Medieros RN has mad injector skills and always makes me look and feel beautiful. This is definitely an office I look forward to visiting!

  • Yarymary Diaz

    Excelente facilidad, cálida y acogedora. Su personal muy amable y profesional. Mi Dra. Michelle Montville es la mejor por su carisma, empatía y se toma su tiempo en explicarte todo lo que necesitas saber

  • Katie Woods

    It’s so very rare to find a provider that will truly sit and listen to you and work with you. Dr. Montville is amazing and the front office goes above and beyond to help.

  • Candice mcIntyre

    I have had a wonderful experience here. Staff is professional and never makes you feel like they are in hurry to run out the door. Very knowledgeable about women’s health. Finally a place that has an interest in what’s going on with women after the birthing years! Refreshing!


Get in touch with our Patient Advocate Team

Your Body,
Your Health,



Live your best life - inside and out.

Better care is here

Live your best life - inside and out.