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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 people have vaginismus?

It is not known within the general population how many people 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, to eliminate involuntary contractions/spasms of the muscles surrounding the vaginal opening and to promote intercourse.

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

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Meet Your Women’s Healthcare Leadership Team

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But don’t just take our word for it…

  • Sandy Gibson

    Wonderful experience! Dr. Montville is so kind and listens attentively.

  • Amanda Sensing

    Love this practice & Teri Greer. The staff is professional, friendly and always pleasantly helpful.

  • Sheryl Redlin Frazier

    Lovely setting and compassionate practitioner!

  • Kristin Mosher

    I have been seen by Brooke Faught and she is wonderful. She really knows her stuff. She is down to earth and very understanding. It is like talking to your sister. I highly recommend.

  • rachael Holt

    I was seen quickly and the staff is so friendly. Dr. Montville is the absolute best.

  • Beth Croley

    Really wonderful experience. I felt heard and supported.


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