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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 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

TYPICAL OB GYN OFFICE HerMD
  • 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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But don’t just take our word for it…

  • Makayla Kerns


    Wonderful clinic, highly recommend! If I could change anything I would add to their patient portal a way for patients to be able to access their medical records online.

  • MaryAnn

    Cincinnati, OH

    Lexi is the best when it comes to your skincare needs

  • Shell G


    Everyone is great at HerMd KY. The office is so homey and welcoming.

  • Elizabeth Cotton


    I’m so thankful to find HerMD. A group of women physicians treating women. The care was great but also the experience was great. The nurse practitioner spent a lot of time with me and didn’t rush through the appointment. It was great!

  • Elizabeth Velazquez-Noll


    Rachel was fabulous. She is friendly and knowledgeable, gave me options without making me feel pressured and I am so happy with the outcome!

  • Anthony Ripepi

    Cincinnati, OH

    Great staff and always get me in last minute. The only place I never have to go back for touchups because they do a great job the first time.

  • Jessica Lewis

    Cincinnati, OH

    Friendly staff and amazing 1:1 time during your appointment, they listen and take care of your needs

  • Karen Jarrold

    Cincinnati, OH

    Michelle is great! Made me feel comfortable. She is very good, knowledgeable. Highly recommend!

  • Tina Hochwalt

    Cincinnati, OH

    The best services ever!!!! Lexi is the Bomb Diggity

  • Nicole S.

    Cincinnati, OH

    I highly, highly recommend this practice – especially for people who are neurodivergent and/or who have anxieties around receiving medical care. All staff members were pleasant to interact with; I let the medical assistant know that I’m typically a hard stick, but bless her, she got it in one try. I wish I could give them more than five stars!

Questions

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