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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

TYPICAL OB GYN OFFICE HerMD
  • 10 minute appointments
  •  20 – 40 minute appointments
  • Fragmented
  • In-person only
  • Hybrid: in-person and telehealth appointments for existing patients
  • Sterile environment
  • Patient-centric, beautiful and warm
  • Focus on obstetrics, annuals, and STI care
  • Gynecology, sexual health, and menopause-focused care with clinicians following ISSWSH, NAMS, and ACOG guidelines

We’re Revolutionizing Women’s Health Care

But don’t just take our word for it…

  • Elizabeth McFarlane


    First time visit – excellent! The staff was wonderful and Dr. Ramaswamy made the whole annual experience as easy and comfortable as it can be! I’m thrilled that HerMD is in Carmel, IN and part of my healthcare regimen from here on out!

  • Kristina Kohler


    I had a Hydro facial with Brianna. And it was wonderful. My skin is glowing and radiant.

  • Kyra Mohundro


    The best people and environment! Very informative and helpful, definitely recommend!! Love it here

  • Rhonda Franks


    Char is an absolute gem! She takes time to establish a relationship with you. She is thorough and makes sure all of your concerns are addressed. The entire team is amazing! 5 stars!

  • julie logue


    Wonderful place for women.

  • Janice Walker

    Cincinnati, OH

    Michelle was so very helpful abd provided me with several options. When I return I only want to see her!!!

  • Jill Arvanitis


    Amy is amazing! Do not hesitate to make an appointment with her.

  • Taylor Macchiarelli


    I’ve loved my experience at HerMD. I’ve been seeing Brianna for years for Botox treatments as well as lip filler. She always makes me feel comfortable and makes sure to give me the perfect amount to look natural. She is someone you can trust and always makes me leave feeling amazing. I would recommend Brianna to any and every person!

  • Suzanne Frye


    Amy Kinnett is the BEST! She is knowledgeable, professional, and has fun energy. Amy listens to my concerns and provides options to help me make the best decisions. Highly recommend!!

  • Beth B


    I’m so happy to have found HerMD and Char. She took her time with me and answered all my questions and concerns. The information she gave me was invaluable and I look forward to continuing with her and HerMD. The facility is so very nice and the care and professionalism is very impressive.

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