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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 – 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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We’re Revolutionizing Women’s Health Care

But don’t just take our word for it…

  • Michele Steele


    I’ve been searching for a place and provider like this most of my adult life! from the moment you walk in you are greeted with a spa like experience in a dr.’s office wow! then combine that with an amazing provider like Courtney what a huge win! Looking forward to my future opportunities with her on managing my care.

  • Diane M.

    Cincinnati, OH

    The experience was wonderful! The office personnel and Dr. Davidson was great. I’ve informed my sister that she might want to go here. Thank you

  • Sara Stallcop


    Highly recommend this place to any woman looking for care after they are done having children!! And also be sure to see Kendra for all your anti aging needs ❤️❤️

  • Susan Burgio


    I had my fist visit today with Melanie Zavala and I felt heard, and we were able to address my questions and make a plan for treatment. I’m very happy with my visit, this practitioner and the professionalism and courtesy at the office. I look forward to continue my post-menopause health care at HerMD Millburn.

  • Diane Davis


    My doctor listened, took me seriously, and ordered the right tests. I’m so glad this place exists!

  • Liz Gregory

    Cincinnati, OH

    Absolute amazing work experience!!! Michelle is amazing and only wants what is best for her patients!! Highly highly recommend!!

  • Elijiah Gray


    Great atmosphere- felt like a spa not a doctors office. Staff was great

  • Kelsey Burtchaell


    My first appointment and I loved it. Everyone so friendly and helpful. Teri is a fellow breast cancer survivor which was all the better. So happy I made the switch to HerMD.

  • Carly Beth Gamble


    Katie RN and Terri Greer NP are actual angels! So supportive and caring! Would recommend to anyone wanting GYN care!

  • Natalie Fletcher


    A girl’s kind of place. Awesome people & a comfy/inviting office 🙂

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