Botoxing your vagina could help cure painful penetration

When most people think of Botox, they think of face wrinkles and crow’s feet and not being able to move your eyebrows…

But Botox is now being investigated as a potential aid (or possible cure!) for women with a condition called vaginismus.

What is vaginismus?

Vaginismus is  involuntary contraction of the pelvic floor muscles when an attempt is made to insert something (penis, tampon, sex toy, speculum, etc.) into the vagina, and effects approximately 1-7% of women worldwide. This muscle contraction can cause severe pain, aching, and even burning or a feeling of being torn. It is essentially a reflexive muscle spasm; Some evidence suggests that the vaginal “flinch” is caused by the anticipation of pain, kind of like when you involuntarily close your eye when the mascara wand gets too close. This anticipation could be the result of prior sexual abuse or other painful experience (such as a yeast infection or pelvic exam), although many women with vaginismus have not experienced any of these things.

According to the The Society of Obstetricians and Gynaecologists of Canada, vaginismus can be categorized in the following ways:

  • Primary (lifelong) or Secondary (begins after having sex normally for a while)
  • Global (occurs no matter what) or Situational (only occurs in certain situations or with certain objects)

How is vaginismus currently treated?

Since the spasms are involuntary, the main component to treating vaginismus is learning to control the reflex. Depending on the potential root cause, this may include several components: sex therapy, vaginal dilators used to allow the woman to gain control of her pelvic floor muscles, Kegel exercises (also used to gain control of the pelvic floor muscles), and mindfulness and relaxation techniques are all currently employed as treatment.

So where does Botox come in?

According to Medicine Net:

Botox blocks signals from the nerves to the muscles. The injected muscle can no longer contract…

It makes sense that Botox could be used to treat vaginismus, which is, after all, involuntary contractions of the vaginal muscles.

In 2004, one study looked at twenty-four women with moderate to severe vaginismus who had unsuccessfully tried other treatments. Botox was injected in 3 sites of the puborectalis muscles. The results are quite astounding:

  • 23/25 patients had vaginal exams 1 week later and showed little or no vaginismus
  • 18/25 patients  had satisfactory intercourse after the first treatment, and 4/23 had only mild pain.
  • 1 patient was cured after two injections.
  • While the patients were followed up for a mean of 12.3 months, there were no cases of recurrence.

Generally, this treatment has become a “comprehensive program of injecting Botox under anesthesia, progressively dilating the vagina during the same anesthetic, and leaving a dilator in place that the patient wakes up with in the recovery room”. The Botox serves to prevent the contraction, and the woman “learns” not to associate penetration with the pain of muscle contraction -  simply using Botox alone would mean the patient would have to consistently return for injections. Thus the progressive dilation is continued at home, essentially “training” the muscles.

One study has noted that 90.3% of patients who underwent this treatment achieved pain free intercourse after a median of 3.5 weeks.

What are the side effects?

As with any treatment, there are potential side effects to consider.

  • Vaginal bleeding (usually for 24 hours or less following the procedure)
  • Mild flu-like symptoms
  • Increased urinary incontinence or flatal incontinence

Botox looks to be a very promising new treatment option for women who suffer from vaginismus.

The good news is that vaginismus can be highly treatable. If you experience pain during penetration of any kind (sex related or not), talk to your health care provider.




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