Botox Injections for Vaginismus?

Using Botox injections to help women who struggle with vaginismus seems radical, but it truly is not!

Once upon a time, maybe 15 years ago, I was working with a patient who was hyperventilating from fear during a dilation session. She sat up on the exam table and said “Bat Sheva, there has to be another way to do this.” And she was right.


I started doing research and set out to find a treatment method for women who are overwhelmed, fearful and panicked at the idea of putting something into their vagina. Or for those women who have not been successful using traditional dilator therapy.  And I found a procedure using Botox injections and lidocaine in the vagina.


A woman is put under IV sedation for the procedure which takes about 30 minutes. The medical professional injects Botox and  anesthetic in the vaginal walls and massages the introital muscles to break any muscle spasms.  Once the muscles are relaxed,  a large dilator is inserted. The patient wakes up with the dilator in place.


This is the first step, but it is only a first step. Once the procedure is over, the patient’s brain and vagina need to learn to be friends, communicate and relax. She needs to learn to insert the dilators herself, feel comfortable with touching her vulva and vagina and to relax with penile penetration.


Here are some of my random thoughts if you are interested in finding out more:

      •   For the right patient it works really, really well! What I have discovered is that for a patient whose pain is primarily tight muscles and who have the fear that goes with the pain, the Botox injections can bypass months of scary and overwhelming dilator work.
      •   It’s really not such a big deal. The entire procedure takes 15-25 minutes and seems to have little to no side effects at all.
      •   “Waking up” from the procedure with the large dilator inserted is an exciting and moving experience for women who have, until then, not been able to insert anything into their vagina.
      •   It will not work if your pain is primarily from hormonal imbalances or structural issues.
      •   A supportive partner or friend can make a big difference! It’s important to have someone cheering for you.
      •   If you’re single and avoiding dating because of your fears of sex, this might change your life.


I wish more women with vaginismus knew about the possibility of Botox injections. It could change their lives!



Written By

Dr. Bat Sheva Marcus

Sex Therapist & Relationship Expert  |  Author of Sex Points & Satisfaction Guaranteed: How to Have the Sex You've Always Wanted