Botox as a Sexual Aid?

The proven list of uses for BOTOX® Cosmetic may now include sexual aid. More commonly used to treat wrinkles, excessive sweating, and migraine headaches, Botox injections are now being tested on females with vaginismus or vaginal spasms, a sometimes painful condition that can prevent intercourse and inhibit sexual relationships.

What is Vaginismus?

Vaginismus is the involuntary contraction of pelvic muscles around the vagina when penetration is imminent. These contractions often cause discomfort or pain during sex. In more severe cases, vaginismus can prevent women from using tampons or from having sex altogether. Unsurprisingly, vaginismus is a source of tremendous strain and dissatisfaction in marriages and long-term relationships. Some patients are unable to become pregnant or have children.

Vaginismus is considered highly treatable through proper education, pelvic muscle training, relaxation techniques and emotional counseling if necessary. However, New Hampshire plastic surgeon Dr. Peter Pacik believes he has a simpler but very effective solution: Botox injections.

Why Botox Injections for Vaginismus?

According to Dr. Pacik, the author of "When Sex Seems Impossible: Stories of Vaginismus & How You Can Achieve Intimacy," botox injections’ capacity to relax "other tense muscle areas" can also be used to treat vaginismus. Indeed, botox is already being used off-label for muscle spasms in other body areas.

Botox for vaginismus isn’t currently FDA-approved, but Dr. Pacik has been conducting FDA clinical trials of botox-vaginismus treatments since 2010. By February 2011, Pacik had reportedly treated 78 women for vaginal spasms and noted a success rate "in excess of 90 percent".

Even though vaginismus is considered a highly treatable condition through counseling and pelvic exercises, there’s a lengthy timeline involved for success. Due to the lack of definitive medical tests for vaginismus, and many physicians’ unfamiliarity with the condition, vaginismus patients are also misdiagnosed on a frequent basis. This can result in a long, frustrating and sometimes fruitless treatment path for patients. Surgical procedures like hymenectomies and even vestibulectomies have been recommended for vaginismus patients in the past, even though neither one of these techniques can correct pelvic muscle spasms.

Problems may also arise from strict reliance on counseling as the sole treatment method. Vaginismus is an involuntary muscle response, so patients normally can’t cure the problem just by talking about it; a physical element is usually required. Giving patients dilators (inserted devices used to gradually relax the pelvic muscles) and prescribing Kegel exercises isn’t always effective either. Many vaginismus patients are too afraid or too resistant to try penetrative devices on their own. If dilator exercises aren’t performed consistently, progress will be limited.

Dr. Pacik believes botox injections can treat vaginismus faster, and often more effectively, than alternative methods can. He advises patients to seek counseling or additional therapy after receiving botox injections for vaginismus. That way patients can have the support and guidance of a therapist while they continue to recover and become sexually active.

About the Botox-Vaginismus Treatment Process

According to Dr. Pacik’s method, botox is injected into the intravaginal muscles to relax pelvic contractions. Reportedly, this has helped the majority of his clinical trial patients engage in intercourse with their partners—in some cases, for the first time.

Dr. Pacik maintains that his process isn’t just about botox injections. Rather it is a "comprehensive program" for vaginismus treatment that begins with injecting 150 units of botox and a local anesthetic into the intravaginal muscles. Then, dilators coated with anesthetic are used to progressively relax and expand patients’ tight muscles. Patients will continue to work with dilators at the clinic over the next 2-3 days.

Once the botox starts to take effect, patients find that their vaginismus condition improves even more rapidly and intercourse becomes possible. Dr. Pacik states that "within 2-6 weeks of Botox injection," his patients are able to achieve pain-free sex. Botox effects tend to wear off within a few months, but Dr. Pacik is confident that patients’ continued dilation progress will negate the need for subsequent botox injections.

Who Could Benefit From Botox for Vaginal Spasms?

While this type of botox treatment is primarily being studied in relation to vaginismus, botox injections for other vaginal or sexual pain disorders like vulvodynia and dyspareunia may soon follow.

According to vaginismus.com, vaginismus affects about two women out of every 1000 patients. The exact number is unknown. This same source states that the majority (53%) of U.S. vaginismus patients are aged 26-35, with 26% of patients falling in the 36-50 age range. Patients over 51 have the lowest reported rates of vaginismus.

Dr. Pacik believes his botox treatments can help patients with both primary vaginismus and secondary vaginismus. Patients with primary vaginismus have often never achieved intercourse and are in unconsummated marriages or relationships; they have generally never been able to withstand penetration. Secondary vaginismus patients develop vaginismus later in life due to pelvic or medical problems, abnormal healing of the tissues after childbirth, residual effects from vaginal infections, sexual trauma, etc.

Dr. Pacik firmly believes that botox injections will be able to help many women of varying ages and vaginismus conditions. "The majority of my patients have had vaginismus for many years, often four to seven years, though some of my patients have been afflicted with vaginismus for over 20 years."

If you’re looking into botulinum toxin injections to treat vaginismus or vaginal spasms, be sure to discuss your possibilities with a medical professional and an expert botox provider first. They should be able to inform you about potential botox risks and side effects, botox costs, and what reasonable expectations you should have for treatment results.

When it comes to newer uses for botox injections, you should always conduct personal research and consult with experienced practitioners to determine if off-label botox use will be safe and effective for you.