Recently the use of Botox for vaginismus has been a hot topic in some circles. Vaginismus is a condition that is sometimes described as uncontrollable muscle spasms that prevent women from being able to comfortably have vaginal intercourse or, sometimes, other forms of vaginal penetration including tampon use and gyn exams. (A difficulty with this description, however, is that vaginal spasms have not been found to be the most effective diagnostic predictors of vaginismus, and controversy continues to swirl around how vaginismus is similar to or different from other vaginal pain disorders.)
But on to Botox and what it has to do with vaginismus, since most people think of Botox as being used for cosmetic purposes as a facial injection. In fact, Botox has been used in many “off-label” ways – for example, research has shown that some healthcare providers have used it to effectively treat sweat gland disorders in the underarm and genital areas. It’s also been used to treat certain types of urge incontinence (peeing when one doesn’t intend to pee).
One of these off-label (read: not FDA approved) uses of Botox has been to treat vaginismus. In fact, there have been several studies in which researchers have examined the effectivess of Botox as a treatment for vaginismus and have found encouraging results with few problems/side effects.
That said, it’s important to remember that all cases of vaginal and vulvar pain are different, and that what works for one woman may not work for others. Botox is not approved by the FDA for specific treatment of vaginismus or vulvodynia, though there may be instances in which a woman and her healthcare provider discuss their options and choose to try Botox as a treatment. Also, I am not aware of any long term studies on the safety of using Botox in the genital area.
Whenever a woman finds that sex hurts, or that when she even tries to have sex it hurts, she should check in with her healthcare provider for a thorough gynecological exam. Meeting with a trained sex therapist is often advised, too, as some cases of vaginismus (and other genital pain problems) may improve with sex therapy. Some women who have been diagnosed with vaginismus find, for example, that using dilators in conjunction with information/guidance from a sex therapist helps them learn to have comfortable, pleasurable sex.
The bottom line is that we still have an enormous amount to learn about how to most effectively help women who experience vaginismus and other genital or sexual pain conditions. Learn more about vaginismus from the Vaginismus Awareness Network and learn about vulvodynia (vulvar pain) from the National Vulvodynia Association.