Dr. Jaime Schwartz: Botox Isn’t Just for the Face

Because of my long history of dealing with women’s healthcare issues like breast cancer and breast reconstruction—when Buzz Feed reached out to me recently with a patient that nobody else would treat, I said yes.

This patient had a rare disorder called Vaginismus.

Vaginismus is technically vaginal tightness. Not the kind of desirable vaginal tightness that many women come to me seeking to restore after pregnancy—this is a tightness caused by an involuntary contraction of the pelvic floor muscles, so tight that the woman is unable to engage in vaginal penetration, including using tampons.

This tightness makes intercourse intolerably painful or impossible, and sets up a lifelong cycle of pain and avoidance surrounding intimacy. The body braces, anticipating pain, the muscles contract, and the cycle continues. Like many others with this condition (5-15%), this patient was unable to have vaginal intercourse.

During my first consultation with her, Lara told me she’d been dealing with this condition for many, many years, and she couldn’t get any answers or relief. She wanted to film her entire treatment so she could share with people what she’s been through: I Got Botox in my Vagina.

I’ve been aware of Vaginismus for a long time, but had no idea how misunderstood the condition was until I started treating more women like Lara. Nobody had an answer. This woman had even gone to the Mayo clinic, and they said there was nothing they could do. She was put on a regimen of dilators and physical therapy to retrain the muscles of her pelvic floor, but she was still unable to have intercourse. Other doctors told her it was all in her head. “Get over it,” they said. “Go have a glass of wine and relax.”

Because Vaginismus is caused by both physical and psychological factors—menopause, childbirth, infection, surgery, trauma, or abuse—it is largely unrecognized and underdiagnosed. As a result, a lot of women suffering with this condition feel like they have nowhere to turn, and choose to avoid intimacy entirely.

Lara’s condition was so bad that it was difficult to examine her. But this is actually quite common for vaginismus patients, some of the worst cases I’ve seen, the women can’t even get regular pap smears. They’re so nervous and have been in pain for so long that they need to be put under anesthesia to be examined.

When you look at the pathophysiology of vaginismus, the issue is extremely tight and tense pelvic floor muscles and Botox is used to relax muscles throughout the body, making it an ideal tool for correcting the problem.

I brought in a friend of mine Dr. Mickey Karram, an amazing OBGYN and pelvic surgeon, to help with the treatment. Once we targeted the areas she was having the most trouble with, we treated her by injecting Botox into the vaginal muscles to prevent the pelvic floor from contracting and break the cycle of pain. The entire treatment took about 10 minutes.

About 10 days after the treatment, we recommended she resume her physical therapy and dilator usage. She talks about her treatment and results here: I Got Botox in My Vagina and it Changed my Life.

We have never seen her back; Lara reports that she’s 80% better.

We’ve treated many women with vaginismus using Botox, with more than a 90% success rate; women from all over the world come to me seeking treatment and relief (I had a woman fly in from the Bahamas the other day for a consultation); many of the women we treat can go on to have vaginal intercourse and have normal sex lives after just one treatment—and yes, changing lives feels amazing!

Please share this article to help us raise awareness and help more women seeking relief from vaginismus get treatment. Thank you.

For more information on treatment or to schedule a consultation, please contact us at: 310-882-5454 The Roxbury Institute 450 North Roxbury Drive, Beverly Hills, California 90210.

SchwartzPractitioner at the Roxbury Institute and founder of The Beverly Hills Breast Institute, Dr. Jaime Schwartz the highest quality and most comprehensive breast surgery care to men, women and transgender patients, alike.

View Dr. Jaime Schwartz profile and contact information here. 



Image courtesy of Dr. Jaime Schwartz