Botulinum toxin is an effective therapeutic option for patients with vaginismus. WellMedica is one of the top-rated sexual wellness centers in Northern Virginia, Maryland, and Washington, DC.


Vaginismus is vaginal tightness that results from the involuntary tightening of the pelvic floor. This causes the vagina to go in panic, and the anticipation of vaginal penetration to be too much to bear. This is a medical condition that is not just “in a woman’s head” and is a very real physical pain from the panic of penetration.  It is not always clear which come first, the vaginismus or the anxiety.


The two main types of Vaginismus are:

Primary Vaginismus – It is often discovered during the teenage years or early twenties during first attempts at using a tampon or engaging in sexual intercourse. This is when a woman starts a lifelong condition in which the spasming begins the first time a person tries to have sexual intercourse or insert an object into the vagina like a tampon. Even gynecological examinations may be difficult for a person to undergo.

During sex, a partner can describe it as “hitting a wall” at the vaginal opening. A person may experience generalized muscle spasms, pain, and a burning sensation. The symptoms stops immediately when the attempt at vaginal entry stops.

Secondary Vaginismus – Secondary vaginismus is often experienced after a period of normal sexual function without pain before but then it becomes difficult or impossible. This is also known as Acquired Vaginismus and is often attributed to hormonal changes, childbirth, frequent infection (UTI, STD’s, pelvic inflammatory disease, and others), gynecological surgery or trauma, or a traumatic event.

Women who experience vaginismus may also experience fear, general anxiety, avoidance of certain activities including sex, and protective behaviors. These protective behaviors may include muscular guarding or clenching of the muscles in the pelvic floor, buttocks, hips, thighs, neck, chest, and shoulders. 

BOTOX FOR VAGINISMUS - vagitox (v-tox)™

Did you know that Botox has been used to treat Vaginismus since 1977? It is known that Botulinum toxin – “Botox” earned a reputation for its role in reducing facial lines. But the paralyzing effects known to smooth facial expressions can be just as helpful in addressing the painful and involuntary contractions of vaginismus as well.  Dr. Dima has been doing this procedure since 2014 and has helped hundreds of women with this chronic, debilitating vaginal condition.  If you suffer from pelvic floor dysfunction or spasms at the opening of the vagina, VagiTox (V-Tox)™ may alleviate these symptoms.  It can be a “cure” for a condition called Vaginismus which is involuntary muscle spasms at the introitus.  Women with this condition cannot insert tampons or have intercourse.  Typically, 200 units of Botox are used and both a topical and/or local anesthetic is used.


One of the most practiced treatment options for Vaginismus is the vaginal dilators which can improve symptoms. However, these improvements are often temporary and are not enough to make a difference in pain during sex (dyspareunia).  The best candidates for these treatments are patients who have tried both physical therapy and behavioral therapy without improvement of their symptoms. Dr. Dima Ali is proud to offer a breakthrough vaginismus treatment option that is reliable, life-changing for these women, in less than 20-minute outpatient procedure.


During the VagiTox (V-Tox)™ treatment, Dr. Dima Ali will inject Botox into the pelvic floor muscles and around the introitus (the opening of the vagina). We use a topical anesthetic for this procedure and patients rarely feel anything at all. The Botox takes full effect after approximately 3 weeks and lasts 3-4 months. During that time penetration during intercourse is comfortable if not pain free. Our patients tell us this procedure is “life changing.” This procedure can be  combined with other intimate treatments such as VagiNu (V-Nu)™ and VagiTite (V-Tite)™.

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