Boston Vaginal Botox
Pelvic Floor Injections:
What You Need to Know
You’re not alone—and you’re not imagining it
If you’re experiencing burning at the vaginal opening, pain with penetration, vaginal tightness, or muscle spasms that feel like your body just won’t let go—this may be coming from overactive or tense pelvic floor muscles. These symptoms are common in conditions like vaginismus, vulvodynia, levator ani syndrome, and pelvic floor dysfunction.
One of the most effective treatments—especially when pelvic floor physical therapy isn’t enough on its own—is pelvic floor injection therapy, including vaginal Botox.
What Are Pelvic Floor Injections?
Just like you can develop tight knots in your neck or shoulders, your pelvic floor muscles can become stuck in a contracted, painful state. These tight areas—called trigger points—can contribute to:
PAIN AT THE VAGINAL OPENING
PAIN WITH SEX
VULVAR BURNING OR RAWNESS
VAGINAL MUSCLE SPASMS
DIFFICULTY PROGRESSING IN PHYSICAL THERAPY
CONSTIPATION OR DISCOMFORT WITH BOWEL MOVEMENTS
PAIN DURING PELVIC EXAMS
When these muscles stay clenched, they can make any form of internal care—including pelvic PT or intimacy—feel impossible. Pelvic floor injections help reduce that tension so your body can begin to heal.
1. Trigger Point Injections (TPI)
Trigger point injections involve a combination of numbing medication and a small amount of anti-inflammatory steroid, placed directly into the overactive pelvic floor muscles. These injections
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Calm local inflammation
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Disrupt the pain-spasm-pain cycle
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Are performed vaginally with local numbing for comfort
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Can be repeated as needed every 3–4 months
Trigger point injections are often helpful for patients whose pain is localized to one or more muscle groups, or when pelvic PT alone has plateaued.
Types of Injections Offered
Vaginal Botox is a well-established treatment that helps relax muscles that are chronically tight or resistant to manual therapy. This treatment:
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Reduces involuntary pelvic floor muscle clenching
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Supports improved tolerance of pelvic floor PT
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Typically begins to take effect within 7–14 days
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Often leads to decreased pain with sex, exams, and internal work
2. Vaginal Botox Injections
Expert Care, Collaborative Approach
All injections are performed by a highly experienced, trauma-informed Nurse Practitioner who specializes in pelvic and sexual health. Your care is coordinated with your Wellest pelvic floor physical therapist, so we can ensure your treatment plan is personalized, timely, and aligned with your goals.
We believe that progress happens faster when your care team is in communication—so we’ve built that into your experience.
Aftercare and Recovery
What to expect:
Some pelvic cramping, bloating, or pressure for a few days
Mild vaginal spotting is common
You may experience a temporary increase in symptoms before improvement begins
You do not need to delay pelvic floor physical therapy after injections. In fact, one of the advantages of receiving care in an interdisciplinary clinic is that you can return to pelvic PT right away, often with better tolerance and less pain.
Final Thoughts
Pelvic floor injections—including vaginal Botox—are an effective tool for helping your body reset and re-engage in therapy and daily life with less pain. Many people find this treatment allows them to move forward after months or years of being stuck.
You deserve expert care that sees the full picture of your health. We're here to listen, to support, and to offer real, evidence-informed solutions that help you feel more at home in your body again.
