Botox For Better Sex?

Could Botulinum toxin actually improve female sexual function?

It sounds counterintuitive, but the science is fascinating.

Most people think of getting a Botox treatment as a muscle relaxer. In medicine, however, botulinum toxin (BoNT-A) does much more. It's FDA-approved for conditions like chronic migraine because it modulates nerve signaling and reduces abnormal nerve activity—not just muscle movement.

Researchers are now exploring whether these same neuromodulatory effects could benefit women with sexual dysfunction.

A 2024 pilot study investigated ClitTox (incobotulinumtoxinA injected into the clitoris) and found improvements in desire, arousal, lubrication, orgasm, satisfaction, and overall sexual function. Women who received BoNT-A combined with PRP showed greater improvements than those who received BoNT-A alone. While these findings are exciting, this was a small pilot study of 14 women, there weren't any negative side effects and very promising results! In fact, one of the side effects was "suffering hyper-sexuality" for 4 weeks.

So why doesn't it decrease sensation?

The goal isn't to "numb" the area. Researchers believe BoNT-A may help regulate overactive sympathetic ("fight-or-flight") nerve activity, allowing improved blood flow, pelvic floor relaxation, and parasympathetic function—the nervous system responsible for arousal, lubrication, and orgasm. PRP may further support tissue healing and nerve health through its concentrated growth factors, making the combination an exciting area of regenerative medicine research. 

Women's sexual health has historically received far less research than men's. While botulinum toxin has shown promising results in many clinical studies for erectile dysfunction in men, it is not FDA-approved for ED, and women still have very few evidence-based therapies that directly target genital tissue function.

 Women's sexual wellness deserves the same innovation and investment as every other field of medicine. At Siren Medical Spa, we're committed to bringing patients innovative, evidence-informed regenerative treatments while staying grounded in the latest scientific research. In an effort to bring awareness to this adjunct therapy. I am going to offer the BoNT-A injection in conjunction with the O-Shot PRP procedure for no additional charge to those women seeking an increase in sexual desire and satisfaction. I believe that a healthy sex life and sexual fulfillment is directly related to a better quality of life. While this procedure is considered off-label, many treatments are considered off-label and not FDA approved yet tremendously beneficial to the patient. Many of the treatments we use every day in medicine are off-label. It simply means the FDA has not specifically approved that exact indication, even though published research may support its use.

Let's explore some examples of off-label non-FDA approved treatments with BoNT-A include:

Neurology

• Chronic neuropathic pain

• Trigeminal neuralgia

• Occipital neuralgia

• Post-herpetic neuralgia

• Hemifacial spasm (before specific approvals)

• Essential tremor (selected patients)

Urology

• Chronic pelvic pain syndrome

• Interstitial cystitis/bladder pain syndrome

• Erectile dysfunction (investigational; not FDA-approved)

• Chronic prostatitis

• Pelvic floor dysfunction

Gynecology & Pelvic Medicine

• Vaginismus

• Levator ani syndrome

• Pelvic floor myalgia

• Vulvodynia

• Persistent genital arousal disorder (PGAD)

• Female sexual dysfunction (investigational, including clitoral injection)

Gastroenterology

• Anal fissures

• Achalasia

• Gastroparesis (selected cases)

• Sphincter of Oddi dysfunction

ENT (Ear, Nose & Throat)

• Sialorrhea (drooling; some products/ages have approvals, but off-label use still exists in certain populations)

• Cricopharyngeal dysfunction

• Vocal cord disorders

• Chronic rhinitis (intranasal injections)

Dermatology

• Rosacea flushing

• Oily skin

• Enlarged pores

• Acne (investigational)

• Hypertrophic scars

• Keloids (adjunctive therapy)

Pain Medicine

• Myofascial pain syndrome

• Temporomandibular joint (TMJ) disorders

• Thoracic outlet syndrome

• Plantar fasciitis

• Tennis elbow

• Chronic neck pain

Orthopedics

• Muscle contractures

• Spasticity in muscles not specifically covered by labeling

• Piriformis syndrome

• Iliopsoas syndrome

Pediatrics

Botulinum toxin has been used for years in children by pediatric neurologists and rehabilitation specialists. Depending on the product, some pediatric indications are FDA-approved, while many others remain off-label.

Examples include:

• Cerebral palsy–related spasticity (some uses approved, others off-label depending on muscle group, age, and product)

• Toe walking

• Muscle contractures

• Upper extremity spasticity

• Lower extremity spasticity

• Drooling (sialorrhea; depending on the toxin formulation and age)

• Dystonia

• Strabismus (historically)

• Neurogenic bladder in selected patients

Cosmetic Medicine

Many aesthetic treatments also began as off-label uses before becoming mainstream:

• Masseter reduction

• TrapTox

• MicroBotox/MesoBotox

• Lip flip (before it became widely accepted)

• DAO injections

• Bunny lines

• Nasal tip lift

• Platysmal band treatment (before formal approvals for some products)

• Calf slimming

  
  

Would you try it? I would love to hear your thoughts!

XOXO - Sara Cole NP

Runels C, Runnels A. “The Clitoral Injection of IncobotulinumtoxinA for the Improvement of Arousal, Orgasm & Sexual Satisfaction—A Specific Method and the Effects on Women.” Journal of Women’s Health Care. 2024;13:715. DOI: 10.35248/2167-0420.24.13.715