Botox for Vaginismus and Vulvodynia: Success Rates, Who It's For, and What to Expect | Dr Corey Babb

Can Botox really help treat vaginismus and vulvodynia - and if so, how does it actually work?In this episode, I sit down with Dr. Corey Babb, a board-certified gynecologist, ISSWSH fellow, and one of only four providers worldwide trained in the Pacik Multimodal Botox Protocol for vaginismus. Dr. Babb is the founder of Haven Center in Tulsa, Oklahoma, and co-authored the landmark research that established the five-point grading scale for vaginismus, now used internationally.We go deep into how Botox works physiologically, how it relates to the pain-fear-spasm cycle, who is a good candidate for it, and what the treatment and recovery process actually looks like. Dr. Babb also shares the success rates he's seeing at his clinic (around 95% of patients achieving pain-free penetration within three months), how desire is impacted after years of painful sex, and how Botox can also be used for vulvodynia patients with hypertonic pelvic floor dysfunction. We also discuss trauma-informed care and the importance of patient agency when undergoing this type of procedure.This is one of the most detailed and practical conversations on Botox as a treatment for vaginismus and vulvodynia that you'll find anywhere. Whether you're someone navigating one of these conditions, a partner trying to understand, or a clinician - I think you'll take a lot away from this one.Connect with Dr. Corey Babb: Haven Center: https://havencenter.com Instagram: @dr.coreybabb Research paper: Pacik PT, Babb CR, et al. "Case Series: Redefining Severe Grade 5 Vaginismus." Sexual Medicine, 2019 - https://pmc.ncbi.nlm.nih.gov/articles/PMC6963107/Connect with MathildeIG: @theworldstightestcommunity or [email protected]:00:00 - Welcome & introduction01:00 - Dr. Babb's origin story (from music theory to sexual medicine)03:09 - The patient case that changed everything04:08 - The 2019 research paper & the five-point vaginismus grading scale07:49 - Walking through grades 1-510:27 - Measuring hypertonicity vs. psychological distress13:11 - How widely adopted is the grading scale?15:05 - The GPPPD debate and why vaginismus deserves its own classification16:36 - What is Botox and what does it do in the body?18:22 - How Botox works for vaginismus (muscles, dilution, injection technique)20:49 - Breaking the pain-fear-spasm cycle23:32 - Success rates and Botox as an "accelerator"25:16 - The missing piece: desire after years of painful sex27:18 - Traditional Botox injections vs. the Pacik protocol34:36 - Trauma-informed care and patient agency during treatment37:34 - The post-procedure protocol (dilators, timelines, what to expect)39:56 - Long-term outcomes: why most patients don't relapse41:51 - Botox for vulvodynia: who it's for and how it differs46:38 - The future of vulvovaginal pain treatment & mast cell activation