Episode 258: Vaginal Botox for Painful Sex: When Your Pelvic Floor Won't Relax — with Dr. Chailee Moss

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Recorded05 Jul 2026

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She's been told to have a glass of wine. To just relax. That the pain is in her head. And she is still in pain — every time she has sex, every time she uses a tampon, sometimes just sitting at her desk. What she may have is a hypertonic pelvic floor: muscles stuck in a state of tension they cannot release on their own. In this episode, Dr. Carolyn Moyers sits down with Dr. Chailee Moss, board-certified OB/GYN at the Centers for Vulvovaginal Disorders in Washington, DC, and one of the country's leading experts in sexual pain — to talk about a treatment most women have never been offered: vaginal Botox.In this episode:• What a hypertonic pelvic floor actually is — and why it is so often missed• Why painful sex in midlife is not always "just hormones"• Who is a candidate for vaginal Botox, and what has to be tried first• What the procedure is really like: units, timeline, results, and side effects• Whether pelvic floor physical therapy is still necessary alongside Botox• Dr. Moss's current clinical study on incobotulinumtoxinA for pelvic floor dysfunction• Her published JAMA research on medical gaslighting in vulvovaginal careIf sex hurts, tampons hurt, or exams hurt — and no one has been able to tell you why — this episode is for you.🔗 Connect with Dr. Carolyn Moyers📸 Instagram: @drcarolynmoyers🎥 YouTube: @drcarolynmoyers🌐 Website: www.skywomenshealth.com🔗Connect with Dr. Moss📸 Instagram: @drchaileemoss🎥Podcast: https://podcasts.apple.com/us/podcast/vulva-talk/id1800293848?l=vi🌐 Website: https://vulvodynia.com/Study refererenced: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2833711?__cf_chl_f_tk=OLsdlLvt_yGlGELQw_cAXUG3OvtyeWEIHUOmORJNnKg-1783169445-1.0.1.1-pul.JSpT5O0ZhZ3a2S4.ewkDiByn6Lwj3LUpBR3DIng

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