Received March 21, 2025
Accepted November 25, 2025

Objective: Vaginismus is a psychosexual disorder involving involuntary vaginal muscle contractions that hinder penetration, causing distress. Despite its impact, large-scale studies are limited. This study analyzes 143 patients (2018–2024) to assess the efficacy and safety of intravaginal Botox injections. Methods: A total of 143 married women diagnosed with vaginismus were included. Of these, 106 underwent intravaginal Botox injections, while 37 with vulvar vestibulitis syndrome received surgery. Demographic data were collected to evaluate treatment outcomes. Results: Among the 106 patients receiving Botox, 81.13% (86 patients) achieved pain-free intercourse within two weeks, while 18.87% (20 patients) showed no improvement. The average age was 26.59 years, and marriage duration ranged from 2 months to 8 years. The treatment was well tolerated, with no severe adverse effects reported. Conclusion: Vaginal Botox injections combined with psychological support showed an 81.13% success rate, confirming its efficacy and safety. However, 18.87% of patients did not respond, highlighting the complexity of vaginismus. This study, one of the largest on vaginismus, underscores the need for further research to refine treatment approaches.