Therapeutic Botox

While best known for its cosmetic applications, botulinum toxin (Botox) is a powerful medical therapy with growing applications in men’s sexual health and pelvic pain management. At The Performance Medicine Institute, we use low-dose, precisely targeted Botox injections to treat conditions such as hard flaccid syndrome, chronic pelvic pain, penile tension disorders, and erectile dysfunction linked to overactive smooth or skeletal muscle tone. Botox works by temporarily relaxing hyperactive muscles, reducing neural hypersensitivity, and restoring normal blood flow and tissue function.

Penile tension syndromes — such as those seen in hard flaccid, dorsal nerve entrapment, or post-traumatic myofascial dysfunction — often involve involuntary contraction of the bulbospongiosus, ischiocavernosus, and perineal musculature. This chronic muscle overactivity can compress nerves and vessels, contributing to persistent pain, reduced sensation, coldness, and difficulty achieving or maintaining erection. In these cases, Botox offers a highly targeted, reversible, and non-systemic treatment option that complements pelvic floor therapy, neuromodulation, and regenerative treatments like PRP.

Our approach begins with a detailed evaluation including pelvic floor muscle assessment, penile Doppler ultrasound, and neurovascular screening. When indicated, Botox is injected under ultrasound guidance into specific perineal or penile structures — typically in combination with a comprehensive treatment plan that includes pelvic retraining and lifestyle optimization. Most patients experience significant improvement in symptoms within 7–10 days, with effects lasting 3–6 months or more.