Penis Botox:
Therapeutic Botox for ED (BOCOX)
Traditionally thought of as a solution to remove wrinkles, Botox is also a promising treatment for erectile dysfunction. Over the last five years, medical research has suggested Botox is a safe and seemingly highly effective treatment not just for ED but also for enhancing performance and improving sexual confidence.
Several promising studies have shown that a one-time injection of Botox helped treat erectile dysfunction by improving vascular health and function in the penis, with results lasting an average of six months. What’s convincing about these particular placebo-controlled studies is that the cohort of men treated were patients who had no longer responded to ED medications. In other words, these patients were very challenging to treat, and many responded well to Botox.
What is BOCOX™, aka Penis Botox?
“BOCOX” is a non-surgical treatment that uses Botox to improve penile health and function. Botox (also known as botulinum neurotoxin) is a neuromodulator produced by the bacterium Clostridium A. Botox has been FDA-approved since 2002 to treat wrinkles, and since then, hundreds of millions of Botox injections have been administered to treat everything from wrinkles to migraine headaches to urinary problems.
How Therapeutic Botox for Erectile Dysfunction Works
Penile Botox works via the following mechanisms:
Relaxes Smooth Muscle - Botox works by temporarily relaxing the smooth muscle in the walls of the blood vessels in the penis, resulting in improved dilation, expansion, and filling of these blood vessels.
Reduces Constriction - As men age, the endothelial lining becomes more dysfunctional, meaning the blood vessels in the penis become more contracted, more regularly. Botox blocks the nerve impulses sent to the vessel walls, resulting in a more relaxed state with a wider diameter, allowing vessels to expand and carry a greater volume of blood, which improves erections. The mechanism of action for Botox seems to be effective not just for age-related erectile dysfunction but also for other types of neurogenic vasoconstriction.
Improves hemodynamics or blood flow - Through the mechanisms listed above, several studies have demonstrated, via Doppler ultrasound, improved hemodynamics to the penis (i.e., enhanced circulation and blood volume).
Penile Botox Benefits
According to several placebo-controlled trials, patients receiving Botox penile injections have reported several benefits:
Firmer and longer-lasting erections: many men have reported firmer and more sustainable erections
Increases Erection Size: Men reported that Botox increased erection size and fullness
Increases Penile Size at Rest: Men report that Botox increased flaccid penile length and girth
Addresses Erectile Dysfunction: men reported less erectile dysfunction and more successful attempts at initiating and maintaining erections during intercourse.
Improved Medication Responsiveness: men reported that Botox improved their response to PDE5 inhibitors (Viagra and Cialis). Botox seems to have a synergistic effect with PDE5s. Some men required less medication / lower doses.
Increases Sexual Satisfaction: Some men have reported a more intense and satisfying sexual experience.
Key Scientific Studies on Botox
Botulinum Neurotoxin and Its Potential Role in the Treatment of Erectile Dysfunction [1]
Application of Botulinum Neurotoxin in Male Sexual Dysfunction: Where Are We Now? [2]
Intra-cavernous injection of BOTOX® (50 and 100 Units) for treatment of vasculogenic erectile dysfunction: Randomized controlled trial [3]
Botox for ED:
What the Research Says
There are several high-quality, placebo-controlled studies demonstrating the safety and effectiveness of Botox for the treatment of ED. According to one study, a one-time treatment with intracavernosal injection of Botox showed significant improvement in all areas, including the Sexual Health Inventory for Men (SHIM) score & Erection Hardness Score (EHS), Sexual Encounter Profile (SEP), Global Assessment Score (GAS), and Doppler (ultrasound evaluating blood flow) parameters.
While intracavernosal Botox is proving to be well-supported and safe according to scientific literature, this treatment approach is not yet referenced as a standard treatment protocol by governing boards. We encourage patients to review the relevant literature and discuss with their doctor to support informed treatment decisions.
Many of our patients have already tried conventional treatments and turned to KPM for innovative approaches.
For your reference, here are the accepted national treatment protocols from the Canadian Urological Association and the American Urological Association.
1. Ghanem H, et al. Botulinum Neurotoxin and Its Potential Role in the Treatment of Erectile Dysfunction. Sexual Medicine Reviews. 2018;6:135-142.
2. Reddy A, et al. Application of Botulinum Neurotoxin in Male Sexual Dysfunction: Where Are We Now? Sexual Medicine Reviews. 2021;9:320-330.
3. El-Shaer W, et al. Intra-cavernous injection of BOTOX® (50 and 100 Units) for treatment of vasculogenic erectile dysfunction: Randomized controlled trial. Andrology. 2021;9:1166-1174.
The Penis Botox Procedure: What to Expect
Here’s what to expect before, during and following the procedure:
Topical anesthesia is used to numb the penile tissue before the injections are administered.
A clinician will inject precise amounts of Botox into each side of the penis, specifically the two columns of spongy tissue in the corpus cavernosum.
The procedure is usually completed in less than three minutes.
Some patients may experience minor swelling or tenderness for a few days after the procedure.
Timing and Length of Results
The effects of therapeutic botox generally improve and progress over the span of two weeks, with some noticing results within a few days. Maximum observable results are usually around six weeks.
Published literature on therapeutic botox for ED showed that 100 units of Botox usually lasted around six months.
Patients can return every four to six months for additional treatments.
Combining Botox with the P-Shot: Enhanced Results
For more significant results, we like to combine BOCOX™ with the P-Shot. The P-Shot promotes new blood vessel formation and improved endothelial function in the penis and pairs synergistically with Botox. You can learn more about the P-Shot on our The P-Shot for ED page.
Synergistic Effects of Therapeutic
Botox for ED and the P-Shot
Botox™ Function
Enhances parasympathetic tone, i.e. relaxes smooth muscle in the lining of the blood vessel, improving dialation and expansion of blood vessels.
P-Shot Function
Improves erectile function by improving blood vessel density, improving endothelial function, and increasing nitric oxide production in penile tissues.
Combined Benefits
Enhances blood flow, stimulates vessel regeneration, and optimizes sexual function when used together.
Reported Outcomes
Patients report holistic improvements in sex life, increased confidence, heightened sensitivity, enhanced sexual performance, and improved penile size.
Goal of Integration
To achieve superior results and a more gratifying sex life by combining both treatments.
Long-term Enhancements
Increased penile size and long-term improvements in sexual health and function.
