Botox and Sex

What could possibly botox injections and sexual pleasure have in common? Curiously, scientists have found a link! Unfortunately, this means bad news for women. 

It sounds counterintuitive, but apparently the injections of toxin into facial muscles could affect female ability to experience orgasm, even reduce it.

To understand this phenomenon we should come back to the frivolous 1960s when famous (or infamous!) Masters and Johnson ran a 10,000 participant strong study of people's behaviour during sex. In their 1966 paper called Human Sexual Pleasure they mention among other things a common occurrence of the O-Face in women during a plateau phase prior to orgasm. Later it was confirmed by many studies and became one of the scientific indicators of sexual excitement successfully followed by an orgasm.

O-Face is a facial expression combining frowning and slack jaw. 

Fun fact, it is common in primates too. 

At first, scientists hypothesised that this expression can be a part of non-verbal communication, indicating emotion, but it turned out to be more complicated than that. 

O-Face happens to be not a result of sexual excitement, but a part of it and without it the whole experience is significantly reduced. 

So, what happens to the O-Face when you cannot frown, because facial muscles are paralysed by botulinum toxin injections?

Researchers invited women seeking wrinkle treatment to take part in a study, without revealing any details of their hypothesis. Female patients of aesthetic clinics filled numerous questionnaires, among them Female Sexual Function Index (FSFI), and emotion recognition tests prior to the treatments. 

Before you get all skeptical, let me just say that The FSFI has been validated in multiple languages and populations, showing good reliability, validity, and responsiveness, making it a standard tool for assessing female sexual health.

The first questionnaire they filled a week before their beauty treatment and the follow-up one — 35-40 days after. All women have been divided into 3 different groups: in the first one they didn’t receive botox injections opting instead for other treatments, such as chemical peels, microneedling, etc. The second group of women received botulinum toxin injections in the frown lines and the third group had injections in the frown lines and crow's feet wrinkles in the corners of the eyes, also called smile lines.

In cases of botox injections, their findings did not encourage optimism. 

The toxin-treated groups showed a drop in the overall orgasm satisfaction score after treatment regardless of whether the crow’s feet were treated or not — a drop that was not apparent in the non-injected group which actually showed a slight improvement of orgasm. 

Simply speaking, women reported that, following cosmetic injections of botulinum toxin in their forehead and around eye area, they experienced a decrease in sexual function: in particular, orgasms were harder to achieve and were less satisfying.

These findings have been one of the most unexpected and likely the least desirable for the beauty industry. We certainly need more research to answer some important questions. However, even now it is important to ask: is it even ethical to advertise anti-ageing procedures which could reduce sexual pleasure? Or make people sadder? Or undermine their ability to communicate? The press is already coming up with headlines such as “Is Botox Killing Your Sex Life?” — and sensationalist as it may sound, these are valid concerns. 

And we should definitely all be more careful using toxins for aesthetic purposes: their effects may turn out to be unexpected and unpleasant.