Penile Botox
What is penile botox?
Penile Botox means injecting botulinum toxin into the erectile tissue of the penis. The toxin relaxes smooth muscle, which may let more blood flow in. It is being studied for erectile dysfunction that does not respond to pills, and some clinics offer it for firmer erections or cosmetic aims. It is not approved for any of these uses.
Listed here because well-known people have tried it on themselves. Trying something is not recommending it; each entry says whether the person tells others to do it.
Who has tried it
Tried by 1 person we can source: 1 testing.
Testing
Bryan JohnsonEntrepreneur, founder of BlueprintBlueprint (Bryan Johnson)
Dates not stated · Does not recommend it to others
Reported adding Botox injections to the penis, with shockwave therapy, after starting tadalafil, and said they lowered his nighttime erection biological age to around 20.
“nighttime erection biological age to around 20”
People, Why Bryan Johnson gets Botox in his penis (March 2025, via AOL) · Status checked March 28, 2025 · Suggest a correction
What the evidence shows
The best trial is small. In 70 men whose erectile dysfunction did not respond to pills, one injection of 100 units improved erection hardness, blood flow and symptom scores for up to 12 weeks compared with saline [1]. A larger phase 2 trial in 165 men, combining the toxin with sildenafil, found no significant improvement in the main score [2].
A meta-analysis found better blood flow and hardness scores but no clear change in a standard symptom score [3], and an umbrella review in 2026 rated the certainty of the evidence low to very low [4].
No study has tested it in men without erectile dysfunction, for length, or for longevity. It is not approved for any penile use.
Safety
- Botulinum toxin is approved for other uses, such as wrinkles and bladder overactivity, but not for erectile dysfunction or penile enhancement.
- Reported side effects in trials were mild, such as pain or bruising at the injection site, but numbers are small.
- Effects wear off after a few months, so it would need repeat injections; long-term safety is unknown.
- People with nerve-muscle disorders such as myasthenia gravis, or with infection at the site, should not have it.
Common questions
Did Bryan Johnson get Botox in his penis?
Yes. In a March 2025 post reported by People, he said he added Botox and shockwave therapy after starting tadalafil, and that they lowered his nighttime erection biological age to around 20. These are his own measurements. His current protocol page does not mention it.
Does penile Botox work?
Is penile Botox safe?
Trials report mostly mild injection-site effects [2], but they are small and short. Long-term safety and use in men without erectile dysfunction are unstudied.
Sources
- 1.Abdelrahman IFS, Raheem AA, Elkhiat Y, et al. Safety and efficacy of botulinum neurotoxin in the treatment of erectile dysfunction refractory to phosphodiesterase inhibitors: Results of a randomized controlled trial. Andrology, 2022. doi:10.1111/andr.13104
- 2.Giuliano F, Denormandie AC, Madec FX, et al. Efficacy and safety of intracavernosal incobotulinumtoxinA (Xeomin) as add-on therapy to sildenafil for the treatment of erectile dysfunction insufficiently responsive to phosphodiesterase type 5 inhibitors. J Sex Med, 2025. doi:10.1093/jsxmed/qdaf225
- 3.Abou Zahr R, Bou Kheir G, Mjaess G, et al. Intra-Cavernosal Injection of Botulinum Toxin in the Treatment of Erectile Dysfunction: a Systematic Review and Meta-Analysis. Urology, 2022. doi:10.1016/j.urology.2022.08.039
- 4.Cobo VT, Yánez Ruiz CA, Tapia Tapia MD, et al. Intracavernosal botulinum toxin type A in refractory erectile dysfunction: umbrella review with GRADE certainty assessment and corrected covered area analysis. J Sex Med, 2026. doi:10.1093/jsxmed/qdag311