Name: Zuri A. Murrell, M.D. - Los Angeles Colon and Rectal Specialist
Telephone: (323) 310-1137
Rating: 4.5

Botox for anal bottoming relaxes the internal anal sphincter to ease pain, tearing, and tightness during receptive anal intercourse. Dr. Zuri Murrell offers this treatment at his Beverly Hills practice as part of a comprehensive, judgment-free approach to anal health.

A Discreet, Judgment-Free Approach to Intimate Health

Dr. Zuri Murrell is a double board-certified colorectal surgeon and Director of the Colorectal Cancer Program at Cedars-Sinai in Los Angeles, with fellowship training in both colorectal and laparoscopic colorectal surgery. Patients travel from across Los Angeles, West Hollywood, Beverly Hills, and Long Beach to see him precisely because he treats sensitive anal and rectal concerns, including sexual comfort, with the same clinical rigor and discretion as any other area of the body.

If pain or tightness is getting in the way of intimacy, Dr. Murrell's office is a place to talk about it directly and get an evidence-based treatment plan.

What Is Botox for Anal Bottoming?

Botox for anal bottoming is a series of small injections of botulinum toxin into the internal anal sphincter, the involuntary muscle ring that controls tone at the anal canal. The toxin temporarily blocks the nerve signals that keep this muscle contracted, allowing it to relax rather than resist penetration.

For some patients, the internal sphincter stays too tight, whether from natural anatomy, anxiety-related tensing, scar tissue, or a history of anal fissures. That excess tone is what causes pain, micro-tears, and bleeding during bottoming. According to guidelines from the American Society of Colon and Rectal Surgeons, botulinum toxin injection works precisely this way in the closely related condition of chronic anal fissure, functioning as a temporary chemical sphincterotomy that reduces sphincter spasm and pressure.

This is distinct from the tightening techniques Dr. Murrell uses in his ANAL REJUVENATION™ procedure, which relies on laser and surgical methods to restore elasticity and shape to a loose or lax sphincter. Botox for anal bottoming addresses the opposite problem: a sphincter that is too tight for comfortable, pain-free intimacy.

Benefits of Botox for Anal Bottoming

Relaxing an overly tight internal sphincter can improve both physical comfort and confidence during intimacy.

Reduced pain and burning during penetration
Fewer micro-tears and less bleeding
Lower risk of developing or re-developing anal fissures
Easier, more comfortable dilation
Less involuntary tensing driven by anxiety about pain
A non-surgical option with a quick office visit and short recovery

Are You a Candidate for Botox for Anal Bottoming in Los Angeles?

You may be a good candidate if you experience:

Pain, burning, or tearing during receptive anal intercourse
A current or past anal fissure
Difficulty tolerating dilation, whether for sexual, therapeutic, or gender-affirming purposes
Noticeable involuntary tightening tied to anxiety around pain
Tightness from scarring or a previous anorectal procedure

Candidacy depends on an exam of sphincter tone and a conversation about your history and goals. During your consultation, Dr. Murrell will assess whether Botox alone is appropriate or whether an underlying issue, such as a fissure, should be treated first or alongside it.

Why Choose Dr. Zuri Murrell for Botox for Bottoming in Beverly Hills?

Dr. Murrell's colorectal training means he evaluates the sphincter the way a specialist does, not the way a general aesthetics provider does. A few reasons patients choose him specifically for this treatment:

Colorectal-specific expertise.

As Director of the Colorectal Cancer Program at Cedars-Sinai and a Member of the American Board of Colon and Rectal Surgery, Dr. Murrell treats the anal sphincter as his core specialty, not an add-on service.

Accurate diagnosis first.

Pain during bottoming can come from a fissure, hemorrhoids, or pelvic floor tension rather than tone alone. Dr. Murrell examines for these before recommending treatment.

A comprehensive anal health practice.

Botox for anal bottoming sits alongside Dr. Murrell's broader anal health and aesthetics services, so any related condition, such as an active fissure, hemorrhoids, or scarring, can be addressed in the same practice.

Inclusive, respectful care.

Dr. Murrell's Beverly Hills office is built around making sensitive conversations comfortable for patients of every gender identity and sexual orientation.

Schedule a Consultation

Schedule Appointment

What to Expect: Consultation, Procedure, and Recovery

Consultation. Your visit starts with a private conversation about your symptoms, sexual history relevant to your care, and goals, followed by a physical exam to assess sphincter tone and rule out fissures, scarring, or other contributing issues.

The procedure. Botox for anal bottoming is performed in-office. Dr. Murrell applies a topical numbing agent, then injects botulinum toxin at several points around the internal sphincter. The visit itself typically takes well under an hour.

Recovery. Most patients return to normal daily activities the same day. The relaxing effect on the sphincter builds over the following days, with many patients noticing improved comfort with dilation or intercourse within about a week. The effect is temporary, as with any botulinum toxin treatment, so maintenance injections are typically needed every several months.

How This Fits Into Dr. Murrell's ANAL REJUVENATION™ Program

Botox for anal bottoming is one piece of Dr. Murrell's broader anal health and aesthetics work, alongside his signature ANAL REJUVENATION™ procedure. The two treatments solve different problems: ANAL REJUVENATION™ uses laser and surgical techniques to tighten and restore a lax or aged sphincter, while Botox for anal bottoming relaxes an overly tight sphincter to ease pain and improve comfort during receptive intercourse.

Patients dealing with more than one concern, tightness and pain in different areas, or looking for skin tag or discoloration treatment alongside their comfort concerns, can have both addressed through a single, coordinated treatment plan.

Schedule a Consultation for Botox for Anal Bottoming in Beverly Hills

If pain or tightness during bottoming has been affecting your comfort or confidence, Dr. Zuri Murrell offers a discreet, medically grounded evaluation to determine whether Botox for anal bottoming is right for you. Call (323) 310-1137 or request a consultation online to get started at the Beverly Hills or Los Alamitos office.

Botox for Anal Bottoming FAQ's

Does Botox for anal bottoming hurt?

The area is numbed before injection, so most patients describe the procedure itself as a series of brief pinches or pressure rather than significant pain. Mild soreness for a day or two afterward is common.

How long does Botox for anal bottoming last?

Like other botulinum toxin treatments, the effect is temporary, generally lasting a few months before sphincter tone gradually returns. Many patients repeat injections periodically to maintain comfort.

Is Botox for anal bottoming safe?

Botulinum toxin injection into the internal anal sphincter is a well-studied technique, most extensively documented as a treatment for chronic anal fissure. A comparative study published in the New England Journal of Medicine found the injections to be an effective, low-risk alternative to surgical sphincterotomy for that condition. As with any injection, temporary soreness, bruising, or (rarely) transient difficulty controlling gas can occur.

Will insurance cover Botox for anal bottoming?

When used purely to improve comfort during intimacy, this treatment is generally considered elective and is not typically covered by insurance. If an underlying medical condition, such as a chronic anal fissure, is also being treated, part of your care may be billable to insurance. Our office can walk you through what applies to your situation.

How is this different from Botox used for anal fissures?

The injection itself works the same way in both cases, relaxing the internal sphincter. The difference is the goal: fissure treatment focuses on breaking the cycle of spasm and tearing so the tissue can heal, while Botox for anal bottoming focuses on comfort during intercourse. Many patients with a fissure history benefit from both outcomes at once.

Can Botox for anal bottoming be combined with other anal aesthetic treatments?

Yes. Because it addresses tightness rather than tone, texture, or pigmentation, it can be paired with other services in Dr. Murrell's anal aesthetics practice, such as skin tag removal or anal bleaching, as part of one coordinated plan.

Sources

American Society of Colon and Rectal Surgeons, "Management of Anal Fissures: Guidelines From the American Society of Colon and Rectal Surgeons," summarized by the American Academy of Family Physicians: https://www.aafp.org/pubs/afp/issues/2024/0200/practice-guidelines-anal-fissures.html
Brisinda G, et al., "A Comparison of Injections of Botulinum Toxin and Topical Nitroglycerin Ointment for the Treatment of Chronic Anal Fissure," New England Journal of Medicine: https://www.nejm.org/doi/full/10.1056/NEJM199907083410201