Botox for fissure during pregnancy

Published 13 March 2026 ·Last reviewed 13 March 2026 by the editorial team ·How we create our content

A composite account, drawn from many real anonymised experiences. It is not any one person's story.

What this experience covers

This experience describes what people face when considering botox for an anal fissure during pregnancy — the questions that arise, the decisions that need to be made, and the alternatives that are typically explored. It is a composite drawn from anonymised accounts.

The pattern

The situation

Some people develop a chronic anal fissure during pregnancy that does not respond to conservative treatment. The pain is severe. Topical treatments may be limited during pregnancy. The condition significantly affects quality of life at a time that is already physically demanding.

Botox injection for fissure is an established treatment in non-pregnant adults. But during pregnancy, the question becomes more complex.

The decision

The key consideration: botox (botulinum toxin) has limited safety data during pregnancy. It is not typically recommended as a first-line treatment during pregnancy because the effects on the developing baby have not been thoroughly studied.

People describe this as a difficult position:

The fissure is causing severe pain that affects daily life
Conservative measures are not working
The most effective non-surgical treatment is not routinely offered during pregnancy
They are told to wait until after delivery, which may be months away

What typically happens

Most clinicians recommend maximising conservative treatment during pregnancy:

Stool softeners and fibre management
Sitz baths
Topical treatments that are considered safe in pregnancy (discuss with your care team)
Pain management with pregnancy-safe medication

Some people describe being offered botox during pregnancy after thorough discussion of the limited evidence and the severity of their symptoms. This is a decision made between the patient and their care team on a case-by-case basis.

Others describe waiting until after delivery and then proceeding with botox or other treatments.

The waiting

The hardest part people describe is being told to wait. Months of pain, with delivery approaching (which may worsen the fissure), and no definitive treatment available. The emotional toll is significant.

People who managed this period describe:

Focusing on the best possible conservative care
Accepting that the situation is temporary
Having a clear plan for treatment after delivery
Staying in regular contact with their care team

What people wish they had known

That fissures during pregnancy are common and that the treatment limitations are temporary. Having a plan — both for managing symptoms now and for treatment after delivery — helps maintain hope during a difficult period.

When to contact your doctor

Seek medical attention if you experience:

Severe pain that affects your ability to function
Heavy or persistent bleeding
Symptoms that are rapidly worsening
Any concerns about your fissure or your pregnancy

When to seek care Heavy bleeding or feeling faint? Get emergency help now. Emergency: 911

Not sure how urgent it is? Get help today.

Emergency
Heavy bleeding, black tarry stools, feeling faint, severe pain or trouble breathing.

Call 911 or go to the ER.
Today
Fever, pain getting worse, a hot swollen lump, or trouble passing urine.

Call your doctor or go to urgent care.
Soon
Bleeding or bowel changes nobody has checked, or anything lasting 3 weeks.

Book a doctor’s appointment.

Feeling overwhelmed? Call or text 988, any time.

See all the signs

For this topic, get medical advice if you notice:

Severe or worsening pain
Heavy bleeding
Fever
Black stools
Fainting or dizziness
Pus or unusual discharge
Inability to pass stool or gas
Unexplained weight loss

Recording how you feel is not the same as being checked. These are the signs that need a doctor’s attention.

Call 911 or go to the emergency room now if you have:

bleeding that will not stop, a lot of blood (the toilet water turns red, or you pass large clots), or any bleeding with feeling faint or dizzy
fainting, a racing heart or trouble breathing
confusion or slurred speech, extreme shivering, no urine in a day, or blotchy skin
sudden severe belly pain, or a swollen, hard belly with vomiting or not passing stool or gas
you cannot pass urine at all, or your bladder feels full and painful and you can’t empty it
redness, swelling or severe pain spreading quickly around your anus, genitals or groin, especially with a fever or feeling very ill
a fever with a painful swelling near your anus if you have diabetes or a weakened immune system (for example, from chemotherapy or transplant medicines)
black, tarry stools

Call your doctor or go to urgent care today (or the ER if you can’t be seen today) if you have:

a temperature of 100.4°F (38°C) or higher, chills, vomiting, or feeling generally unwell
pain that is getting worse over days, or severe pain that stops you sitting or sleeping
a hot, swollen or very tender lump near your anus or at the top of the crease between your buttocks, or foul-smelling discharge
trouble urinating
bleeding that is getting heavier or more frequent, or blood mixed into your stool
feeling much more tired than usual, looking pale, or getting out of breath more easily than you used to
not passing stool for several days, or new belly pain

Make an appointment with your doctor if:

you have never had these symptoms checked by a doctor or nurse — whatever your age
you have had rectal bleeding for more than 3 weeks
your bowel movements have been looser, thinner or more frequent than usual for 3 weeks or more, or you have lost weight without trying
symptoms have not settled after a week or so, or keep coming back
you notice a new lump near your anus, between your buttocks or in your belly, or an itch or discharge that does not clear
you have new leakage or trouble controlling your bowels
you are 45 or over, or have a family history of bowel cancer or inflammatory bowel disease, and any of these symptoms are new for you

If you are unsure, it is always reasonable to ask. If things feel overwhelming, call or text 988 (Suicide & Crisis Lifeline) or chat at 988lifeline.org, any time. If you don’t feel safe, call 911.

Showing US care routes. Change region at the foot of the page.

Discreet symptom tracking

Symptoms that come and go? Keep track, day by day.

For hemorrhoids, fissures, fistulas and other anal and rectal problems. A short, discreet email asks how things have been, and saves each answer, so you can look back at every flare and every good week in your own words. If you haven’t had your symptoms checked, see your doctor first.

About ten seconds a check-in. No app, no password.
Nothing in the subject or preview says what it’s about.
Each Sunday, a link to your week, ready for your next appointment.

Start tracking →

Your notes

Your check-in

Takes about ten seconds.

20:00

Example. Nothing on the lock screen hints at symptoms or conditions.