frustratedgal,
Absolutely not! Botox is not necessary. I didn’t use botox and I overcame my vaginismus with dilators only.
That being said, I personally used the help of Maze Women’s health to help me insert them for the first times (any pelvic floor physical therapist / similar women’s health center would be able to help). There are others with vaginismus (especially those who have used tampons before) that could probably use the dilators without the help of a professional, but for me going to Maze and having them put the dilator in for me and teach me to use them (and encourage me along my journey as I moved to larger dilators, etc.) was what helped me overcome my vaginismus.
You can read more about my journey here (from 2017):
http://mazewomenshealth.com/forums/topic/reflections-in-the-new-year/
For me, it was very important to NOT GIVE UP. It might not be easy but with time and determination you can do it! Vaginismus is SO TREATABLE, it CAN BE FIXED!
Cheers!