Phexxi: What To Know About The Non
Lately, a friend of mine has been talking about Phexxia newish non-hormonal birth control gel she was thinking of trying. I don’t love admitting this, but I had somehow missed the news on this product and had no idea what she was referring to.
Given that this non-hormonal birth control gel has been growing in popularity, there’s a pretty good chance you might have heard of it too. To help you out, our team at Byrdie decided it’s time to reach out to some experts in the field of gynecology to learn the ins and outs of this new birth control gel.
Meet the Expert
- Tamika Cross, MD, is a board-certified obstetrician and gynecologist who practices in the Pearland, TX, area.
- Sophia Yen, MD, is board-certified in adolescent medicine and holds an MPH in maternal child health. She is the CEO of Pandia Health.
Here’s what you need to know about Phexxi birth control gel.
Consumer Health Info: Phexxi Contraceptive Gel
What is Phexxi?
On May 22, 2020, the U.S. Food and Drug Administration approved a new contraceptive method, Phexxi, expanding the number of non-hormonal, on-demand options available to users who can become pregnant. Made by Evofem Biosciences , Phexxi is a contraceptive in gel form that can be used instead of traditional spermicides.
How Does Phexxi Work?
Phexxi is a gel placed in the vagina used up to an hour before penis-in-vagina sex. It works by taking advantage of the vaginas natural acidity and sperms vulnerability to acidic environments.
The pH scale is used to measure how acidic or basic a substance is.
The pH scale is used to measure how acidic or basic a substance is, with the most acidic substances registering as 0 and the most basic substances registering as 14.
The natural pH of a healthy vagina ranges from 3.5 to 4.5 but during sex, semen raises the vaginas pH to 7 or 8 in order to create an environment that is livable for the sperm. Phexxi works by keeping the vaginal pH within the vaginas normal pre-sex range, counteracting the influence of the semen and incapacitating the sperm. The gel is comprised of lactic acid , citric acid , and potassium bitartrate .
Phexxi can be used any time during a persons menstrual cycle and as soon as it is safe to have sex again after giving birth, having an abortion, or experiencing a miscarriage.
How Is Phexxi Different from Spermicide?
How Do You Get Phexxi?
How Effective & Safe is Phexxi?
Types Of Nonhormonal Birth Control
- What is it? A saucer-shaped silicone cup that you put into your vagina to block semen from entering your womb. You must be fitted for a diaphragm at first by your doctor.
- How well does it work? If you use the diaphragm correctly and add spermicide, you have a 6% chance of getting pregnant after a yearâs use. But the odds double if you donât always use it or donât use it exactly right, the way a typical person does.
- Pros and cons. You can carry your diaphragm and put it in just before you have sex. Itâs reusable for 12 months. If you decide you want to start a family, stop using it. A diaphragm wonât protect you from STDs. You have to leave it in for at least 8 hours after sex. You also may be more likely to get vaginal or urinary tract infections. Learn about the best ways to prevent a UTI.
Outercourse and the pull-out method
Natural family planning
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Natural Ways To Prevent Or Delay Pregnancy
Hopefully Ive made a case for why taking artificial hormones arent the best option for delaying pregnancy, but if just balancing hormones isnt the reason for taking hormonal contraceptives and there is the need to delay or prevent pregnancy, there are other options .
Ill address the methods I have tried so that I can speak from experience:
Natural Family Planning or Fertility Awareness Methods are natural ways of preventing or achieving pregnancy based on the bodys natural hormonal cues. These methods carry no side effects and actually help women get to know their bodies better. I know of several cases of women who discovered problems from practicing these methods since they were in touch with their hormonal cues.
While these methods get a bad rap, they have come a really long way from the Rhythm Methods of the past and many are now as effective as hormonal methods when used consistently. These methods can be used to delay or achieve pregnancy, so those who decide to conceive dont have to worry about the risk of infertility, birth defects or delayed fertility after coming off of contraceptives.
The basic concept is using cues like Basal Body Temperature , mucus production, cervical position and other symptoms to effectively predict ovulation and avoid intercourse during this time. You can also use an ovulation calculator like this one to find the fertile window in your cycle.
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A Word From Verywell’s Medical Expert Board
“Phexxi is a new vaginal gel contraceptive. It is female-controlled and on-demand, meaning you only use it when you need it. Many women may like the fact that it is non-hormonal. This means it may have fewer side effects. But if you decide to try it, know that it is probably not as effective as IUDs or the pill. It also will not protect against STIs.” Anju Goel, MD, MPH
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Who Should Use Phexxi
The FDA discourages women with recurrent UTIs or a history of urinary tract abnormalities from using Phexxi.
According to Culwell, there’s no specific demographic of women that Phexxi’s best suited for. She said it’s a good option for any woman looking for non-hormonal contraception, “either because shes tried hormones in that past and hasnt liked them … or they have side effects shes not happy with.”
Culwell also stressed that Phexxi users must be willing to apply the product before every act of intercourse. For women seeking a “set it and forget it” option, like an IUD, this isn’t the best choice. Phexxi is sold in a box of 12 single-dose applicators, and the price will depend on an individual’s insurance coverage.
According to Pathy, this product is ideal for women in monogamous relationships who don’t want to use hormonal, long-acting or permanent birth control and who understand how to use it correctly.
CORRECTION : An earlier version of this article misstated that adverse reactions to Phexxi occurred in less than 2% of users. Adverse reactions occurred in greater than or equal 2% of users.
Does Phexxi Have Side Effects Or Drawbacks
One of the concerns with Phexxi is that it has to be timed an hour or less before sex, which can be hard to plan for. It may be easily forgotten and compliance may be far from perfect, Dr. Sekhon says. It is only 93% effective if timed correctly, so user error is a bit of a concern, though if you trust you’ll remember to use it before sex, it could be a good option.
There are also some physical side effects of Phexxi to know about. The most common side effects reported in clinical trials were vaginal burning and itching, Dr. Sekhon says. Less commonly, users might experience UTI. Male partners may also notice local discomfort , most of which are mild.
There have been a few cases of urinary bladder infection and kidney infection reported in clinical studies. Dr. Chambers says to avoid Phexxi if you have had repeated urinary tract infections or other urinary tract problems. Of the women who used Phexxi in studies, 1.6% discontinued the clinical trials because of an adverse reaction, per the drugs website.
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Birth Control Options For Women Who Can’t Use Hormones
Although they are popular, not every woman can use, or wants to use, the pill or other hormonal contraceptive for birth control.
- Some women cannot use hormones at all because of health reasons, breastfeeding, side effects or a host of other reasons.
- Some may only need occasional pregnancy protection and prefer not to use a full-time birth control method.
- Certain women prefer to avoid hormones in general based on personal beliefs.
There are several birth control options that do not contain hormones, that are effective if used correctly, and that are usually affordable, or even free.
What If You Cannot Use Hormonal Contraceptives
Some contraceptives work by using hormones that are similar to the hormones women produce naturally. These hormones are oestrogen and progestogen.
Contraceptives that contain these hormones arent suitable for some women, such as those who have medical conditions like breast cancer.
Not all contraceptive methods use hormones. Some work in other ways, including:
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Fda Approves New Hormone
Nearly all women use birth control at some point in their lives, and soon theyll have one more option available. On May 22, the U.S. Food and Drug Administration approved Phexxi, a non-hormonal contraceptive gel that works by keeping the pH levels in the vagina acidic, and thus inhospitable to sperm.
What makes this new option different? As mentioned, it will offer women a new non-hormonal option, so women who cant or prefer not to use birth control with hormones will have an alternative to condoms, the copper IUD, diaphragm or cervical cap. Its also an on-demand option, meaning it can be used as needed. The gel comes in an applicator and can be inserted just before sex.
In clinical trials, Phexxi was about 86% effective on average over seven menstrual cycles. Some women developed cystitis, pyelonephritis and other upper urinary tract infection , so its not recommended for women with a history of recurrent urinary tract infection or urinary tract abnormalities.
Expect to see this option available in September.
Alternative Contraception Methods That Address Birth Control Risks
One alternative to the above hormonal methods of birth control is a non-hormonal, copper IUD. This type of IUD relies on copper instead of hormones to prevent pregnancy. The birth control risks associated with this type of IUD include severe premenstrual cramps, heavy bleeding, and spotting between periods. You may also be more likely to expel this type of IUD if you have never been pregnant or suffer from heavy menstrual cramps.
There are also several more natural alternatives to consider.
Does Phexxi Have Any Side Effects Or Risks
According to the FDA, the following symptoms or conditions are listed as potential side effects of using Phexxi:
- Vaginal burning
- Pain when you pee
- Vulvovaginal pain
Phexxi isn’t perfect, and experts are particularly concerned about the 86% effectiveness. “It doesn’t give ideal contraception, so if you are going to be having frequent intercourse-and particularly if you are a young fertile woman-I would suggest speaking with your health care provider to get a more effective contraceptive,” Mary Jane Minkin, MD, a clinical professor of obstetrics and gynecology and reproductive sciences at Yale Medical School, tells Health.
There are non-hormonal birth control options that are more effective, Dr. Minkin says, like the Paragard IUD, which uses copper instead of hormones. “It gives them 99% effective contraception, has no hormones, and lasts for at least 10 years,” she says.
The side effects can also make Phexxi a less-than-ideal choice for some women. “Women prone to urinary tract infections or recurrent yeast infections should definitely check in with their doctor,” Dr. Wider says.
Overall though, Phexxi adds one more birth control option to the table for women, which is never a bad thing. “It’s a great addition for women who are seeking non-hormonal methods,” Dr. Wider says. And when more options are available, more women may use them to prevent pregnancy. As Dr. Levitt says: “Anything is better than nothing.”
Emerging Birth Control Options
Birth control is an ever-evolving area of study, and researchers are always testing new methods. Some of the newest contraceptives in the works are a redesigned female condom and hormonal male birth control.
Theres definitely options being looked at for male contraception, Dr. Plastino said. The problem is, to decrease sperm, you have to decrease testosterone. When you decrease testosterone, you also decrease male characteristics.
If you are thinking about starting birth control, talk with your healthcare provider about which option is best for you. Some methods are more effective at reducing your risk of pregnancy than others, and none are 100% effective. Keep in mind that only condoms reduce your risk of getting a sexually transmitted infection like HIV. All of the other methods have no reduction in STIs.
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Natural Methods Of Contraception
Natural methods or fertility awareness methods of contraception include rhythm, symptothermal, cervical mucus observation and basal temperature methods. They are based on you monitoring your bodily signs daily , such as changes to your bodys temperature and to your vaginal fluid. This is to determine when you are potentially fertile during your menstrual cycle.Practising natural methods of contraception requires you to abstain from sex when you could get pregnant. Depending on your menstrual cycle, you may need to abstain from sex for up to 16 days.Fertility awareness methods are not recommended in some circumstances for example if you:
- have a fever, vaginal infection or polycystic ovary syndrome
- regularly travel through different time zones
- are under stress.
The effectiveness of natural family planning varies, depending on which method or combination of methods is used.
How Effective Is Phexxi At Preventing Pregnancy Whats The Pregnancy Rate With Phexxi
When used as prescribed, Phexxi is an effective birth control option. According to the manufacturer, Phexxi may be up to 93% effective at preventing pregnancy when used correctly.
But when Phexxi is used incorrectly, the risk of pregnancy increases. One study found Phexxi to be 86.3% effective for preventing pregnancy. This study may have included results from participants who used the medication incorrectly.
Following your doctors instructions for using Phexxi may help the drug work more effectively. To learn more, see the How is Phexxi used? section below. Your doctor or pharmacist can also advise you on how to use Phexxi.
For more information about the effectiveness of Phexxi, talk with your doctor or pharmacist.
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How Do I Get Phexxi
You need a prescription to get Phexxi. You can get a prescription from a doctor or nurse at a doctors office, health clinic, or your local Planned Parenthood health center. In a few states, you can even get a prescription directly from a pharmacist. You may also be able to get a prescription through the Phexxi website.
You may be able to get Phexxi for low-cost or free if you have health insurance. To find out more about using health insurance to pay for Phexxi, talk with your nurse or doctor, or call your insurance provider . Phexxi also has a cost saving program that may be able to help you save money if you have private insurance .
If you dont have health insurance, you still have options. Your local Planned Parenthood health center may be able to help you get Phexxi for free or low-cost. You can also check out the Phexxi website for more information about the cost of Phexxi.
What Are The Pros And Cons Of Phexxi
Pros of Phexxi:
- Side effects are usually limited to the local/vaginal area.
- May be covered by insurance .
- Phexxi does not contain hormones .
- No need to remember to take pillscan be used as needed before intercourse.
Cons of Phexxi:
- Phexxi is not as effective as other methods of birth control.
- Phexxi does not protect against sexually transmitted infections.
- Some side effects may be bothersome.
- Patients with urinary tract infections or problems may not be able to use Phexxi.
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What Does Phexxi Cost
Costs of prescription drugs can vary depending on many factors. These include what your insurance plan covers and which pharmacy you use. To find current prices for Phexxi in your area, visit GoodRx.com.
If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. Or visit the Phexxi manufacturers website to see if they have support options.
You can also check out this article to learn more about saving money on prescriptions.
Like most drugs, Phexxi may cause mild or serious side effects. The lists below describe some of the more common side effects it may cause. These lists dont include all possible side effects.
Keep in mind that side effects of a drug can depend on:
- your age
- other health conditions you have
- other medications you take
Your doctor or pharmacist can tell you more about the potential side effects of Phexxi. They can also suggest ways to help reduce side effects.
Accessible Medication Containers And Labels
If its hard for you to read the label on your prescription, tell your doctor or pharmacist. Certain pharmacies may provide medication labels that:
- have large print
- use braille
- contain a code you can scan with a smartphone to change the text into audio
Your doctor or pharmacist may be able to recommend a pharmacy that offers these options if your current pharmacy doesnt.
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