Everything You Need to Know About Phexxi, the New Hormone-Free Birth Control
Birth control has come a long way since it was first introduced in the 1960s. From the pill to the IUD to the patch to the Depo-shot, there are so many options available, including the latest to hit the market: Phexxi, a hormone-free vaginal gel. According to Phexxi's website, the on-demand revolutionary contraceptive works by inserting a pre-filled applicator into the vagina—very similar to a tampon. Once comfortably inside, simply push the plunger rod to release the gel, as you would a tampon. That's all there is to it!
Like all birth control, Phexxi comes with its own set of rules. For example, the gel is only applicable if inserted right before having sexual intercourse. Meaning, if you insert the gel but don't have sex within the following 60 minutes, you'll need to apply again.
Birth control sans the hormones? Sounds too good to be true, no? HelloGiggles spoke with three OB-GYNs to break down everything there is to know about Phexxi, and whether or not they recommend it.
How does Phexxi work?
According to Phexxi's website, the hormone-free gel works by using a combination of lactic acid, citric acid, and potassium bitartrate to manipulate your vaginal pH. This means the sperm won't have the vigor and motility to travel or "swim" from the vagina into the cervix, thus decreasing your chances of unplanned pregnancy. To put it in layman's terms, sperm thrive in pH environments that are higher than 4.5, so by tricking your vaginal pH to stay between 3.5 to 4.5, the vaginal gel suppository is immobilizing the sperm from taking the next step, Megan Gray, MD, FACOG, a board-certified OB-GYN in Florida, explains to HelloGiggles. It should also be noted that Phexxi is not a spermicide.
How effective is Phexxi? Oh, and are there side effects?
"Based on data from clinical trials, Phexxi used on its own (versus in combination with another method) appears to be slightly more effective than spermicide and internal (female) condoms, and slightly less effective than external (male) condoms," says Erica Montes, MD, FACOG, a board-certified OB-GYN in Arizona.
She went on to explain that with a typical (meaning not always used correctly) efficacy rate of about 86 percent, the vaginal gel suppository can fail in about 15 out of 100 women. For reference, male condoms are 98 percent effective, birth control pills are 99 percent effective, and IUDs are more than 99 percent effective. Of course, these statistics are only accurate when the contraceptives are thoroughly used correctly.
Safety-wise, Phexxi is a secure gel contraceptive. The website states that "less than two percent of women stopped using Phexxi because of side effects." Some of those were vaginal itching, vaginal yeast infection, UTI, vaginal discomfort, and discharge.
Do OB-GYNs recommend Phexxi?
To cut to the chase, yes. All the doctors we spoke to recommend the contraceptive; however, it comes with an asterisk of additional information you should keep in mind prior to obtaining a prescription. The biggest one being that Phexxi does not (I repeat, does NOT) protect against STDs (HIV, chlamydia, herpes, gonorrhea, etc.). Likewise, Dr. Montes advises those who have a history of repeated UTIs or other urinary tract problems should not use Phexxi. The same goes for those who have a vaginal ring.
"Phexxi is perfect for sexually active women who are not ready to grow their family and have contraindications to or a personal preference against hormonal or long-acting birth control, but would rather not use male or female condoms," says, Ruth Arumala, DO, MPH, FACOG, a board-certified OB-GYN and gynecologic surgeon in Texas.
However, she also stressed that Phexxi has a human element to its effectiveness. Because of this, it may cause more stress than ease for those who are sexually active. Which is why Dr. Gray recommends using Phexxi in combination with another form of contraceptive such as a male condom. If you are on hormonal birth control, she assures Phexxi can also be used with the pill or Depo-shot.
Generally speaking, using Phexxi alone is not the best option if you're currently not trying to start a family. On the contrary, if you're trying to prevent but would be prepared for pregnancy if there was a failure (i.e. you're coming off the pill and looking to start a family relatively soon), Phexxi is more than an acceptable option, Dr. Gray says.
Are there other alternatives to Phexxi?
Phexxi is the only on-demand, FDA-approved hormone-free gel available on the market. Though, there are other hormone-free options like Nonoxynol-9, which isn't as promising as it has a higher incidence of vaginal irritation, resulting in a possible increased risk for STIs, according to Dr. Gray. "These types of vaginal contraceptive film (VCF) or spermicide products kill sperm rather than change the vaginal environment and can be less effective in pregnancy prevention," Dr. Arumala further clarifies.
Where can I buy Phexxi?
Phexxi is only accessible via prescription, which can easily be taken care of by your OB-GYN or via Telehealth. Those interested in the latter will need to fill out a short and fast medical questionnaire, which will then virtually connect you with a board-certified doctor. It's like visiting the doctor's office without ever leaving your couch.
Forbes reported that paying for Phexxi out of pocket—aka without insurance—can cost you anywhere from $250 to $275 per box. (One box comes with 12 pre-filled applicators.) The company does however offer a Phexxi Savings Program and it can potentially cut the cost down to only $30 per month if eligible.
We know that was a lot of information thrown at you. So, what's the general consensus? Phexxi is a positive, safe form of contraception, but do proceed with caution. As with other methods of barrier protection, there's a risk for unplanned pregnancy or STDs. Just like how a condom can break, the gel may not hold up its side of the bargain. Be sure to thoroughly follow directions, and if you are concerned or have more questions, do not hesitate to reach out to your doctor. You got this!