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Phexxi: A new form of birth control you can use on demand
Phexxi is a contraceptive gel that doesn’t require planning, pills or injections. But you do need a prescription.
There’s no such thing as too many birth control options. And women now have one more that you may not have heard about. Phexxi is a prescription contraceptive gel that was approved by the Food and Drug Administration in May of 2020. You put the gel in your vagina right before having sex (or up to an hour beforehand). It prevents pregnancy by stopping sperm from reaching an egg.
Phexxi is hormone-free, unlike hormonal contraceptives such as pills or patches. The gel contains natural acids — specifically, lactic acid, citric acid and potassium bitartrate — that make the vagina less hospitable to sperm.
How does Phexxi work?
You insert a prefilled applicator of gel into your vagina (similar to using a tampon). Phexxi keeps your vaginal pH in the normal range of 3.5 to 4.5. (The pH scale is a way of describing how acidic a substance is.)
This is significant because when semen enters the vagina, it normally raises the vaginal pH level to somewhere between 6.5 and 7.2. That higher pH level allows sperm to swim up the reproductive canal to reach the egg and cause pregnancy.
By lowering your vaginal pH level, Phexxi makes it hard for sperm to move. This reduces the chance of pregnancy. The gel stays in your vagina while you’re having sex.
How effective is Phexxi?
With typical use, Phexxi is about 86% effective at preventing pregnancy. When it is used correctly and consistently, the effectiveness rate rises to 93%, says Lisa Rarick, MD. She’s an obstetrician-gynecologist in Chesapeake Beach, Maryland, and a board member of Evofem Biosciences, the company that makes Phexxi.
“It’s not as good as things such as IUDs (intrauterine devices), which are closer to 98% effective,” says Dr. Rarick. Phexxi is also less effective than hormonal contraceptives. “But a lot of women don’t like hormones or can’t use them, or they don’t want a long-acting method such as an IUD or implant.”
(P.S. Here’s how to know if your birth control plan needs an update.)
What else should I know about Phexxi?
Phexxi is a welcome contraceptive option because you can use it at a moment’s notice.
Here are a few other benefits, plus some precautions:
It’s a good alternative to spermicides. Phexxi is gentler than spermicides that contain nonoxynol-9, which kills sperm but can also irritate sensitive genital tissues.
“We know from studies in sex workers that frequent, daily use of nonoxynol-9 spermicides is associated with vaginal and genital irritation,” says Andrew Kaunitz, MD. He’s a professor of obstetrics and gynecology at the University of Florida College of Medicine — Jacksonville.
You need a new dose each time you have sex. For extra protection, you can use Phexxi with condoms or diaphragms (but not vaginal rings). But keep in mind that you must insert a new applicator every time you have sex.
Each dose of gel can only keep the vaginal pH level low enough to fend off sperm in one act of intercourse, Dr. Rarick says. You also need to insert a new dose if you wait more than an hour to have sex.
It could lead to urinary tract infections (UTIs). If you’re prone to recurring or frequent UTIs, you may not want to use Phexxi. It was associated with an increased risk of UTIs in clinical trials, Dr. Rarick says.
You might be itchy. In studies, Phexxi caused vulvovaginal burning in 18% of women and vulvovaginal itching in 14.5% of women. But most of these reactions were mild and didn’t cause the women to stop using the product.
Phexxi comes in a box of 12 prefilled applicators. It requires a prescription that you can fill at most brick-and-mortar or online pharmacies. It’s fully covered by most forms of insurance, which means you won’t pay any out-of-pocket costs.
Ready to switch up your birth control? Check out the options, including Phexxi, available from the Optum Store. Fill out a quick assessment and get contraception delivered right to your door. Start now.