Most sexually active people have used some form of birth control, whether it's the natural birth control method, condoms, oral birth control, or an IUD. We're lucky to have a lot of options in 2020, but some of them—especially those that use hormones to prevent pregnancy—can lead to not-so-great side effects like spotting, nausea, breast tenderness, headaches, loss of libido, and potentially more dangerous implications like blood clots. Others, like the natural birth control method, can lead to unwanted pregnancies if you're not super careful or if your cycle is off for a few months.
Any OB/GYN will probably be the first to tell you the best birth control option is the one that works best for you and your body, but there's an exciting new innovation in the world of contraception. It's called Phexxi, and it's a new FDA-approved, hormone-free contraceptive gel. But how does Phexxi work, exactly? And how effective is it? We asked Dr. Charis Chambers, board-certified OBGYN and women’s health expert, known as “The Period Doctor,”
What Is Phexxi and How Does It Work?
Phexxi is a birth control gel meant for use on an "as-needed" basis. It resembles spermicide, but it works by maintaining a vaginal pH that make it inhospitable to sperm. The idea is before you have sex, you apply Phexxi to your vagina, and it will prevent sperm from being able to swim up your reproductive tract and fertilize the egg.
But how is Phexxi applied, exactly? "Phexxi is self-administered using an applicator, similar to a tampon, that is easy to use in the moment and must be applied either immediately before sex or any time up to one hour before each act of sex," explains Dr. Chambers. "If you don’t have sex within the one hour of applying Phexxi or if you have sex more than once within that hour, you’ll need to use a new pre-filled applicator for each act."
As long as you use Phexxi as directed, it's pretty effective — although not quite as effective as oral birth control, which is 99% effective if you use it perfectly. "Phexxi was 86% effective at preventing pregnancy with typical use and 93% effective at preventing pregnancy when used as directed in clinical trials," Dr, Chambers explains. "Typical use includes those women who did not correctly adhere to the instructions for use."
Meet the Expert
Do You Need a Prescription for Phexxi?
Unfortunately, you can't walk into your local CVS and grab a tube of Phexxi. Like oral birth control or an IUD, a doctor needs to prescribe it—but Phexxi has options that make it easy. "Women can secure a prescription either through their healthcare provider or through Phexxi’s telehealth platform," explains Dr. Chambers. "If you're interested in speaking with a nurse education specialist, Phexxi offers a concierge service on their website that can connect you to someone directly."
Does Phexxi Have Side Effects?
Phexxi does have a few side effects: Some reported vaginal burning, itching, yeast infection, UTIs, vaginal area discomfort, bacterial vaginosis, and vaginal discharge. Some also reported genital discomfort and pain while urinating, and some partners reported genital discomfort as well. If you have a history of repeated UTIs it might be best to find a different form of birth control, as in one known case a UTI that developed after a woman used Phexxi became serious.
Who Should Try Phexxi?
If you're looking for a new birth control option, there's no reason not to give Phexxi a shot. While some have experienced side effects, side effects come with most forms of birth control. "We’re now seeing people start to explore moving away from more traditional hormonal forms of birth control that require daily use or long-term device implantation," Chambers says.
Again, if the birth control method you're using now works for you, you should feel fine about continuing down that path—Phexxi simply gives you another option. "Hormonal methods are still very vital to women who need them," Chambers notes. "They can help manage certain medical condition, and some women simply use them based on their personal preference."