What You Need To Know About The New Hormone-Free Birth Control Phexxi

You’ve probably seen commercials and pop-ups for Phexxi, but what does it actually do and how does it work? Is it actually the new frontier of birth control, or just a lot of fluff with appealing marketing? Here’s what you need to know about Phexxi. 

The Claims

Phexxi’s ads cleverly market it as the “solution” to all your contraception problems. “Condom Cait” for example is tired of constantly relying on her man to supply her birth control. “The Pill Pia” is tied to a rigid schedule, not to mention damaging artificial hormones for her contraception. “Cycle Tracking Terra” won’t be able to have sex every day of her calendar as long as she’s ovulating (more on that later). 

When this commercial faced backlash for supposedly bashing all “women’s options,” CEO of Evofem Biosciences (which produces Phexxi) Saundra Pelletier explained, “The campaign was designed to highlight some of the compromises women may wrestle with in everyday life. There hasn’t been a new kind of birth control in decades…the brand’s goal is to empower women to be in control of their body, sex life, and pregnancy prevention.”

Phexxi helps your vagina maintain its acidic PH level, thereby incapacitating sperm motility.

These are apparently the only problems we’re facing when we examine the contraception market, and to be fair these problems are valid, but they don’t really tell the whole story. Phexxi’s advertising does touch on the superficial everyday problems we encounter with mainstream forms of birth control, but it fails to mention risks like hormonal birth control is tied to depression or IUD uterine wall perforation or expulsion, to name just a few (which would simultaneously help their marketing strategy and educate their target audience). 

One of Phexxi’s big crutches is that it’s not hormone-based. While this is nothing new to those of us not using traditional birth control, in this market that’s something unique. Think about how many ads and commercials we get every day for birth control, featuring huge celebrities like Vanessa Hudgens and other spokeswomen endorsing their product. Phexxi doesn’t have any of that because it’s hormone-free.

Phexxi, which was approved by the FDA in May 2020 and is described as a “vaginal gel” instead of a spermicide, contains three ingredients: lactic acid, citric acid, and potassium. Essentially, the gel combination helps your vagina maintain its PH level, thereby incapacitating sperm motility and preventing pregnancy. Dr. Karen Duncan, an Ob/Gyn from NYU, explains that our vaginal PH levels are naturally acidic, around 3.5 to 4.5 (with 0 being most acidic on a PH scale). When sperm enter, they temporarily make the vaginal PH more alkaline so as to help sperm motility. Phexxi keeps the vaginal PH acidic, thereby stopping sperm in their tracks. Sounds great — but is it actually effective? 

Pros and Cons

Phexxi comes packaged in a tampon-like applicator and is meant to be inserted 60 minutes to immediately before sexual intercourse, and has to be used before each and every sexual encounter to be effective. One applicator contains a 5 gram dose of the gel. The gel is ineffective when used after sex and doesn’t prevent sexually transmitted diseases or infections. 

Saundra Pelletier successfully raised $406 million to go towards Phexxi’s development, trials, and eventual FDA approval. Having been diagnosed with late-stage breast cancer, which she was told directly correlated to her having used hormonal birth control for nearly 20 years, she used her position as CEO of a pharmaceutical company to bring hormone-free contraception to the birth control market. “I really care about empowering women so that they have control and they don’t have to suffer from side effects if they don’t want to use hormones,” Pelletier said. 

The most common side effects include vaginal itching, burning, discharge, and infections. 

The convenience and effectiveness, coupled with the female-centered approach to contraception, is what Phexxi is banking on potential users wanting to take advantage of. But there are a few cons that women need to be cognizant of as well.

Phexxi can potentially cause bladder or kidney infections. The most common side effects include vaginal itching, burning, discomfort, discharge, and vaginal bacterial or fungal infections. UTIs are also common, especially if you’re prone to them. In addition to that litany of possibilities, Phexxi is about 86% effective when used typically, which means not always used perfectly. Based on those odds, it can fail for approximately 15 in 100 women. Condoms are statistically more effective than Phexxi, in addition to fertility-based awareness methods which are 99.6% effective when used correctly (a statistic which Phexxi didn’t give “Cycle Tracking Terra” a chance to explain). 

Is Phexxi Right For You?

I’m not a scientist nor a doctor so this might sound harsh — but as most of us know when it comes to pregnancy prevention, we can’t afford to take any chances. 86% efficacy is good, but it isn’t...great, especially when there are more effective safeguards out there. 

Part of adulthood and maturing is also realizing the price we pay for sex, not to mention the possibilities and potential consequences that are tied to sex. How’s this for paying for sex? Without insurance, women who choose Phexxi can expect to pay around $250-275 for only 12 doses, which works out to about $22 per dose, or $22 each time you have sex. Yikes. In comparison, a box of 12 condoms is around $5, and the fertility awareness method is free.

Phexxi is about 86% effective when used typically.

All that said, a woman’s contraception is completely up to her, and for once it’s nice to see a change from the hormone-laden choices we’re usually offered. I admire Pelletier’s vision for empowerment through contraception, though that depends on each woman’s goals and attitude toward body literacy (as well as their budget).

Closing Thoughts

Eye-catching advertising and convenience aside, hopefully most of us are aware that we shouldn’t be basing our crucial life decisions — birth control being one of the most important of all — on how appealing something may look.

Body literacy, first and foremost, is something we have to consider when making that decision. How will hormones or even something that’s “hormone-free” affect me? How will it affect my sex life? Will I be able to have mindful, meaningful intimacy if I’m constantly worried about my contraception? 

It might be a brave new world of birth control out there, but it’s also an overwhelming one. Just because something may look good on paper or in an ad is not the best of reasons to jump for it. Contraception that helps our long-term goals, not just our short-term ones, and an attitude of healthy desire and body literacy definitely are.

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