A Hormone-Free Birth Control Option Is Finally Here

Presented by Phexxi™

When it comes to finding the right birth control, we have to always remember to put our health first. For a lot of us, finding the right BC leads to ongoing trial and error and, quite frankly, settling is what we are used to doing. Let’s face it, not all of us want to be taking hormones and it can be frustrating to cycle through multiple birth control options and still not find the right fit for our specific and unique needs. Now, there’s a hormone-free birth control option that you use only when you need it—it’s called PhexxiTM (lactic acid, citric acid, and potassium bitartrate) Vaginal Gel 1.8%, 1%, 0.4%. Phexxi is a contraceptive gel that is FDA-approved AND hormone-free. We sat down with the founder of The Period Doctor, Charis N. Chambers, M.D., to discuss how Phexxi works, its benefits, challenges, what we should consider when choosing a birth control, and why it’s important to have a lot of options.

How Does Phexxi Work? How Is This Different From The Way Other BCs Work?

Dr. Chambers says, “Phexxi is a first of its kind, FDA-approved, hormone-free, female-controlled prescription contraceptive vaginal gel.” It’s a pH modulator, which means it works by maintaining the vaginal pH so that it stays at a level that is inhospitable to sperm (within 3.5 to 4.5). She explains, “Without Phexxi, when semen enters the vagina, the pH in the vagina increases, which allows sperm to remain mobile and make their way up the reproductive tract and fertilize the egg.” Phexxi works by maintaining the natural acidic state in a woman’s vagina that reduces sperm mobility and decreases the chance it will get to an egg to fertilize it.

As we all know, the most effective birth control is whichever method you’ll stick to. Phexxi is different than other birth control methods because it’s hormone-free and you only use it when you’re actually having sex (more on that in a sec).

Why Is It Important For There To Be Multiple Available BC Options?

Simply put, Dr. Chambers says, “Women deserve more. The last major hormone-free innovation in the contraceptive market was in the early ’90s with the female condom.” Wow, I feel old. She says that Phexxi is “an important step forward in women’s health as it offers women control over how they choose to prevent pregnancy.”

She adds, “It is important for women to understand what they are putting in their bodies, and the potential outcomes and side effects associated with their birth control. Women should not have to settle when choosing a birth control option that is right for them.” Dr. Chambers says it’s worth noting that Phexxi will feel different to everyone. While the most common side effects are vaginal itching, burning, and yeast infections, most of these were mild to moderate and less than 2% of patients who participated in the clinical trials of Phexxi discontinued use because of side effects. Some male partners reported local discomfort.

How And When Do You Use Phexxi?

Dr. Chambers explains, “Phexxi is easy to use and works immediately, which I know so many of my patients will love! The gel is self-administered through an applicator that is inserted similar to a tampon applicator.” The easy part is that you only use it when you actually need birth control, aka when you’re about to have sex. The only catch: Phexxi is only effective when used before sex, but luckily it works immediately and can be used up to an hour before sex. If you don’t have sex within an hour of using it, or you have sex multiple times in that hour, you’ll need to apply it again. Also note, Phexxi is not effective when used after intercourse and is not approved to protect against STIs, including HIV.

Who Is Phexxi A Good Option For?

If you’ve tried a bunch of birth control methods and still feel like you’re settling, or you no longer want to use hormonal contraceptives, Phexxi may be a good fit for you. Maybe you prefer using birth control in-the-moment vs. ingesting or implanting something in your body, or maybe you are in between pregnancies and looking for an easy-to-use option –whatever the case may be, Phexxi could be a good birth control option since it gives you contraceptive control on your terms. You may want to visit Phexxi.com to learn more and talk to your healthcare provider to see if Phexxi is right for you.

Who Should Not Be Using Phexxi?

While Dr. Chambers says, “Phexxi is appealing to a lot of women who are looking for a contraceptive option that is safe, effective, convenient and easy-to-use,” she acknowledges that it may not be right for women who are “allergic to any ingredients in Phexxi, or who require protection against STIs and HIV.” Dr. Chambers also says you should tell your health care provider if you have a recent history of three or more urinary tract infections per year.

What Are The Challenges—If Any—Of Taking Phexxi?

“It’s important that women using Phexxi remember that Phexxi has to be administered before each act of vaginal intercourse, immediately before or up to one hour before, and that it does not work if used after sex,” Dr. Chambers says. So basically, you can’t get too caught up in the moment that you completely forget to take it.

What Else Should Women Consider When Choosing A BC?

Dr. Chambers says, “I always say the best birth control is the one that you will actually use, so with my patients, I always try to understand what their routine and preferences are. Some birth control requires daily use, like the pill, or you have long-acting reversible contraceptives like the IUD or implant, which is the most effective because they completely remove factors like human error. But many of my patients tell me they don’t want to take birth control every day since they’re not having sex every day – they want birth control on their terms and to only use it when they actually need it.”

She also recommends you address access and insurance coverage with your doctor when discussing birth control options. And if you are only seeing your doctor through telemedicine, no problem—Phexxi has partnered with an exclusive telemedicine service that you can access directly from their website to get a Phexxi prescription.

What Is One Last Thing You Want Women To Know?

Dr. Chambers reiterated, “Women should not have to settle when trying to find a birth control option that fits their needs. I want women to know that when it comes to their reproductive health, there are options out there for those who seek them. It is important that you advocate for your health and wellbeing. If you are one of the 21 million women who have decided not to use hormonal birth control, well I want you to know that you deserve better.”

Talk to your doctor and visit Phexxi.com to learn more about this hormone-free option.

This article is sponsored by Phexxi. Please see the full prescribing information for Phexxi. Please report side effects by contacting Evofem Biosciences® toll-free at 1-833-EVFMBIO or contact FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.


Phexxi is a trademark owned by Evofem Biosciences.

8 Hormone-Free Birth Control Methods For People Who Hate The Pill

Back in my late teens and early twenties (f*ck, I’m so old), I tried four different birth control pills. No matter which pill I was on, I kept feeling like a raging bitch with zero control of my emotions, getting killer headaches, and gaining a bunch of weight from being super bloated all the time. The pill definitely helped to manage my ovarian cysts and keep me from getting pregnant, which is great, but I don’t plan on going back on it ever again because of how negatively it impacted my mental and physical health.

So WTF do I do now to not get pregnant and die? Nothing! JK. I’ve been using a combination of condoms and the calendar method via a fertility tracking app (shout out, Clue), which works well, as long as you know when you are and aren’t ovulating. Although my flow is heavier without hormonal birth control, I feel my (painful) ovulation, my cramps feel like a baby monster is crawling its way through my reproductive system, and my cysts are pretty bothersome every month now, I’ve felt SO much better, in control of my feelings, and like myself again. 10/10 would recommend ditching the pill and doing the same (health permitting, of course).

Don’t get me wrong. Just because hormonal birth control pills didn’t work well for me doesn’t mean they aren’t going to work for you. They’re a super popular BC method for a reason. When you actually remember to take them (endless thanks to phone alarms), birth control pills with estrogen and progesterone, or just progesterone, can help suppress ovulation, regulate abnormal cycles, reduce acne, decrease heavy flows, and manage ovarian cysts from PCOS. They’re easy to take and can also be pretty cheap depending on your insurance, which is why it’s traditionally the go-to BC method. “For young women who aren’t ready to have a child and would like to decrease the risk of having certain types of cancers, prevent unwanted pregnancies, the use of birth control pills is probably the best option. When ready for pregnancy, pills can be stopped and pregnancy can be attempted without any delays,” says Aykut Bayrak, MD, fertility specialist and founder and Medical Director of LA IVF, a group of fertility clinics in Southern California. 

HOWEVER, there *might* be some ugly side effects if this is your main method, which I experienced first-hand for a few years. Let’s just jump right into the worst of it. According to Kecia Gaither, MD, MPH, FACOG, double board-certified in OB/GYN and Maternal Fetal Medicine, Director of Perinatal Services at NYC Health + Hospitals/Lincoln, using oral contraceptive pills (OCPs) long-term may increase risk of breast or cervical cancer (but decrease risk of uterine, ovarian, and colorectal cancer!) and may increase liver tumor formation (which is rare). Greattttt. On another note, Bayrak says the short-term cons may include headaches, irregular bleeding, bloating, spotting in the first few months, irritability, mood swings, and increased risk of clotting. “Most side effects tend to decrease or disappear after a few months or can be managed by trying different brands that can typically have a different dose and combination of hormones,” he adds. 

All this is to say that if you’re not loving how you feel on the pill and want to switch to a non-hormonal birth control, there are options out there! Here are eight popular non-hormonal birth control alternatives and each of their effectivity rates.

IUDs (99% effective)

Don’t wanna be pregnant for a while? Don’t mind undergoing a quick procedure? Gaither says that an IUD can last about 10 whole years. “An intrauterine device (IUD) is a highly effective, non-hormonal method where a T-shaped small device is placed inside the uterus which prevents pregnancy at a rate of 99%,” adds Bayrak. He notes that it can cause cramping and some irregular bleeding on the short run, but it’s generally well-tolerated in the long run. TBH, I’ve heard both horror stories and happy endings from friends who’ve had IUDs, so beware of the pros and cons before getting one. And, to be clear, there are IUDs that use hormones, so I’m specifically talking about the copper one here.

Condoms (98% effective)

“Condoms are the worsttttt. They remove all feelingggg” –f*ckboys everywhere 

Suck it TF up. Condoms are a great alternative to taking that damn pill every day. “Condoms are recommended for all women who do not have a steady partner to avoid pregnancy and sexually transmitted diseases,” says Bayrak, adding to keep in mind that they must be used from the BEGINNING of intercourse until AFTER ejaculation occurs to avoid pregnancy and STD exposure. (Meaning, no, f*ckboys everywhere, you can’t just use it for the first few strokes and call it effective.) Condoms are highly effective (98%!) when used properly. Just always check for holes, tears, or package defects before using. 

Diaphragms (80-95% effective)

The only time I’ve ever seen a diaphragm was in 8th grade health class. Like, I’ve never known anyone under the age of 50 cop to using one. But apparently they’re super effective, so joke’s on us. “Diaphragm is a highly effective barrier contraceptive method when used properly, but not so much popular any longer due to difficulty of use and placement,” says Bayrak. On that note, they’re user-dependent so their effectiveness ranges from 80-95%. Gaither clocks in the average effectivity rate at 94%, though. Plus, I saw a tip once (not a d*ck joke) where you can cut a condom to create a diaphragm at any time, so this might be a good idea… just saying.

Permanent solutions (99% effective)

If you already have kids and don’t want any more, or if you know for certain that you will never ever want kids, there’s a permanent birth control method for that. “Tying of the tubes (tubal ligation) or interruption of the male tubes called vasectomy are highly effective methods,” says Bayrak. 99% effective, to be exact. Remember, this is a PERMANENT option so there’s no going back after you do it. But if you’re absolutely sure kids are not in the cards for you, it’s an option.

According to Gaither, other non-hormonal contraceptive options include cervical cap + spermicide (failure rate 14-29%), spermicides (failure rate about 25-28%), sponges (80-91% effective), and family planning (75-88% effective). Just remember that certain methods (like calendars and IUDs) don’t protect against STIs, so be careful and always use the right forms of protection where necessary. And as with any type of BC option, she reminds that “it’s best to consult with your health provider as some pre-existing conditions may preclude the administration of certain types of contraceptives.” May the healthiest odds of preventing pregnancy be ever in your favor.

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