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The Gel

The birth control gel is one of the newest methods of non-hormonal contraception. It was approved just this year under the brand name Phexxi. The gel does NOT protect against sexually transmitted diseases (STDs).

How does it work?

The gel consists of citric acid, lactic acid, and potassium bitartrate. Together, they work by maintaining a vaginal pH within the normal range of 3.5-4.5. This is too acidic for sperm, which are then unable to mobilize and fertilize an egg.

How well does it work?

With ideal use, the gel is expected to be 93% effective, but with typical use, the effectiveness can drop down to 86.3%.

How do I use it?

The gel comes inside an applicator which dispenses it inside your vagina. Apply it within one hour before sex every time. Even if you did not have sex within an hour of applying the gel, you will still need to apply it again for sex after that hour. It can be used during your period and with other birth control methods, like condoms and the pill, but it cannot be used with the ring.

Isn’t it basically a spermicide?

It is understandable to think of the gel as a new type of spermicide, but it actually works differently. The gel works by keeping the vagina acidic, while spermicides block the cervix and immobilize sperm in other ways. Most spermicides contain the chemical nonoxynol-9, which can be harmful to patients with a high risk of HIV infection or other STDs. The gel Phexxi contains ingredients that are safe enough to use as food additives.

What are some side effects?

The most common complaint of the gel is local discomfort like burning and itching in both partners. Urinary tract infections (UTIs) and other infections may also happen.

Is it right for me?

The gel is worth considering if your body is sensitive to hormonal contraceptives, but don’t use it if you are allergic to any of its ingredients. Caution should be taken if you have a recent history of UTIs. Don’t use the gel if you use the ring. You should also not use the gel if you or your partner have broken skin in the groin area as this could make local discomfort worse.

Is it available?

The gel Phexxi is the first of its kind, and it was approved by the FDA in May 2020. It will become available by prescription in September 2020.