- Birth control
- Spermicide
- Prescription spermicide (Phexxi)
Prescription spermicide (Phexxi)
What is prescription-only spermicide (Phexxi)?
Phexxi is a prescription-only birth control gel that is similar to over-the-counter spermicides in how you use it, but it works a little differently. You insert Phexxi right before sex to prevent pregnancy. Phexxi works by keeping the pH inside the vagina within its naturally acidic (lower) pH range. Semen has a basic (higher) pH, which is the opposite of an acidic pH. Because sperm need a basic pH environment to function, keeping the vagina acidic makes it harder for sperm to move.
Phexxi is more effective at preventing pregnancy than over-the-counter spermicides.
Quick Facts
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Effectiveness
Prescription-only spermicide on its own, without a barrier method like a diaphragm or condom, is pretty effective the way most people use it. It is more effective than over-the-counter spermicide. Using it with a barrier method increases pregnancy protection.
Perfect use: 93% effective
Typical use: 86% effective
What are perfect use and typical use?
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Hormones
Spermicide is hormone-free.
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Side effects
Irritation or urinary tract infections are possible.
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Cost
Anywhere from $0 (with insurance) to around $32 per dose.
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STI protection
Prescription-only spermicide doesn’t protect against STIs.
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Ongoing effort
You have to apply a dose of spermicide before each time you have penis-in-vagina sex.
Phexxi may be right for you if…
Effectiveness at preventing pregnancy is NOT your top priority.
If you plan to use prescription-only spermicide by itself, keep in mind that it is not the most effective method of birth control out there. However, it is more effective than over-the-counter spermicide. Among those who use prescription-only spermicide perfectly, it is 93% effective at preventing pregnancy. That means that on average, seven out of every 100 people who use Phexxi correctly every time they have sex will get pregnant within a year.
However, the effectiveness of prescription-only spermicide with perfect use is based on the experiences of people involved in clinical trials who are using it perfectly for an entire year. Its effectiveness with typical use, which means how real people use it in real life, is going to be more relevant for most people. The effectiveness of prescription-only spermicide by itself with typical use, which means how real people use it in real life, is going to be more relevant for most people. When it’s used as people typically use it, prescription spermicide is 86% effective at preventing pregnancy. That means that, on average, 14 out of every 100 people using it for a year will get pregnant.
You don’t mind using it with another method to make it as effective as possible.
You can use Phexxi with diaphragms and cervical caps to increase its effectiveness, but if you use the ring you shouldn’t use Phexxi.
You just had a baby, and you’re providing milk.
Phexxi is safe to use after you’ve given birth. It’s also safe to use if you’re providing human milk through breastfeeding, chestfeeding, or expressing milk.
You want birth control without hormones.
Phexxi doesn’t affect your hormones at all.
You’re willing to put in some effort before having sex, every single time.
In order for it to be effective, you have to insert Phexxi before you have sex—not after—and you need to insert a new dose each time before your partner ejaculates. You also need to insert a new dose if it’s been one hour since you inserted it, you are still having sex, and your partner is still going to ejaculate.
You’re comfortable touching your body.
Phexxi comes with an applicator, so inserting it is a lot like putting in a tampon or an over-the-counter yeast infection medication.
You aren’t looking for STI protection, or you’re okay with combining over-the-counter spermicide with another method.
Phexxi doesn’t offer any STI protection. So if that’s something you’re looking for, you can use condoms or internal condoms along with it. Dental dams and/or gloves also offer STI protection, depending on what kind of sex you’re having. You may also want to consider PrEP (pre-exposure prophylaxis), which is a daily pill or an injection you can get every two months to decrease your risk of getting HIV.
You want a method that won’t affect your future fertility.
Phexxi does not affect your ability to get pregnant once you stop using it. In fact, it’s only effective at preventing pregnancy for one hour after inserting it and each dose is only effective for one ejaculation.
You don’t mind a method that requires seeing a health care provider (in person or online).
Unlike over-the-counter spermicides, which are available without a prescription, you do need a prescription to get Phexxi. You will have to see a provider in person or via telehealth in order to get it.
You don’t have any of these risk factors.
You shouldn’t use Phexxi if you have a history of recurrent urinary tract infections (UTIs). Phexxi can increase the chances of getting a UTI.
How do you use Phexxi?
Phexxi is a birth control method that you use every time you have sex. Phexxi comes in packages of 12 individually wrapped, pre-filled applicators containing one dose of Phexxi each.
Before sex, follow these steps to use Phexxi by itself (without another form of birth control):
- Wash your hands with soap and water.
- Insert one whole dose of Phexxi deep into your vagina using the applicator that comes with it.
- Insert another dose of Phexxi if:
It’s been more than an hour since you inserted it, and you’re still having sex (meaning that your partner has not ejaculated yet but is going to).
Your partner has ejaculated, and you’re going to have sex again, even if it’s still within an hour of using a dose of Phexxi. You need another dose of Phexxi before each time your partner ejaculates inside your vagina or on your vulva no matter how long it’s been since your last dose.
There are different steps to follow if you’re using spermicide with a diaphragm or a cervical cap.
How much does Phexxi cost?
With insurance
If you have health insurance—whether it’s from work, school, your parents, the ACA marketplace, Medicaid, or elsewhere—chances are good that you’ll be able to get Phexxi with no out-of-pocket cost.
Without insurance
If you don’t have insurance, or you’re on a plan that doesn’t cover birth control, Phexxi can cost up to $389 out of pocket for a box of 12 one-time use, pre-filled applicators. If you need help covering the cost, Phexxi offers a savings program that may lower the price.
What are the side effects and benefits of Phexxi?
There are positive and negative things to say about each and every method. And everyone’s different—so what you experience may not be the same as what someone else experiences.
The Positive
There are lots of things about birth control that are good for your body as well as your sex life. Here are some of the benefits of prescription-only spermicide:
- Doesn’t affect your hormones
- Can be used while breastfeeding
- More effective than over-the-counter spermicides
The Negative
It’s normal to worry about negative side effects, but for many people, they’re not a problem. Potential side effects include:
- Might cause some irritation if you’re sensitive
- Can increase your chances of a yeast infection, bacterial vaginosis, and urinary tract infection
In addition to possible side effects, there are some disadvantages to using Phexxi:
- Can leak out of your vagina and be messy
- Have to remember to use it every time you have sex
- May interrupt the moment to stop and insert it
Where can you get Phexxi?
You need a prescription to get Phexxi. Visit a health care provider in person or use telehealth to get a prescription online. You can also visit Phexxi’s website for a telehealth visit.
We can help you find an in person provider or online birth control delivery service.
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