A different nonhormonal birth control option


Till not too long ago, individuals looking for hormone-free contraception have discovered few choices accessible. The best and long-lasting nonhormonal possibility is the copper intrauterine system (IUD). Barrier strategies (condoms, diaphragms, cervical caps, or the sponge) generally are paired with spermicide to spice up being pregnant prevention charges, or spermicides could also be used alone (a much less efficient selection). Apps and assessments to trace fertile days convey a high-tech sheen to the so-called rhythm methodology, however most ob/gyns don’t suggest these as a technique to stop being pregnant.

Not till 2020 did the FDA approve a brand new nonhormonal contraception, Phexxi, which got here in the marketplace final fall. Do you have to attempt it for those who’re searching for a brand new possibility?

How does it work?

Phexxi is a contraceptive gel consisting of three energetic elements: lactic acid, citric acid, and potassium bitartrate.

To know the way it works to assist stop being pregnant, let’s return to the acids and bases of highschool chemistry class. The vagina is of course acidic, with a pH round 4. Semen is primary, with a pH round 7.5.

Usually when semen enters the vagina, it quickly causes the pH to turn into extra primary to make sure the survival of sperm. Nonetheless, the three elements within the gel hold the vagina acidic. This helps immobilize sperm to maintain them from swimming up the vaginal canal and thru the cervix (the opening to the uterus) to succeed in and fertilize an egg. The gel additionally coats the cervix, which can stop sperm from reaching the uterus.

How do you utilize it?

You insert the gel into the vagina utilizing a prefilled applicator much like the dimensions and form of a tampon. The gel works instantly or lasts for as much as an hour, though you need to use a separate dose every time you may have penis-in-vagina intercourse. So, in case you have intercourse this fashion twice inside an hour, you’ll use two separate prefilled applicators.

The gel adheres to the vaginal partitions and the cervix in order that it stays in place.

Is it a spermicide?

No. Spermicides (gel, cream, foam, and extra) depend on elements that particularly goal sperm, immobilizing or killing them. The Phexxi gel makes use of elements that make the setting within the vagina acidic, which immobilizes sperm.

How efficient is one of these contraception?

FDA approval for this product relies on a multisite research that enrolled sexually energetic ladies ages 18 to 35 (71% recognized as white, 24% as Black or African American, and a couple of.5% as Asian). Ladies who participated had common menstrual cycles and a single male accomplice. They agreed to only use Phexxi for contraception — aside from morning-after, emergency contraception, if essential — and interact in heterosexual intercourse at the very least thrice throughout every cycle all through the research.

Outcomes collected over seven cycles present that just about 14% of 1,183 ladies who accomplished the research grew to become pregnant.

Total, the efficacy fee of Phexxi is 86% for typical use. (Efficacy exhibits how nicely a product works throughout a managed research; in real-life circumstances, precise effectiveness could also be decrease.)

Phexxi will be mixed with another types of contraception to extend the percentages of stopping being pregnant. In contrast with different nonhormonal contraception strategies (be aware: automated obtain) it appears to be more practical at stopping being pregnant than withdrawal; pure household planning; barrier strategies reminiscent of condoms (if used alone) and diaphragms; and most spermicides (if used alone). Nonetheless, as a nonhormonal possibility, the copper intrauterine system is way more practical.

What about uncomfortable side effects?

  • The most typical facet impact is irritation of the vulva and vaginal space, reminiscent of a burning or an itching sensation. Practically a 3rd of ladies reported one among these signs.
  • Lower than 1% of ladies had extra critical uncomfortable side effects, reminiscent of extreme urinary tract an infection. (Phexxi will not be really helpful for ladies who’re vulnerable to recurrent or extreme urinary tract infections.)
  • Practically 10% of male companions reported some itching, burning, or ache as nicely after their accomplice used Phexxi.

Phexxi can not stop sexually transmitted infections (STIs), so ladies ought to proceed to make use of condoms to stop STIs.

The underside line

It is a good possibility to contemplate if you wish to keep away from hormonal contraception, desire to not use an IUD, and are keen to make use of the gel constantly inside an hour of intercourse — each time. In accordance with accessible data, 14 out of 100 ladies get pregnant in a 12 months of use. Its effectiveness is much like or higher than barrier strategies like condoms, diaphragms, and cervical caps, and the standard fee for spermicide use alone.

The copper IUD is a much more efficient nonhormonal possibility: fewer than one out of 100 ladies get pregnant in a 12 months of use.

See the Harvard Well being Beginning Management Middle to search out extra choices that may work nicely for you.

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