Prescription vaginal gel (Phexxi)

Effectiveness at preventing pregnancy is NOT your top priority.

If you plan to use prescription-only vaginal gel 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 vaginal gel 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 vaginal gel 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 vaginal gel 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 vaginal gel 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 prescription-only vaginal gel 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 is 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.