Pros and Cons of the New Birth Control Gel

Perhaps you've seen the commercials touting the brand-new, on-demand, hormone-free contraceptive. Some people are excited about this development because it's been nearly two decades since the last contraceptive method approved by the Food and Drug Administration was placed on the U.S. market, the introduction of the NuvaRing in 2002—and because "new" usually translates to "better" in many people's minds.

But is new actually better?

How does birth control gel work?

Offered under the tongue-in-cheek brand name Phexxi, this new vaginal gel is composed of three active ingredients: lactic acid, citric acid and potassium bitartrate. Although it's in a different classification, the gel works similarly to a spermicide by keeping the vagina's pH acidic, preventing the mobility of alkaline-based sperm from reaching the reproductive canal. Ordinarily, sperm changes the vagina's pH to be more basic, providing a hospitable environment for egg attachment and increasing the likelihood of conception.

If you take birth control pills, you have to remember to take one every single day. The pill and other popular options such as an intrauterine device (IUD) or implant can cause unpleasant side effects for many women. Phexxil differs from hormonal birth control in that the process is short-acting. For women who worry about constant hormones or suffer side effects from popular birth control methods, this gel can be appealing. With it, all they have to do is insert the suppository one hour before sex and they're protected.

This short-acting birth control method also provides no downtime for women who might want to get pregnant relatively soon. IUDs and implants require removal and a waiting period until fertility returns to normal levels.

Sounds like a win-win resolution to the side effects of standard birth control methods, right?

The downsides

Unfortunately, this acid-based gel isn't a miracle problem-solver. For starters, it doesn't protect women from sexually transmitted infections (STIs) or diseases (STDs), so it's not a viable solution for people with multiple partners or who are otherwise at risk of infection. Some studies show it is about 86 to 92 percent effective, depending on the accuracy of the application. It offers less effective protection compared to the pill (98 percent) or the implant (99.5 percent).

You need a new application of Phexxi every time you have sex, regardless of how little time might elapse between encounters, which could be a hassle for those multiple-times-a-day occasions. The gel is effective for only an hour, and this short amount of time could affect foreplay and romantic buildup to intercourse. So if it's going to take you more than 60 minutes to get down to business, you will need to insert a new suppository.

On top of all of that, the price for a box of 12-applications of Phexxi will cost you a whopping $250 or more. Those 12 applications might not provide nearly enough coverage for some couples, considering you need one for each time you have sex, and there is a learning curve to the proper application of the gel.

The birth control gel is not without side effects. Possible complications include vaginal burning, itching, discharge and painful urination. Phexxi is not recommended for patients who get frequent urinary tract infections (UTIs) or yeast infections, which makes sense when you consider the gel changes vaginal pH level. Some of these symptoms have also been reported by male partners who come in contact with the gel, providing even further complications. 

Despite the potential downfalls, this birth control method could be effective and promising for the right candidates, and having many contraceptive options is great for providing more access to birth control. Overall, this addition to the contraceptive world provides further momentum and progress toward developments in female sexuality, a field that perpetually needs more scientific backing and awareness.