When Phexx Isn't Available, What Are Your Options?

Phexx is the only hormone-free, on-demand prescription contraceptive gel on the market — and that uniqueness is both its strength and its challenge. If you can't fill your Phexx prescription because your pharmacy doesn't stock it, insurance won't cover it, or you're looking for a different approach, there are other non-hormonal contraceptive options worth considering.

Before switching, we recommend trying to find Phexx first. Check out our guides on how to find Phexx in stock near you and how to save money on Phexx. But if you need an alternative, here's what's available.

What Is Phexx and How Does It Work?

Phexx (lactic acid, citric acid, and potassium bitartrate) is a vaginal gel that prevents pregnancy by maintaining the vagina's naturally acidic pH (3.5 to 4.5) even after semen enters, which normally raises pH and allows sperm to swim. By keeping the pH low, Phexx reduces sperm motility and makes it much harder for sperm to reach and fertilize an egg.

Key features of Phexx:

• Hormone-free — no systemic hormonal side effects
• On-demand — used only when you need it (0-60 minutes before intercourse)
• 93% effective when used as directed; 86% with typical use
• Prescription required

For a deeper dive, see our post on what is Phexx and how Phexx works.

Alternative #1: Copper IUD (Paragard)

The copper IUD is the most effective hormone-free contraceptive available. It's a small T-shaped device placed in the uterus by a healthcare provider and can prevent pregnancy for up to 10 years.

How it works: The copper creates an environment toxic to sperm, preventing fertilization. It also changes the uterine lining to prevent implantation.

Effectiveness: Over 99% effective — one of the most reliable methods available.

Pros:

• Hormone-free and long-lasting (up to 10 years)
• Set it and forget it — no daily or per-use action needed
• Can be used as emergency contraception if inserted within 5 days of unprotected sex

Cons:

• Requires a healthcare provider to insert and remove
• May cause heavier periods and more cramping, especially in the first few months
• Not on-demand — it's a long-term commitment
• Upfront cost can be $500-$1,000 without insurance (though often covered under ACA)

Best for: Women who want reliable, long-term, hormone-free protection and don't mind an insertion procedure.

Alternative #2: Condoms (Male and Female)

Condoms are the most widely available non-hormonal contraceptive and the only method (besides abstinence) that also protects against sexually transmitted infections (STIs).

How they work: Physical barrier that prevents sperm from entering the vagina (male condoms) or lines the vagina to block sperm (female condoms).

Effectiveness: 87% effective with typical use for male condoms; 79% for female condoms.

Pros:

• Available over the counter — no prescription needed
• Protect against STIs including HIV
• Inexpensive (often free at clinics)
• On-demand, like Phexx

Cons:

• Must be used correctly every time
• Can reduce sensation for some users
• Latex allergies may be an issue (non-latex options available)

Best for: Anyone who wants on-demand protection with the added benefit of STI prevention. Note: Phexx does not protect against STIs, so condoms offer an important advantage in that area.

Alternative #3: Diaphragm With Spermicide (Caya)

The Caya diaphragm is a reusable silicone barrier that covers the cervix and is used with spermicide to prevent pregnancy.

How it works: The diaphragm physically blocks sperm from reaching the cervix while the spermicide immobilizes sperm.

Effectiveness: 83% effective with typical use when used with spermicide.

Pros:

• Hormone-free and reusable (lasts up to 2 years)
• Can be inserted up to 2 hours before intercourse
• One-size-fits-most design (Caya doesn't require a fitting)

Cons:

• Must be used with spermicide for effectiveness
• Must be left in place for 6 hours after intercourse
• Requires a prescription
• Spermicide (nonoxynol-9) may cause irritation

Best for: Women who want a reusable, hormone-free barrier method and are comfortable with insertion.

Alternative #4: Over-the-Counter Spermicides

Spermicidal products containing nonoxynol-9 are available without a prescription in various forms: films (VCF), foams, gels, and suppositories.

How they work: Nonoxynol-9 immobilizes and kills sperm on contact.

Effectiveness: About 79% effective with typical use when used alone. More effective when combined with a barrier method like a condom or diaphragm.

Pros:

• No prescription needed
• Available at most drugstores
• Inexpensive ($8-$15 per package)

Cons:

• Less effective than Phexx when used alone
• Nonoxynol-9 can cause vaginal irritation
• Frequent use of nonoxynol-9 may increase risk of STIs by irritating vaginal tissue
• Not recommended for women at high risk of HIV

Best for: Women who need an immediate, accessible option and plan to use it with a barrier method for better protection.

How Do These Alternatives Compare to Phexx?

Phexx is unique because it's the only hormone-free prescription contraceptive gel that works by regulating vaginal pH rather than using harsh spermicidal chemicals like nonoxynol-9. Here's a quick comparison:

• Most effective hormone-free option: Copper IUD (over 99%)
• Most similar to Phexx (on-demand, non-hormonal): Diaphragm with spermicide or condoms
• Best STI protection: Condoms
• Gentlest on vaginal tissue: Phexx (pH-based, no nonoxynol-9)

Final Thoughts

If you can't get Phexx right now, you still have good options for hormone-free contraception. The copper IUD offers the most reliable long-term protection, condoms add STI prevention, and diaphragms provide a reusable barrier option. Over-the-counter spermicides are the most accessible but least effective choice.

That said, if Phexx is your preferred method, don't give up on finding it. Use Medfinder to locate pharmacies with stock, or explore the telehealth delivery option at phexx.com. And always discuss any changes to your contraceptive plan with your healthcare provider.