Can contraceptive gels cause vaginal discomfort?

Question

Hi doctor,

I am 26 and recently began using a new non-hormonal contraceptive gel, as hormonal options have been unsuitable for me due to migraines with aura. Since starting the gel, I have experienced some concerns. I have noticed increased dryness and irritation, which is causing discomfort. My partner mentioned an unpleasant taste during oral sex, which is affecting our intimacy. Last month, I exhibited symptoms consistent with a yeast infection. I have some questions regarding the gel's usage:

The instructions suggest waiting a full hour after application before engaging in intercourse. Is this necessary for effectiveness? How long does the gel remain effective? If we have multiple sexual encounters in one night, is reapplication required each time?
Does the gel affect the vaginal pH balance, potentially increasing the risk of infections?
The pharmacist advised against using certain soaps or douches, but the guidance was unclear. Could you provide clarity on this?

Currently, my period is three days late. While this could be attributed to stress, I am concerned about the possibility of pregnancy.

I would greatly appreciate your insights on these matters to ensure I am using the product correctly and to address any potential health concerns. Please help.

Thank you for your time and guidance.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

It is commendable that you are using a non-hormonal contraceptive gel like Phexxi (lactic acid, citric acid, potassium bitartrate), especially considering your history of migraines with aura, which makes hormonal birth control less suitable for you.

However, it is important to be aware of some potential side effects associated with Phexxi:

Vaginal health: Some users experience vaginal dryness, irritation, or discomfort. These symptoms can disrupt the balance of the vagina, potentially leading to yeast infections.
Oral sex considerations: The gel contains lactic acid, citric acid, and potassium bitartrate, which can impart a tart taste during oral sex. While this is not harmful, it is something to be mindful of.
Application frequency: Phexxi is designed for single-use effectiveness. It should be reapplied before each act of vaginal intercourse, as its efficacy does not extend beyond one encounter.
Effectiveness: With typical use, Phexxi has an effectiveness rate of approximately 86 %, which is lower than that of hormonal contraceptives like the pill.

Given that your period is late and there was a possibility of multiple sexual encounters with only one application, it would be prudent to take a pregnancy test to ensure everything is in order.

To maintain optimal vaginal health:

Avoid irritants: Refrain from using soaps or douches inside the vagina, as they can disrupt its natural balance and potentially exacerbate irritation.
Consult healthcare providers: If you continue to experience discomfort or recurrent infections, consider discussing alternative non-hormonal contraceptive options with your doctor to find a method that suits you better.

I hope this helps.

Kindly revert so I can assist you further.

Thank you.