Chapter 1: The Struggles with Hormonal Birth Control

My first experience with hormonal birth control left me in a state of distress, spending hours ill in my college dorm's restroom. The nausea persisted for weeks, leading to months of trial and error with various hormonal pills. Ultimately, when my weight dropped below 105 lbs, my doctor advised that it was time to reconsider; my body simply couldn't handle the pill.

I know I’m not alone in this experience. Many women find themselves grappling with the adverse effects of hormonal contraceptives. Even with advancements in the last decade, common side effects include weight gain, headaches, lowered libido, mood fluctuations, and nausea.

So, when the FDA approved Phexxi — the first non-hormonal contraceptive for women — I felt a glimmer of hope. However, my excitement was short-lived when I inquired with my gynecologist about the possibility of using Phexxi. She dismissed my query as if I had suggested a bizarre alternative treatment, explaining that insurance providers were not covering it.

This leads to speculation about why insurers would not support an FDA-sanctioned birth control option that does not interfere with hormonal balances. The history of contraception in this country is marred with troubling practices that often disregard women's health and autonomy.

In 1960, the FDA greenlit Enovid, the first hormonal birth control pill, which was distributed without proper warnings regarding its side effects. By 1961, the FDA had recorded 132 instances of thrombosis linked to Enovid, alongside other negative effects like nausea, mood swings, reduced libido, weight gain, and bloating. The sale of size C bras surged by 50% as many women experienced weight gain while on the pill.

At that time, skepticism surrounding the pill was rampant, fueled by the knowledge that Enovid was tested on impoverished Puerto Rican women as part of a eugenics initiative aimed at population control. Alarmingly, these women were never informed they were part of a clinical trial, and three of them lost their lives without any investigations into their deaths.

Given this troubling background, it’s understandable that women might approach new contraceptive methods with caution.

However, unlike previous hormonal options that often left women feeling bloated and emotionally unstable, Phexxi does not alter hormonal levels and is user-friendly. The gel is inserted into the vagina prior to intercourse, functioning similarly to spermicidal gels but without the irritating chemical nonoxynol-9, which can aggravate sensitive vaginal tissues and heighten the risk of HIV and other STDs.

The science behind Phexxi is straightforward. The vagina typically maintains a moderately acidic pH level ranging from 3.5 to 4.5. During penetrative sex, the pH shifts to a more alkaline state of 6.5 to 7.2, creating a conducive environment for sperm. Phexxi helps keep the vaginal environment in its more acidic state, making it less favorable for sperm, effectively hindering their journey to fertilize an egg.

Despite its efficacy, there are some limitations. Planned Parenthood advises using the gel in conjunction with other contraceptive methods. Statistics indicate that 14 out of 100 users of Phexxi may still become pregnant. Additionally, it does not protect against STDs and is not recommended for women prone to frequent urinary tract infections (UTIs).

While the potential for replacing dangerous side effects with UTIs remains to be seen, preliminary studies from the third phase of clinical trials suggest that Phexxi may actually reduce the incidence of UTIs, likely due to the fact that bacteria responsible for most UTIs thrive less in a more acidic environment.

With a safer contraceptive option now available and fewer side effects, the question arises: why are insurance companies not covering it?

The hope is that this will change soon. Recently, the U.S. Department of Labor and the Health Resources and Services Administration (HRSA) mandated that "most insurers" should provide coverage for birth control without out-of-pocket expenses for women.

Yet, upon checking with my insurance provider, I found that Phexxi was still not covered. With ongoing legislative moves toward restricting contraception access, I wouldn’t be too optimistic about the situation improving anytime soon.

It’s important to note that the challenges surrounding contraceptive access are not solely a women’s issue. Many health plans also do not cover erectile dysfunction medications, leaving numerous men without medical solutions for sexual dysfunction, as these drugs are still classified as "lifestyle-related" rather than medically necessary.

While sexual health is a crucial aspect of overall well-being, the American healthcare system has historically neglected this area. During routine medical visits, healthcare providers often inquire about medications, diet, alcohol use, sleep patterns, and mental health, yet rarely touch upon a patient’s sexual health.

Navigating the right contraceptive is vital for sexual health. Nevertheless, as scientific advancements progress, our profit-driven healthcare system remains bogged down by red tape. Unfortunately, unless insurance companies adapt to support these advancements, scientific progress will not translate into tangible benefits for consumers.

Chapter 2: Understanding Phexxi's Impact

The first video titled "FDA approves first over-the-counter birth control pill" discusses the implications of this historic approval and what it means for women's health.

The second video titled "FDA approves first non-prescription birth control pill" delves into the details of Phexxi's approval and its potential to change women's contraceptive choices.