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Not everyone wants to use hormonal birth control, and that's completely fine.
Whether you're concerned about side effects, have medical reasons to avoid hormones, or simply prefer non-hormonal options, you have effective choices available that prevent pregnancy without altering your body's natural hormone levels.
Two standout non-hormonal birth control options deserve your attention: internal condoms (FC2) and Phexxi vaginal gel. Both give you control over your reproductive health without hormones, and each works differently to prevent pregnancy.
Hormonal birth control methods like the pill, patch, ring, and shot work well for many people, but they're not right for everyone. Non-hormonal birth control options offer alternatives that don't impact your natural hormone levels.
Some people experience unwanted side effects from hormonal contraception, including mood changes, weight fluctuations, or headaches. Others have medical conditions that make hormonal methods less safe, such as a history of blood clots or certain types of migraines.
Non-hormonal birth control methods work with your body as it is. They don't suppress ovulation or change your cervical mucus through synthetic hormones. Instead, they prevent pregnancy by creating physical or chemical barriers that prevent sperm from reaching and fertilizing an egg.
If you're managing fertility awareness or simply prefer to avoid synthetic hormones, non-hormonal contraception gives you effective pregnancy prevention without interfering with your body's natural cycles.
One significant advantage of barrier methods like internal condoms is STD protection. Unlike the pill, IUD, or other non-barrier contraceptives, internal condoms provide a physical barrier that helps prevent sexually transmitted infections alongside preventing pregnancy.
Barrier methods are the only birth control method that can protect against both pregnancy and STIs. If you're with a new partner, have multiple partners, or want comprehensive protection during sex, barrier methods should be part of your contraception strategy.
Non-hormonal options give you on-demand birth control. You use them only when you need them—there's no daily pill to remember or device to keep in your body between sexual encounters. This woman-controlled flexibility appeals to people who don't have sex frequently or who prefer to use protection only when needed.
The internal condom, also known as the female condom or FC2, is a soft, disposable pouch made of synthetic latex-free material called nitrile. It's designed to line the vagina and collect semen during ejaculation, preventing sperm from reaching the cervix.
The FC2 condom is about 6.5 inches long with two flexible rings — one at each end. The inner ring at the closed end helps with insertion and holds the condom in place inside the vagina. The outer ring at the open end stays outside the body, partially covering the external genital area.
When used correctly, internal condoms are about 95% effective at preventing pregnancy. With typical use, they're about 79% effective. They're also FDA-approved for STD protection, making them the only birth control method besides male condoms that protects against both pregnancy and sexually transmitted infections.
Because they're made of nitrile rather than latex, internal condoms are safe for people with latex allergies. They can be used with both water-based and oil-based lubricants, giving you more flexibility than latex male condoms.
You can insert an internal condom up to eight hours before sex, which means you don't have to interrupt sex to put it on. Many people appreciate this flexibility since you can insert it privately beforehand.
During insertion, squeeze the inner ring between your thumb and middle finger, then push it into your vagina as far as it will comfortably go, similar to inserting a tampon. The inner ring should rest behind your pubic bone, while the outer ring stays outside your body.
After ejaculation, twist the outer ring and gently pull the condom out to prevent semen from spilling. Use a new condom for each act of intercourse—internal condoms are single-use only.
(For a more detailed step-by-step guide, check out Twentyeight Health's internal condom guide.)
Myth: Internal condoms are uncomfortable or awkward.
Fact: Many people find internal condoms comfortable once they get used to insertion. The nitrile material is thin and transfers body heat well, and because it lines the vagina rather than fitting tightly around the penis, it can actually enhance sensation for both partners.
Myth: Internal condoms are noisy.
Fact: Earlier versions of female condoms could make rustling sounds, but the FC2 is much quieter. Adding extra lubricant can eliminate any remaining noise.
Myth: They're hard to find.
Fact: While internal condoms aren't as widely available as male condoms at every store, you can buy condoms online through services like Twentyeight Health. Many health clinics and family planning centers also provide them free or at low cost.
Phexxi is a hormone-free, prescription vaginal gel that prevents pregnancy by maintaining your vagina's natural pH level. It's a newer form of non-hormonal contraception that offers on-demand protection without barriers or devices.
Your vagina naturally maintains an acidic pH between 3.5 and 4.5. This acidic environment isn't ideal for sperm survival since sperm prefer a more alkaline environment. During sex, semen (which is alkaline) temporarily raises vaginal pH, creating conditions where sperm can survive longer.
Phexxi contains three acids: lactic acid, citric acid, and potassium bitartrate. When applied before sex, it maintains your vagina's acidic pH even after ejaculation. This makes the environment inhospitable to sperm, reducing their ability to move toward the cervix.
According to clinical trials, Phexxi is about 86% effective with typical use and 93% effective with perfect use. It works differently from spermicide. Rather than killing sperm with chemical agents, it simply maintains your body's natural acidity.
You need to apply Phexxi immediately before sex. More specifically, no more than one hour before vaginal intercourse. The gel comes in pre-filled applicators that deliver one dose. Insert the applicator into your vagina (similar to inserting a tampon) and push the plunger to release the gel.
Phexxi starts working right away and provides protection for one hour. If you have sex again, you need to apply another dose. If more than an hour passes between application and intercourse, you'll also need a fresh application.
After sex, leave the gel in place for at least six hours before washing the vaginal area. You can shower or bathe, but avoid using douches or vaginal products during this time.
Some people experience vaginal burning, itching, or discomfort when they first use Phexxi. These side effects are usually mild and often decrease with continued use as your body adjusts to the product.
Other potential side effects include urinary tract infections, yeast infections, or bacterial vaginosis. If you frequently get UTIs or have a history of pelvic infections, discuss with your healthcare provider whether Phexxi is right for you.
Partners may also experience irritation on the penis during or after sex. If this happens, using male condoms alongside Phexxi can prevent direct contact while still maintaining pregnancy protection.
(For more detailed information about using Phexxi, visit Twentyeight Health's Phexxi guide.)
Understanding how to use non-hormonal birth control in everyday situations helps you feel prepared and confident.
Planning ahead makes using non-hormonal contraception easier. If you're using internal condoms, you can insert one up to eight hours before your date. Keep a spare in your bag just in case. Add a small packet of lubricant too—extra lubrication improves comfort and effectiveness for barrier methods.
If you're using Phexxi, bring the applicator with you. Since you need to apply it within an hour of sex, you'll want it accessible when the time comes. The pre-filled applicators are discreet and easy to carry.
Phexxi can be used alone or combined with condoms for extra protection. Using both methods together gives you backup contraception and, if you're using male or internal condoms, STD protection as well.
If you choose to use condoms alongside Phexxi, apply the Phexxi first, then put on the condom. This combination significantly reduces your risk of unplanned pregnancy while protecting against sexually transmitted infections.
Packing non-hormonal birth control for travel is straightforward. Internal condoms are individually wrapped and don't require refrigeration. So, toss a few in your luggage.
Phexxi requires a prescription, so make sure you have enough applicators for your trip. Store them at room temperature away from excessive heat. Since Phexxi works on-demand, you don't have to worry about taking pills at specific times across time zones.
You can order your non-hormonal birth control from Twentyeight Health before you travel, with discreet delivery straight to your door.
Yes, Phexxi is safe to use with male condoms or internal condoms. Using both methods together provides dual protection. Phexxi maintains vaginal pH to prevent pregnancy while condoms create a physical barrier and protect against STIs.
Yes, the FC2 internal condom is made from nitrile, a synthetic material that's completely latex-free. This makes it safe for anyone with latex allergies. You can also use any type of lubricant with nitrile condoms, including oil-based options that would damage latex male condoms.
No, Phexxi must be applied before intercourse to be effective. It needs to be in place when ejaculation occurs so it can maintain your vagina's acidic pH and prevent sperm from surviving. If you've already had sex without protection, Phexxi won't work retroactively. Consider emergency contraception if you've had unprotected sex and want to prevent pregnancy.
Non-hormonal birth control gives you effective pregnancy prevention without synthetic hormones. Whether you choose internal condoms for their STD protection and flexibility, Phexxi for hormone-free on-demand contraception, or explore other options like the copper IUD or diaphragm, you can find a method that works with your body and lifestyle.
Explore your non-hormonal options. Connect with Twentyeight Health for personalized guidance about birth control methods that fit your needs. Our providers offer judgment-free consultations and can prescribe Phexxi and other contraceptives through convenient telehealth visits.
