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Spermicide Vs. Contraceptive Gel: What’s the Difference?

October 4, 2022

If you’ve explored your non-hormonal birth control options, you’ve likely come across spermicide and contraceptive gels as options. Both of these choices can be used alone or together with barrier methods. When added to some barrier methods, like diaphragms, these substances can increase effectiveness and reduce the chance of pregnancy.

Many people assume that spermicide and contraceptive gel are the same thing—but are they? Let’s find out.

What is Spermicide?

Spermicide is a chemical that kills sperm with the active ingredient known as nonoxynol-9, which has been used as a contraceptive for decades. It comes in several forms, including gel, foam, cream, film, or suppository, and it is introduced into the vagina before sex in order to work properly. Some name brands include VCF gel, Conceptrol, and Gynol II.

You can purchase spermicide over the counter without a prescription for around one dollar per applicator. The effectiveness varies depending on the study, type, and brand name, but the failure rate averages 21% when used alone. However, some brands boast a failure rate as low as 6%. Many women use spermicide together with another barrier method, like a diaphragm, to improve effectiveness. The Caya diaphragm used with Gynol II spermicide has a pregnancy rate of 17%.

The active ingredient in spermicide, nonoxynol-9, has some known health concerns. It’s important to be aware that spermicides containing nonoxynol-9 can increase your risk of contracting HIV and may cause vaginal and skin irritation or vaginal infections.

What is Contraceptive Gel?

Contraceptive gel, currently marketed as Phexxi, is a chemical that stabilizes the vaginal pH so that sperm cannot swim throughout the female reproductive system; therefore, blocking fertilization. Typically, when sperm enters the female’s body, the vaginal pH rises, allowing the sperm to travel more easily. Contraceptive gel keeps the vaginal pH more acidic, limiting sperm’s ability to swim. There are three non-toxic active ingredients:

  • Lactic acid
  • Citric acid
  • Potassium bitartrate

This is a new contraceptive product, receiving FDA approval just a couple of years ago in 2020. The gel is available by prescription only and is inserted into the vagina with an applicator, similar to spermicide. The effectiveness is currently at 86% when used alone; or a failure rate of 14%.

Although the ingredients are labeled as non-toxic, there are still some side effects for some women. Risks of using contraceptive gel include bladder, kidney, and vaginal infections.

The cost of contraceptive gel can be prohibitive. Even coupon sites like GoodRx have the substance listed at $300 to $350 per package of 12 applicators. That means it will cost around $25-$30 per application without insurance. However, insurance may cover the cost if you have it.

Which is Best for My Diaphragm: Spermicide Vs. Contraceptive Gel

So, which one is better for using with my diaphragm: spermicide or contraceptive gel? Right now, the answer is clear: spermicide. That’s because—to our knowledge, only spermicide has been tested with and is currently approved for use with diaphragms.

So you may be wondering—can contraceptive gel be used with diaphragms? The product’s website states that contraceptive gel can be used with diaphragms, but doesn’t specify which diaphragms were tested and deemed compatible. It also noted specifically not to use contraceptive gel with a vaginal ring birth control method.

Before using contraceptive gel together with your diaphragm, check with your doctor, who will be able to determine if it’s ok to combine the use of contraceptive gel in addition to spermicide with your diaphragm. Talk with your doctor to make the decision on which solution is best for your reproductive health.

Comparing Spermicide Vs. Contraceptive Gel

Let’s review what we’ve learned about the similarities and differences between spermicide and contraceptive gel.


  • Both are hormone Free
  • Both are on-demand, fast-acting, and reversible
  • Both are woman-controlled
  • Use is similar: insert the gel into the vagina with an applicator prior to sex
  • Neither provides protection from STDs when used alone


  • Need a prescription for contraceptive gel (not for spermicide)
  • Different active ingredients
  • The way they disable sperm is different
  • Diaphragm instructions show compatibility with spermicide (unclear for contraceptive gel)
  • Contraceptive gel can be very expensive


So the mystery is solved: spermicide and contraceptive gel are two very different chemicals used to prevent pregnancy in different ways. If you’re interested in exploring your contraceptive options, reach out to our online gynecologists today. My Virtual Physician has partnered with Caya to provide the one-size-fits-most diaphragm option to our patients who desire it.

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