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What You Need to Know About a Non-hormonal Birth Control Option and Advocating for Your Sexual Health During and After Breast Cancer Treatment

What You Need to Know About a Non-hormonal Birth Control Option and Advocating for Your Sexual Health During and After Breast Cancer Treatment

My Diagnosis

When I got the call from my doctor in 2018 with a diagnosis of stage III breast cancer, I thought that there had to be a mistake. “You must have the wrong chart,” I told her. Despite not having any family history of breast cancer nor carrying the breast cancer gene, I had been diagnosed with aggressive cancer, despite a clear mammogram the year before.

My first thought was: I cannot have cancer. My son needs me. I’m his person. Especially since I’ve raised him as a single mother since he was one and a half years old.

My second thought: I have to find a way to continue running my company, Evofem Biosciences. I’ve had a full career in women’s healthcare, and I had finally made it to become CEO of a company that I love, and I remembered thinking…. “I’ve worked so hard to get to this point and now cancer is going to take it away from me.”

I decided cancer was going to rue the day it knocked on my door.

Taking an Aggressive Approach to Treatment while Running My Company, Evofem

I told my incredible oncologist, Dr. Shatsky, that I wanted to “kill the fly with a sledgehammer” with my treatments. And I told her that I had to keep working through them. I told her that we needed to move at the speed of light, as fast as my body would let me go.

Within three weeks of my diagnosis, I had a double mastectomy. Then, subsequently in the following weeks and months I had chemotherapy and more surgery with the removal of my uterus and ovaries.

After getting my initial diagnosis, I prepared a well thought out speech for my Chairman and my Board of Directors that was a long list of reasons why and how I was going to continue to keep working and keep Evofem moving forward. I prepared as if he (my Chairman) would tell me to take a medical leave of absence when I shared my diagnosis.

Thankfully, it was quite the opposite and he simply said:

“Saundra, if anyone can beat cancer, it is you.”

It was never a question of ‘Will I survive?’ but rather feeling and deciding that I had to be here to raise my son and run my company because there is no one better suited to do so than me and because of that I loved my life.

When my work in women’s sexual healthcare became personal

My diagnosis came at a critical time...probably the worst possible time for Evofem, as we were in the middle of a phase III clinical trial for our first ever product, Phexxi: the first and only prescription, non-hormonal birth control gel for women. I had been working relentlessly to get this product through clinical trials and FDA approval and to women - imagine - a birth control that doesn’t have hormones that is women-controlled, use only when you need it - it is truly an innovation!

Phexxi is and was the first non-hormonal birth control innovation meant for women in decades, and I wasn’t going to let a cancer diagnosis stop me from getting this important and much needed product out to the 23 million women in the U.S. who are beyond hormones (meaning they either cannot or will not take hormonal birth control.)

This is when my work became even more personal. In going through cancer, I learned many cancer treatment protocols require women (of reproductive age) to use birth control while undergoing treatment to prevent pregnancy. And many require a non-hormonal option, especially women with hormone driven cancers, like breast cancer. So, until we introduced Phexxi in September of 2020, the only non-hormonal prescription birth control options for women were limited to condoms or the copper IUD.

This was an aha moment for me. Not only was Phexxi important for women...but Phexxi was an extremely important birth control option for women with cancer, many of whom REQUIRE non-hormonal birth control during and long after treatment.  These women deserve an on-demand option.  No women have sex every day and the fact that the only non-hormonal choice was a copper IUD was draconian to me.

Aside from being here for my son, knowing that I needed to get Phexxi into the hands of women everywhere, especially in the hands of women with cancer and survivors, drove me to get through treatment.

My mission is and always has been to revolutionize women’s sexual healthcare and improve women’s lives. So I put up the strongest fight of my life.

What is Phexxi?

Phexxi was approved by the FDA in May 2020, amidst the pandemic, and became available to women in September of 2020. The goal behind launching Phexxi and getting it to cancer patients and survivors is to put women in the driver’s seat when it comes to their sexual health.

Not only does Phexxi represent a non-hormonal birth control option for women with cancer, but it also allows women with cancer to take control of their family planning and sexual health. And when you’re going through something like cancer treatment, it feels good to finally be in control...of something.

So, what is Phexxi and how does it work?

  • Phexxi is a prescription, non-hormonal birth control gel that you insert into the vagina up to 60 minutes before sex. (The applicator looks sort of similar to a tampon.)
  • Phexxi does not work when used after sex.
  • Phexxi is easy to use and used only when needed.
  • Phexxi maintains the pH of the vagina to prevent pregnancy.
  • You can visit or ask your healthcare provider for more information.
  • Phexxi is available via telehealth too, if you’re not comfortable or not able to see your doctor for an office visit during the pandemic.
  • All of the info on Phexxi is on the website: including the important safety information.

Advocating for your sexual health

Cancer shouldn’t take away your chance to have intimacy with your partner.

Women with cancer and cancer survivors often do not want to bring up sex during their doctors’ appointments. Once we’re diagnosed with cancer, we feel like we should just be thankful to be alive.

But isn’t that unfair? Shouldn’t we get to care as much as anyone else or even more so about how cancer will impact our sex lives and sexual health?

Even if sex isn’t at the forefront of your mind upon diagnosis, it IS important to have a conversation with your doctor about your sexual health and the impact your treatment and diagnosis can have on your body.

If you don’t advocate for your sexual health...who will?

And, especially in the decision-making process of choosing a birth control, you have to do what feels right for you. I want all women, and especially women with cancer, to know about Phexxi as an important non-hormonal birth control option. It is important to be educated about your options so you can make the most informed decision possible.

My parting words...

Look. I get it. Not one part of dealing with cancer is easy. It sucks. And once you make it past treatment, survivorship comes with its own challenges.

But we are fighters. We are conquerors. And we deserve to live as fully as we can. And that includes feeling sexually fulfilled and feeling good about what we put in our bodies.

We have already faced a major battle. So, having a conversation with our doctor about sex and birth control options….this is a cake walk compared to what we have braved.

My advice for women going through cancer / cancer survivors...

Advocate for your sexual health.

Do your research on your options.

Ask questions.

Ask more questions.

Do not accept the status quo if it does not feel right for you.
And do not be afraid to break the silence around sex and cancer.

Women are extraordinary. We really are. And we deserve to feel good about the choices we make around our health and sexuality. Cancer or not.



For more information about Phexxi, talk to your healthcare provider and review the full Product Information.  If you have had a history of urinary tract infections that keep coming back or other urinary tract problems, you should not use Phexxi. The most common side effects were vaginal burning & itching, yeast infection, urinary tract infection, vaginal area discomfort, bacterial vaginosis, vaginal discharge, genital discomfort (including in male partners) and pain while urinating. Phexxi does not protect against any sexually transmitted infections, including HIV. Contact your healthcare provider if you are experiencing severe genital irritation or discomfort or urinary tract symptoms. 

Head shot of SaundraSaundra Pelletier is a mother, daughter, CEO and trailblazer. Undoubtedly and unapologetically, Saundra is one of the most dynamic women in today’s healthcare industry. She sits at the head of Evofem Biosciences, a female-forward company revolutionizing women’s healthcare with game-changing products, including Phexxi, the first – and highly anticipated – hormone-free, prescription, on-demand female contraceptive gel. But her impact transcends her executive title and illustrious resumé.At her core, Saundra is a passionate advocate for women’s wellness and empowerment. She is a leader in the boardroom and beyond, using her experience, voice and vision for real, progressive change for women. Saundra is a force of energy that blends substance and excitement with straight talk and strong opinions. Never mind being a breast cancer survivor who fought the illness as she remained solidly at the helm of Evofem, securing $400+ million and achieving FDA approval. All while raising a son as a single mother. Once you meet Saundra Pelletier, you won’t forget her. You won’t want to.

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