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Copper IUD vs External Condom

A side-by-side comparison of two birth control methods — efficacy, cost, how they work, and who shouldn't use them.

Last verified October 11, 2026Updated October 11, 2026

Side-by-side comparison

Copper IUD A small copper device placed in the uterus that works for up to 10 years and is over 99% effective.
External Condom A barrier method worn over the penis that also lowers the risk of STIs, available over the counter.

Method	Copper IUD A small copper device placed in the uterus that works for up to 10 years and is over 99% effective.	External Condom A barrier method worn over the penis that also lowers the risk of STIs, available over the counter.
Efficacy	Copper IUD 99.2% typical use Most effective: over 99 out of 100 people successfully prevent pregnancy per year.	External Condom 87% typical use Least effective: under 90 out of 100 people successfully prevent pregnancy per year.
Cost	Copper IUD $0–$1,167 Insurance: Usually	External Condom $0–$2 per unit Insurance: Varies
Duration	Copper IUD Up to 10 years	External Condom Single use
Reversibility	Copper IUD Reversible	External Condom Reversible
STI protection	Copper IUD No	External Condom Yes
How it works	Copper IUD Releases copper into the uterus, which interferes with sperm movement and fertilization and may prevent implantation.	External Condom A sheath worn over the penis that keeps sperm from entering a partner's body. Latex and plastic condoms also block contact with semen and vaginal fluids that can carry STIs.
Prescription	Copper IUD Required In-Person Procedure	External Condom Not required Over-the-Counter
Side effects	Copper IUD Heavier or longer periods (especially first few months) Increased cramping Spotting between periods Small risk of uterine perforation at insertion	External Condom Allergic reaction to latex in people with a latex allergy
Who shouldn't use this	Copper IUD Active pelvic infection or PID (FDA label) Uterine abnormality that distorts the uterine cavity (FDA label) Wilson's disease (copper metabolism disorder) (FDA label) Known copper allergy (FDA label) Current pregnancy (FDA label)	External Condom Known allergy to latex (use polyisoprene or polyurethane instead)

Key differences

With typical use, 0.8 in 100 people using Copper IUD get pregnant in a year, vs 13 in 100 with External Condom (most effective vs least effective). How long it lasts: Copper IUD, up to 10 years; External Condom, single use. STI protection: only with External Condom. A prescription is needed for Copper IUD, not for External Condom. Copper IUD: costs $0–$1,167. External Condom: costs $0–$2 per unit.