Copper IUDvsInternal Condom

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

Side-by-side comparison

Method	Copper IUD A small copper device placed in the uterus that works for up to 10 years and is over 99% effective.	Internal Condom A soft pouch worn inside the vagina that blocks sperm and protects against STIs, available by prescription.
Efficacy	99.2% typical use Most effective: over 99 out of 100 people successfully prevent pregnancy per year.	79% typical use Least effective: under 90 out of 100 people successfully prevent pregnancy per year.
Cost	$0–$1,424 Insurance: Usually	$0–$4 /per unit Insurance: Usually
Duration	Up to 10 years	Single use
Reversibility	Reversible	Reversible
STI Protection	No	Yes
How it works	Releases copper ions into the uterus that make the environment toxic to sperm and may prevent implantation if fertilization occurs.	A soft, loose-fitting nitrile pouch lines the vagina and collects semen. The inner ring anchors it at the cervix and the outer ring stays outside the vaginal opening.
Prescription	Required Prescription required	Required Prescription required
Side effects	Heavier or longer periods (especially first few months) Increased cramping Spotting between periods Small risk of uterine perforation at insertion	Mild irritation or discomfort Noise during use if not positioned correctly Slippage with incorrect insertion
Who shouldn't use this	Active pelvic infection or PID (FDA label) Uterine anomaly preventing insertion (FDA label) Wilson's disease (copper metabolism disorder) (FDA label) Known copper allergy (FDA label) Current pregnancy (FDA label)	Sensitivity to nitrile (rare)

Key differences

Copper IUD is more effective (99.2% vs 79% typical use). Copper IUD duration: Up to 10 years. Internal Condom duration: Single use. Only Internal Condom protects against STIs. Copper IUD: costs $0–$1,424. Internal Condom: costs $0–$4 per unit.