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Copper IUD vs Internal 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.
Internal Condom A soft pouch worn inside the vagina that blocks sperm and lowers the risk of STIs, usually obtained with a prescription.

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 lowers the risk of STIs, usually obtained with a prescription.
Efficacy	Copper IUD 99.2% typical use Most effective: over 99 out of 100 people successfully prevent pregnancy per year.	Internal Condom 79% typical use Least effective: under 90 out of 100 people successfully prevent pregnancy per year.
Cost	Copper IUD $0–$1,167 Insurance: Usually	Internal Condom $0–$3 per unit Insurance: Usually
Duration	Copper IUD Up to 10 years	Internal Condom Single use
Reversibility	Copper IUD Reversible	Internal Condom Reversible
STI protection	Copper IUD No	Internal Condom Yes
How it works	Copper IUD Releases copper into the uterus, which interferes with sperm movement and fertilization and may prevent implantation.	Internal Condom 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	Copper IUD Required In-Person Procedure	Internal Condom Required Telehealth Prescription
Side effects	Copper IUD Heavier or longer periods (especially first few months) Increased cramping Spotting between periods Small risk of uterine perforation at insertion	Internal Condom Mild irritation or discomfort Slippage with incorrect insertion
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)	Internal Condom None reported

Key differences

With typical use, 0.8 in 100 people using Copper IUD get pregnant in a year, vs 21 in 100 with Internal Condom (most effective vs least effective). How long it lasts: Copper IUD, up to 10 years; Internal Condom, single use. STI protection: only with Internal Condom. Copper IUD: costs $0–$1,167. Internal Condom: costs $0–$3 per unit.