Copper IUDvsPill

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.	Pill No non-hormonal birth control pill is FDA-approved in the US. Ormeloxifene (centchroman) is approved and used in India.
Efficacy	99.2% typical use Most effective: over 99 out of 100 people successfully prevent pregnancy per year.	Limited evidence see details Limited evidence: no verifiable efficacy data available.
Cost	$0–$1,424 Insurance: Usually	Contact provider Insurance: Varies
Duration	Up to 10 years	Weekly pill (ongoing)
Reversibility	Reversible	Reversible
STI Protection	No	No
How it works	Releases copper ions into the uterus that make the environment toxic to sperm and may prevent implantation if fertilization occurs.	Ormeloxifene (centchroman) is a selective estrogen receptor modulator (SERM) that prevents pregnancy by inhibiting implantation of a fertilized egg in the endometrium. It does not suppress ovulation and does not contain estrogen or progestin. It is not FDA-approved in the US.
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	Menstrual irregularities (delayed or altered periods; rates varied widely across studies, up to about 12%) Headache Nausea Abdominal discomfort Breast tenderness
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)	Polycystic ovarian disease (PCOS) Recent history of jaundice or hepatic impairment Renal impairment Cervical hyperplasia or chronic cervicitis Pregnancy Hypersensitivity to ormeloxifene

Key differences

Copper IUD duration: Up to 10 years. Pill duration: Weekly pill (ongoing). Copper IUD: costs $0–$1,424. Pill: Contact provider.