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Copper IUD vs Spermicide

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.
Spermicide A chemical gel, foam, or film inserted into the vagina before sex to disable sperm, 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.	Spermicide A chemical gel, foam, or film inserted into the vagina before sex to disable sperm, available over the counter.
Efficacy	Copper IUD 99.2% typical use Most effective: over 99 out of 100 people successfully prevent pregnancy per year.	Spermicide 79% typical use Least effective: under 90 out of 100 people successfully prevent pregnancy per year.
Cost	Copper IUD $0–$1,167 Insurance: Usually	Spermicide $16–$18 per package Insurance: Varies
Duration	Copper IUD Up to 10 years	Spermicide Single use, one dose before each act of sex (gel works for up to 1 hour; film goes in 15 minutes to 3 hours before sex)
Reversibility	Copper IUD Reversible	Spermicide Reversible
STI protection	Copper IUD No	Spermicide No
How it works	Copper IUD Releases copper into the uterus, which interferes with sperm movement and fertilization and may prevent implantation.	Spermicide A chemical (usually nonoxynol-9) immobilizes or kills sperm on contact. Inserted into the vagina before sex.
Prescription	Copper IUD Required In-Person Procedure	Spermicide 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	Spermicide Vaginal or penile irritation Increased risk of UTI Allergic reaction
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)	Spermicide Sensitivity to nonoxynol-9 High risk of HIV exposure, or HIV in you or a partner (frequent use may increase transmission risk)

Key differences

With typical use, 0.8 in 100 people using Copper IUD get pregnant in a year, vs 21 in 100 with Spermicide (most effective vs least effective). How long it lasts: Copper IUD, up to 10 years; Spermicide, single use, one dose before each act of sex (gel works for up to 1 hour; film goes in 15 minutes to 3 hours before sex). A prescription is needed for Copper IUD, not for Spermicide. Copper IUD: costs $0–$1,167. Spermicide: costs $16–$18 per package.