Copper IUDvsSponge

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.	Sponge A soft foam disc placed deep in the vagina before sex. It covers the cervix and contains spermicide.
Efficacy	99.2% typical use Most effective: over 99 out of 100 people successfully prevent pregnancy per year.	Least effective see details Least effective: under 90 out of 100 people successfully prevent pregnancy per year.
Cost	$0–$1,424 Insurance: Usually	$15–$20 /per package Insurance: No
Duration	Up to 10 years	Single use (can be left in place up to 24 hours and for multiple acts of sex)
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.	A polyurethane foam disc impregnated with spermicide is placed over the cervix before sex. The spermicide kills or disables sperm and the physical barrier blocks sperm from entering the uterus.
Prescription	Required Prescription required	OTC No prescription / OTC
Side effects	Heavier or longer periods (especially first few months) Increased cramping Spotting between periods Small risk of uterine perforation at insertion	Vaginal irritation or dryness Increased risk of urinary tract infection Rare allergic reaction
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)	Allergy to nonoxynol-9, benzalkonium chloride, or other spermicide ingredients History of toxic shock syndrome Active vaginal infection Inability to insert or remove reliably High risk of HIV exposure (frequent nonoxynol-9 use may increase vaginal irritation; CDC cautions)

Key differences

Copper IUD duration: Up to 10 years. Sponge duration: Single use (can be left in place up to 24 hours and for multiple acts of sex). Copper IUD requires a prescription; Sponge does not. Copper IUD: costs $0–$1,424. Sponge: costs $15–$20 per package.