Copper IUD
vs
Withdrawal

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

Copper IUD

A small copper device placed in the uterus that works for up to 10 years and is over 99% effective.
Withdrawal

Withdrawal

The man withdraws his penis from the vagina before ejaculation to reduce the chance of sperm reaching the egg.
Efficacy99.2% typical use

Most effective: over 99 out of 100 people successfully prevent pregnancy per year.

80% typical use

Least effective: under 90 out of 100 people successfully prevent pregnancy per year.

Cost$0–$1,424

Insurance: Usually

$0

Insurance: Varies

DurationUp to 10 yearsPer act
ReversibilityReversibleReversible
STI ProtectionNoNo
How it works

Releases copper ions into the uterus that make the environment toxic to sperm and may prevent implantation if fertilization occurs.

The man withdraws his penis from the vagina before ejaculation to keep semen out of the vagina. Pre-ejaculate may contain some sperm, which is why perfect use is not 100%. A 2024 pilot study found sperm in about 13% of pre-ejaculate samples, though roughly 75% of participants had no sperm in any sample.

PrescriptionRequired Prescription requiredOTC No prescription / OTC
Available Products5 productsNo branded products yet
Side effects
  • Heavier or longer periods (especially first few months)
  • Increased cramping
  • Spotting between periods
  • Small risk of uterine perforation at insertion
None reported
Who shouldn't use this
  • Active pelvic infection or PID (FDA label Category 4)
  • Uterine anomaly preventing insertion (FDA label Category 4)
  • Wilson's disease (copper metabolism disorder) (FDA label Category 4)
  • Known copper allergy (FDA label Category 4)
  • Current pregnancy (FDA label Category 4)
  • Partner unable to withdraw consistently before ejaculation
  • Need for highly effective contraception