Compare

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.

Last verified Updated

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.
  • Withdrawal The man withdraws his penis from the vagina before ejaculation to reduce the chance of sperm reaching the egg.
Method
Copper IUD A small copper device placed in the uterus that works for up to 10 years and is over 99% effective.
Withdrawal The man withdraws his penis from the vagina before ejaculation to reduce the chance of sperm reaching the egg.
EfficacyCopper IUD 99.2% typical use

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

Withdrawal 80% typical use

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

CostCopper IUD $0–$1,167 Insurance: UsuallyWithdrawal $0
DurationCopper IUD Up to 10 yearsWithdrawal Per act
ReversibilityCopper IUD ReversibleWithdrawal Reversible
STI protectionCopper IUD NoWithdrawal No
How it worksCopper IUD

Releases copper into the uterus, which interferes with sperm movement and fertilization and may prevent implantation.

Withdrawal

The man withdraws his penis from the vagina before ejaculation to keep semen out of the vagina. Pre-ejaculate may contain some sperm. A 2024 pilot study found sperm in about 13% of pre-ejaculate samples, though roughly 75% of participants had no sperm in any sample.

PrescriptionCopper IUD Required In-Person ProcedureWithdrawal Not required Self-Directed
Side effectsCopper IUD
  • Heavier or longer periods (especially first few months)
  • Increased cramping
  • Spotting between periods
  • Small risk of uterine perforation at insertion
Withdrawal None reported
Who shouldn't use thisCopper 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)
Withdrawal
  • Partner unable to withdraw consistently before ejaculation
  • Need for highly effective contraception

Key differences

With typical use, 0.8 in 100 people using Copper IUD get pregnant in a year, vs 20 in 100 with Withdrawal (most effective vs least effective). How long it lasts: Copper IUD, up to 10 years; Withdrawal, per act. A prescription is needed for Copper IUD, not for Withdrawal. Copper IUD: costs $0–$1,167. Withdrawal: costs $0.