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Diaphragm
vs
External Condom

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
Diaphragm

Diaphragm

A reusable silicone dome that covers the cervix to block sperm, used with spermicide each time you have sex.

External Condom

External Condom

A non-hormonal barrier method that also lowers the risk of STIs, available over the counter.

Efficacy83% typical use

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

87% typical use

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

Cost$80–$200

Insurance: Usually

$0.5–$3 /per unit

Insurance: Varies

DurationReusable for 1-2 years (replace every 1-2 years or sooner if damaged)Single use
ReversibilityReversibleReversible
STI ProtectionNoYes
How it works

A reusable silicone dome covers the cervix to block sperm from entering the uterus. Used with spermicide for added effectiveness.

A physical sheath worn over the penis that blocks semen from entering the vagina and reduces skin-to-skin contact that transmits STIs.

PrescriptionRequired Prescription requiredOTC No prescription / OTC
Available Products2 products3 products
Side effects
  • Increased risk of urinary tract infection
  • Vaginal irritation from spermicide
  • Discomfort if not fitted correctly
  • Rare local irritation from latex or lubricants
Who shouldn't use this
  • Uterine or cervical anomaly preventing fit
  • Sensitivity to silicone or spermicide
  • Inability to insert or remove reliably
  • Known allergy to latex (use polyisoprene or polyurethane instead)