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Diaphragm vs Tubal Ligation

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

Diaphragm A reusable silicone dome that covers the cervix to block sperm, used with spermicide each time you have sex.
Female Sterilization A permanent surgical procedure that blocks or removes the fallopian tubes to prevent pregnancy.

Method	Diaphragm A reusable silicone dome that covers the cervix to block sperm, used with spermicide each time you have sex.	Female Sterilization A permanent surgical procedure that blocks or removes the fallopian tubes to prevent pregnancy.
Efficacy	Diaphragm 83% typical use Least effective: under 90 out of 100 people successfully prevent pregnancy per year.	Female Sterilization 99.5% typical use Most effective: over 99 out of 100 people successfully prevent pregnancy per year.
Cost	Diaphragm $0–$250 Insurance: Usually	Female Sterilization $0–$6,000 Insurance: Usually
Duration	Diaphragm Reusable for up to 2 years (replace sooner if damaged)	Female Sterilization Permanent
Reversibility	Diaphragm Reversible	Female Sterilization Permanent
STI protection	Diaphragm No	Female Sterilization No
How it works	Diaphragm A reusable silicone dome covers the cervix to block sperm from reaching an egg. Used with spermicide for added effectiveness.	Female Sterilization Surgical disruption (clipping, banding, cauterization, or complete removal) of the fallopian tubes prevents sperm from reaching the egg.
Prescription	Diaphragm Required Hybrid (Fitting or Ship)	Female Sterilization Required In-Person Procedure
Side effects	Diaphragm Increased risk of urinary tract infection Vaginal irritation from spermicide Toxic shock syndrome risk (rare)	Female Sterilization Surgical risks (bleeding, infection, organ damage) Anesthesia side effects Ectopic pregnancy (a serious risk if pregnancy occurs after the procedure)
Who shouldn't use this	Diaphragm Uterine or cervical anomaly preventing fit Sensitivity to silicone or spermicide Inability to insert or remove reliably History of toxic shock syndrome High risk of HIV exposure (because of the spermicide)	Female Sterilization Medical instability for general anesthesia or laparoscopy Uncertainty about future fertility desires Known allergy or hypersensitivity to materials used in the procedure

Key differences

With typical use, 17 in 100 people using Diaphragm get pregnant in a year, vs 0.5 in 100 with Female Sterilization (least effective vs most effective). How long it lasts: Diaphragm, reusable for up to 2 years (replace sooner if damaged); Female Sterilization, permanent. Diaphragm: reversible. Female Sterilization: permanent. Diaphragm: costs $0–$250. Female Sterilization: costs $0–$6,000.