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Diaphragm vs Internal Condom

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.
Internal Condom A soft pouch worn inside the vagina that blocks sperm and lowers the risk of STIs, usually obtained with a prescription.

Method	Diaphragm A reusable silicone dome that covers the cervix to block sperm, used with spermicide each time you have sex.	Internal Condom A soft pouch worn inside the vagina that blocks sperm and lowers the risk of STIs, usually obtained with a prescription.
Efficacy	Diaphragm 83% typical use Least effective: under 90 out of 100 people successfully prevent pregnancy per year.	Internal Condom 79% typical use Least effective: under 90 out of 100 people successfully prevent pregnancy per year.
Cost	Diaphragm $0–$250 Insurance: Usually	Internal Condom $0–$3 per unit Insurance: Usually
Duration	Diaphragm Reusable for up to 2 years (replace sooner if damaged)	Internal Condom Single use
Reversibility	Diaphragm Reversible	Internal Condom Reversible
STI protection	Diaphragm No	Internal Condom Yes
How it works	Diaphragm A reusable silicone dome covers the cervix to block sperm from reaching an egg. Used with spermicide for added effectiveness.	Internal Condom A soft, loose-fitting nitrile pouch lines the vagina and collects semen. The inner ring anchors it at the cervix and the outer ring stays outside the vaginal opening.
Prescription	Diaphragm Required Hybrid (Fitting or Ship)	Internal Condom Required Telehealth Prescription
Side effects	Diaphragm Increased risk of urinary tract infection Vaginal irritation from spermicide Toxic shock syndrome risk (rare)	Internal Condom Mild irritation or discomfort Slippage with incorrect insertion
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)	Internal Condom None reported

Key differences

With typical use, 17 in 100 people using Diaphragm get pregnant in a year, vs 21 in 100 with Internal Condom (both least effective). How long it lasts: Diaphragm, reusable for up to 2 years (replace sooner if damaged); Internal Condom, single use. STI protection: only with Internal Condom. Diaphragm: costs $0–$250. Internal Condom: costs $0–$3 per unit.