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Diaphragm vs Vasectomy

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.
Vasectomy A permanent outpatient procedure that blocks the vas deferens so sperm cannot enter the semen.

Method	Diaphragm A reusable silicone dome that covers the cervix to block sperm, used with spermicide each time you have sex.	Vasectomy A permanent outpatient procedure that blocks the vas deferens so sperm cannot enter the semen.
Efficacy	Diaphragm 83% typical use Least effective: under 90 out of 100 people successfully prevent pregnancy per year.	Vasectomy 99.85% typical use Most effective: over 99 out of 100 people successfully prevent pregnancy per year.
Cost	Diaphragm $0–$250 Insurance: Usually	Vasectomy $0–$1,000 Insurance: Varies
Duration	Diaphragm Reusable for up to 2 years (replace sooner if damaged)	Vasectomy Permanent
Reversibility	Diaphragm Reversible	Vasectomy Permanent
STI protection	Diaphragm No	Vasectomy 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.	Vasectomy A clinician cuts, seals, or blocks the vas deferens so sperm cannot mix with semen during ejaculation. The body absorbs the sperm, and the semen remains normal in appearance and volume.
Prescription	Diaphragm Required Hybrid (Fitting or Ship)	Vasectomy Required In-Person Procedure
Side effects	Diaphragm Increased risk of urinary tract infection Vaginal irritation from spermicide Toxic shock syndrome risk (rare)	Vasectomy Mild pain or swelling for a few days Bruising or bleeding at the site Sperm granuloma (swelling from leaked sperm that usually goes away on its own) Chronic post-vasectomy pain syndrome (5% in a 2020 meta-analysis)
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)	Vasectomy 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 0.2 in 100 with Vasectomy (least effective vs most effective). How long it lasts: Diaphragm, reusable for up to 2 years (replace sooner if damaged); Vasectomy, permanent. Diaphragm: reversible. Vasectomy: permanent. Diaphragm: costs $0–$250. Vasectomy: costs $0–$1,000.