External CondomvsTubal Ligation

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	External Condom A non-hormonal barrier method that also lowers the risk of STIs, available over the counter.	Female Sterilization A permanent surgical procedure that blocks or removes the fallopian tubes to prevent pregnancy.
Efficacy	87% typical use Least effective: under 90 out of 100 people successfully prevent pregnancy per year.	99.5% typical use Most effective: over 99 out of 100 people successfully prevent pregnancy per year.
Cost	$0.5–$3 /per unit Insurance: Varies	$0–$6,000 Insurance: Usually
Duration	Single use	Permanent
Reversibility	Reversible	Permanent
STI Protection	Yes	No
How it works	A physical sheath worn over the penis that blocks semen from entering the vagina and reduces skin-to-skin contact that transmits STIs.	Surgical disruption (clipping, banding, cauterization, or complete removal) of the fallopian tubes prevents eggs from reaching the uterus and sperm from reaching the egg.
Prescription	OTC No prescription / OTC	Required Prescription required
Side effects	Rare local irritation from latex or lubricants	Surgical risks (bleeding, infection, organ damage) Anesthesia side effects Ectopic pregnancy (small but serious risk if failure occurs)
Who shouldn't use this	Known allergy to latex (use polyisoprene or polyurethane instead)	Medical instability for general anesthesia or laparoscopy Uncertainty about future fertility desires

Key differences

Female Sterilization is more effective (99.5% vs 87% typical use). External Condom duration: Single use. Female Sterilization duration: Permanent. External Condom is reversible; Female Sterilization is permanent. Only External Condom protects against STIs. Female Sterilization requires a prescription; External Condom does not. External Condom: costs $0.5–$3 per unit. Female Sterilization: costs $0–$6,000.