External CondomvsInternal 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	External Condom A non-hormonal barrier method that also lowers the risk of STIs, available over the counter.	Internal Condom A soft pouch worn inside the vagina that blocks sperm and protects against STIs, available by prescription.
Efficacy	87% typical use Least effective: under 90 out of 100 people successfully prevent pregnancy per year.	79% typical use Least effective: under 90 out of 100 people successfully prevent pregnancy per year.
Cost	$0.5–$3 /per unit Insurance: Varies	$0–$4 /per unit Insurance: Usually
Duration	Single use	Single use
Reversibility	Reversible	Reversible
STI Protection	Yes	Yes
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.	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	OTC No prescription / OTC	Required Prescription required
Side effects	Rare local irritation from latex or lubricants	Mild irritation or discomfort Noise during use if not positioned correctly Slippage with incorrect insertion
Who shouldn't use this	Known allergy to latex (use polyisoprene or polyurethane instead)	Sensitivity to nitrile (rare)

Key differences

External Condom is more effective (87% vs 79% typical use). Internal Condom requires a prescription; External Condom does not. External Condom: costs $0.5–$3 per unit. Internal Condom: costs $0–$4 per unit.