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External Condom vs Internal Condom

A side-by-side comparison of two birth control methods — efficacy, cost, how they work, and who shouldn't use them.

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Side-by-side comparison

  • External Condom A barrier method worn over the penis that also lowers the risk of STIs, available over the counter.
  • Internal Condom A soft pouch worn inside the vagina that blocks sperm and lowers the risk of STIs, usually obtained with a prescription.
Method
External Condom A barrier method worn over the penis that also lowers the risk of STIs, available over the counter.
Internal Condom A soft pouch worn inside the vagina that blocks sperm and lowers the risk of STIs, usually obtained with a prescription.
EfficacyExternal Condom 87% 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.

CostExternal Condom $0–$2 per unit Insurance: VariesInternal Condom $0–$3 per unit Insurance: Usually
DurationExternal Condom Single useInternal Condom Single use
ReversibilityExternal Condom ReversibleInternal Condom Reversible
STI protectionExternal Condom YesInternal Condom Yes
How it worksExternal Condom

A sheath worn over the penis that keeps sperm from entering a partner's body. Latex and plastic condoms also block contact with semen and vaginal fluids that can carry STIs.

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.

PrescriptionExternal Condom Not required Over-the-CounterInternal Condom Required Telehealth Prescription
Side effectsExternal Condom
  • Allergic reaction to latex in people with a latex allergy
Internal Condom
  • Mild irritation or discomfort
  • Slippage with incorrect insertion
Who shouldn't use thisExternal Condom
  • Known allergy to latex (use polyisoprene or polyurethane instead)
Internal Condom None reported

Key differences

With typical use, 13 in 100 people using External Condom get pregnant in a year, vs 21 in 100 with Internal Condom (both least effective). A prescription is needed for Internal Condom, not for External Condom. External Condom: costs $0–$2 per unit. Internal Condom: costs $0–$3 per unit.