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Tubal Ligation 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

Female Sterilization A permanent surgical procedure that blocks or removes the fallopian tubes to prevent pregnancy.
Internal Condom A soft pouch worn inside the vagina that blocks sperm and lowers the risk of STIs, usually obtained with a prescription.

Method	Female Sterilization A permanent surgical procedure that blocks or removes the fallopian tubes to prevent pregnancy.	Internal Condom A soft pouch worn inside the vagina that blocks sperm and lowers the risk of STIs, usually obtained with a prescription.
Efficacy	Female Sterilization 99.5% typical use Most effective: over 99 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	Female Sterilization $0–$6,000 Insurance: Usually	Internal Condom $0–$3 per unit Insurance: Usually
Duration	Female Sterilization Permanent	Internal Condom Single use
Reversibility	Female Sterilization Permanent	Internal Condom Reversible
STI protection	Female Sterilization No	Internal Condom Yes
How it works	Female Sterilization Surgical disruption (clipping, banding, cauterization, or complete removal) of the fallopian tubes prevents sperm from reaching the egg.	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	Female Sterilization Required In-Person Procedure	Internal Condom Required Telehealth Prescription
Side effects	Female Sterilization Surgical risks (bleeding, infection, organ damage) Anesthesia side effects Ectopic pregnancy (a serious risk if pregnancy occurs after the procedure)	Internal Condom Mild irritation or discomfort Slippage with incorrect insertion
Who shouldn't use this	Female Sterilization Medical instability for general anesthesia or laparoscopy Uncertainty about future fertility desires Known allergy or hypersensitivity to materials used in the procedure	Internal Condom None reported

Key differences

With typical use, 0.5 in 100 people using Female Sterilization get pregnant in a year, vs 21 in 100 with Internal Condom (most effective vs least effective). How long it lasts: Female Sterilization, permanent; Internal Condom, single use. Female Sterilization: permanent. Internal Condom: reversible. STI protection: only with Internal Condom. Female Sterilization: costs $0–$6,000. Internal Condom: costs $0–$3 per unit.