Internal CondomvsSponge

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	Internal Condom A soft pouch worn inside the vagina that blocks sperm and protects against STIs, available by prescription.	Sponge A soft foam disc placed deep in the vagina before sex. It covers the cervix and contains spermicide.
Efficacy	79% typical use Least effective: under 90 out of 100 people successfully prevent pregnancy per year.	Least effective see details Least effective: under 90 out of 100 people successfully prevent pregnancy per year.
Cost	$0–$4 /per unit Insurance: Usually	$15–$20 /per package Insurance: No
Duration	Single use	Single use (can be left in place up to 24 hours and for multiple acts of sex)
Reversibility	Reversible	Reversible
STI Protection	Yes	No
How it works	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.	A polyurethane foam disc impregnated with spermicide is placed over the cervix before sex. The spermicide kills or disables sperm and the physical barrier blocks sperm from entering the uterus.
Prescription	Required Prescription required	OTC No prescription / OTC
Side effects	Mild irritation or discomfort Noise during use if not positioned correctly Slippage with incorrect insertion	Vaginal irritation or dryness Increased risk of urinary tract infection Rare allergic reaction
Who shouldn't use this	Sensitivity to nitrile (rare)	Allergy to nonoxynol-9, benzalkonium chloride, or other spermicide ingredients History of toxic shock syndrome Active vaginal infection Inability to insert or remove reliably High risk of HIV exposure (frequent nonoxynol-9 use may increase vaginal irritation; CDC cautions)

Key differences

Internal Condom duration: Single use. Sponge duration: Single use (can be left in place up to 24 hours and for multiple acts of sex). Only Internal Condom protects against STIs. Internal Condom requires a prescription; Sponge does not. Internal Condom: costs $0–$4 per unit. Sponge: costs $15–$20 per package.