Internal CondomvsVasectomy

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.	Vasectomy A permanent outpatient procedure that blocks the vas deferens so sperm cannot enter the semen.
Efficacy	79% typical use Least effective: under 90 out of 100 people successfully prevent pregnancy per year.	99.85% typical use Most effective: over 99 out of 100 people successfully prevent pregnancy per year.
Cost	$0–$4 /per unit Insurance: Usually	$0–$3,500 Insurance: Usually
Duration	Single use	Permanent
Reversibility	Reversible	Permanent
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 clinician cuts, seals, or blocks the vas deferens so sperm cannot mix with semen during ejaculation. The body absorbs the sperm, and the semen remains normal in appearance and volume.
Prescription	Required Prescription required	OTC Procedure (in-person)
Side effects	Mild irritation or discomfort Noise during use if not positioned correctly Slippage with incorrect insertion	Mild pain or swelling for a few days Bruising or bleeding at the site Sperm granuloma (small lump, usually harmless) Chronic post-vasectomy pain syndrome (rare, 1-2%)
Who shouldn't use this	Sensitivity to nitrile (rare)	Uncertainty about future fertility desires Active local or systemic infection Bleeding disorder

Key differences

Vasectomy is more effective (99.85% vs 79% typical use). Internal Condom duration: Single use. Vasectomy duration: Permanent. Internal Condom is reversible; Vasectomy is permanent. Only Internal Condom protects against STIs. Internal Condom requires a prescription; Vasectomy does not. Internal Condom: costs $0–$4 per unit. Vasectomy: costs $0–$3,500.