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Sponge
vs
Withdrawal

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
Sponge

Sponge

A soft foam disc placed deep in the vagina before sex. It covers the cervix and contains spermicide.

Withdrawal

Withdrawal

The man withdraws his penis from the vagina before ejaculation to reduce the chance of sperm reaching the egg.

EfficacyLeast effective see details

Least effective: under 90 out of 100 people successfully prevent pregnancy per year.

80% typical use

Least effective: under 90 out of 100 people successfully prevent pregnancy per year.

Cost$15–$20 /per package

Insurance: No

$0

Insurance: Varies

DurationSingle use (can be left in place up to 24 hours and for multiple acts of sex)Per act
ReversibilityReversibleReversible
STI ProtectionNoNo
How it works

A 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.

The man withdraws his penis from the vagina before ejaculation to keep semen out of the vagina. Pre-ejaculate may contain some sperm, which is why perfect use is not 100%. A 2024 pilot study found sperm in about 13% of pre-ejaculate samples, though roughly 75% of participants had no sperm in any sample.

PrescriptionOTC No prescription / OTCOTC No prescription / OTC
Available Products1 productNo branded products yet
Side effects
  • Vaginal irritation or dryness
  • Increased risk of urinary tract infection
  • Rare allergic reaction
None reported
Who shouldn't use this
  • 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)
  • Partner unable to withdraw consistently before ejaculation
  • Need for highly effective contraception