The Withdrawal Method

Also Known as Pulling Out

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Withdrawal. Photo Courtesy of 4FR/Getty Images

What is the Withdrawal Method?

Withdrawal (also known as pulling out) is the behavioral action where a man pulls his penis out of the vagina before he ejaculates during sex (this is the moment when semen begins to spurt out of the penis). This form of contraception is considered to be a natural birth control method.

How Reliable is the Withdrawal Method?

The withdrawal method is not super reliable as a birth control method.

This is due to a couple of reasons. When he is aroused (and still inside the vagina), a man actually ejects pre-ejaculate fluid. Even though pre-ejaculate fluid may only consist of a few drops, this fluid can still have at least 300,000 sperm in it -- and it only takes ONE of these sperm to find and fertilize an egg). Plus, pulling out really relies on a man's self-control. When he is in the "heat of the moment," a man must have enough control to pull out before he ejaculates. This can be extremely difficult. Finally, even if he pulls out and ejaculates out of the vagina, sperm can still swim. So even though this is rare, semen landing anywhere on the outside of the vagina can still possibly lead to pregnancy.

Are There Advantages of the Withdrawal Method?

  • Pulling out allows for sexual spontaneity.
  • Withdrawal doesn't cost anything.
  • If you have great self-control, experience, and there is trust between partners, pulling out can be used more reliably.

What are the Disadvantages of the Withdrawal Method?

  • The pull out method is not a good contraceptive for men who ejaculate prematurely.
  • Requires experience and a high level of self-control.
  • The withdrawal method is not recommended for sexually inexperienced men or for teenagers.
  • Pulling out is not a reliable method for men who do not understand their body's sexual response. You must be able to realize and predict the moment when you are reaching the point in your sexual excitement when ejaculation can no longer be stopped or postponed.

So What is the Effectiveness of the Withdrawal Method?

The withdrawal method is 82% to 96% effective. This means that with perfect use, 4 out of every 100 women who's partner pulls out will become pregnant in one year. With typical use, 18 out of every 100 women who use the withdrawal method will become pregnant in one year.

Men who have more experience, self control, and understand their bodies will make using the withdrawal method more effective. Effectiveness may also be increased by peeing between ejaculations (before having sex again). The thinking behind this is that peeing can "wash" the urethra.

This helps to reduce the number of sperm in your pre-ejaculate fluid.

Does Withdrawal Offer Any STD Protection?

The withdrawal method does not protect you against sexually transmitted infections.

What Some Newer Research Reveals About the Withdrawal Method:

The withdrawal method (pulling out)  is sometimes referred to as the birth control method that is better than doing nothing at all. But a 2009 article published the Contraception journal suggests that the withdrawal method should be referred to as a method that is almost as effective as the male condom.

The researchers of this article analyzed evidence from several studies. They came to the conclusion that withdrawal is almost nearly as effective as condoms when it comes to preventing pregnancy. The effectiveness rates of withdrawal appear to be very similar to the perfect and typical-user rates for the male condom, which are 2% (for perfect use) and 18% (for typical use).

This article also explains that use of the withdrawal method may be underestimated. This may be because women may be more likely to use withdrawal along with another birth control method:

It seems that among 18-30 year old women, about 21% use the pull out method regularly. Very few women said that they use either pulling out or condoms alone. Sixty-eight percent of withdrawal users report that they used male condoms in the last month, and 42% of condom users also said that they were using the withdrawal method. It appears that women may be more likely to combine pulling out with another method -- like using condoms during their more fertile days.

The article concludes that the withdrawal method may be an effective back-up method for couples -- especially ones who have problems using other birth control methods... such as women who have trouble remembering to taking the pill regularly, and couples who don't always use condoms. Because of this, the researchers suggest that people become more informed about the pull out method. Even though the withdrawal method my be less effective as other birth control methods, it is still substantially more effective than using no contraception. They recommend that doctors discuss the withdrawal method with their patients, so there is more awareness of this being a "legitimate" contraceptive option for couples who can correctly and reliably practice it.

Source:

Jones RK, Fennell J, Higgins JA, & Blanchard K. "Better than nothing or savvy risk-reduction practice? The importance of withdrawal." Contraception. 2009; 79:407–410. Accessed via private subscription.

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