What is Withdrawal?
Withdrawal, also knows as “coitus interruptus,” is the removal of the penis from a partner’s vagina before ejaculation, or coming. Withdrawal may be the most common method of birth control since it’s free and always an option for preventing contact between egg and sperm, reducing the possibility of an unintended pregnancy. While withdrawal has been criticized as a non-method, it is 73-96% effective for birth control, depending on the male partner’s self-knowledge and self-control. While 85% of heterosexual partners who use chance are likely to become pregnant in a year, only19% of partners who use withdrawal are. Withdrawal does not protect against sexually transmitted infections (STIs), including HIV/AIDS.
Where’s the sperm?
During sex, the penis releases two kinds of fluids. The first is pre-ejaculate or pre-cum, a lubricant made in a gland in the penis. This fluid usually contains no sperm, but can transmit infections. The second, released with ejaculation, is semen, which is made in the testicles and carries thousands of sperm in addition to any sexually transmittable infections that may be present.
Many sources that discuss the ineffectiveness of withdrawal argue that pre-cum can contain sperm. This is because previous ejaculations can leave some sperm behind in the folds of the penis. While there is a need for further study, it is likely that urination before intercourse washes leftover sperm from the urethra, the tube from which both urine and semen exit the penis.
Using this Method
To ensure no sperm enter the vagina during sex, the male partner should urinate and wipe the tip of the penis before intercourse. During sex, partners can have vaginal-penile sex until the male partner nears ejaculation. It is likely that pre-ejaculate fluid will enter the vagina, but this should not contain sperm nor lead to an unplanned pregnancy.
When the male partner feels close to ejaculation, he must withdraw his penis from his partner’s vagina and crotch. Both partners can continue to stimulate each other and themselves as long as they avoid putting sperm in contact with the vulva. Even sperm outside the vagina, but on the vulva or on the legs near the vulva, can travel to the uterus and cause pregnancy.
Some partners may also choose to have intercourse in the early stages of their sex play, withdraw, and use other forms of stimulation to reach mutual orgasm. This use of withdrawal can reduce anxiety about the timing of a partner’s ejaculation and reduce the risk of an unintended pregnancy.
The effectiveness of withdrawal depends on communication between partners before and during sex, as well as the male partner’s knowledge and experience with his own body. Withdrawal may not be effective if the male partner is unable to withdraw before his orgasms.
Partners who are less experienced with withdrawal may have a higher risk of pregnancy during their first attempts with this method. Teens are the age group for which this method is the least effective. To increase effectiveness, new partners may also want to use spermicide or fertility awareness methods to learn when pregnancy is more or less likely in a female partner’s menstrual cycle. If sperm come near or inside the vagina, taking Emergency Contraception can still be an option for preventing pregnancy.
Withdrawal is not an effective method for preventing the spread of sexually transmitted infections (STIs), including HIV/AIDS.
There are no side effects to using withdrawal. Some partners may experience nervousness that may, in turn, decrease pleasure. Using additional methods of birth control can help reduce anxiety.
- Free and always available.
- No side effects.
- Does not alter the menstrual cycle.
- Does not affect future fertility.
- Can help partners be more aware of and learn about their sexual responsiveness.
- More effective with better partner communication.
- May be a more acceptable form of birth control for people with religious concerns about using other contraceptive tools.
- More effective than using no birth control.
- Does not protect against HIV/AIDS.
- Nervousness and sexual interruption may lessen pleasure.
- Requires male’s ability to predict ejaculation and use self-control.
- Less effective with less sexual experience.
- Less effective than other methods of birth control.
- Less effective if under the influence of alcohol or drugs.
Joint Participation in Pregnancy Prevention
Like condoms, withdrawal is one of the few methods of birth control that male partners control. Female partners play an important role in withdrawal through communication and attention to their and their partners’ sexual responses.
You can prevent pregnancy after sexual intercourse by taking Emergency Contraception pills (EC). EC works by giving the body a short burst of synthetic hormones that disrupt the hormone patterns needed for a pregnancy to start. Brand names include Plan B and Preven. Also some types of regular birth control pills will work. EC is most effective 24-48 hours after unprotected intercourse but it can work for several days.
To find the EC provider closest to you, call the nationwide EC Hotline at 1-800-584-9911, 24 hours a day in English or Spanish. If you already have birth control pills, ask them about the dosage to take for EC.
Women 17 and older can request EC directly from a pharmacist, without first getting a prescription from a doctor. Women’s health activists are working to make EC accessible over-the-counter nationwide so that one day soon you could purchase it in advance or when you need it at a variety of stores.
T he Cervix
The cervix is the opening to the uterus where menstrual blood, sperm, and babies pass. It is also the opening through which abortions are performed. Barrier methods of birth control, including the cervical cap, diaphragm, and female condom, work by covering the cervix and preventing sperm from entering the uterus. Hormonal methods of birth control, including oral contraceptives, The Patch, the Vaginal Ring, and Depo Provera, affect the mucus around the cervix and make the opening more resistant to sperm. Withdrawal works by ejaculating the sperm where it will not reach the cervix. Women’s bodies also naturally produce hormones that change the cervix during a menstrual cycle. You can learn more about your cervix using a speculum to perform a self-exam. For instructions and a speculum, ask your clinician.
Feminist Women’s Health Center at www.feministcenter.org 404-728-7900
Contraceptive Technology. Ardent Media, 1998.
Emergency Contraception: ec.princeton.edu
Our Bodies, Ourselves, Boston Women’s Health Book Collective, new version in 2005.