(Published September 2011)
Description
With this method, commonly called “withdrawal,” the penis is withdrawn from the vagina before ejaculation occurs.
Use
In withdrawal, the man withdraws his penis from the woman’s vagina before he climaxes and ejaculates. The practice requires the man to be able to recognize when he is about to ejaculate and to withdraw the penis from the vagina and away from the woman’s external 
genitalia in time. Withdrawal is often used by couples as a backup method to condoms or hormonal methods.92
Effectiveness
- This method is effective. The pregnancy rate with this method appears to be similar to that of the male condom—approximately 4 percent with perfect use and 22 percent with typical use.18
- There is no evidence to support the common belief that pre-ejaculate fluid contains sperm.93
Risks
None
Side Effects
None
Contraindications
None
Advantages
- Readily available
- No cost
- No advance planning necessary
Disadvantages
- Requires cooperation and self-control of male partner
- Lower efficacy than some other methods with typical use
- Required with every act of intercourse
- No protection against STIs
Counseling Messages
- Withdrawal can be part of a larger risk-reduction strategy when used with hormonal, barrier, or other methods.
- Although not as effective as some contraceptive methods, it is substantially more effective than no contraception at all.
- Withdrawal can be discussed as a legitimate, if slightly less effective, contraceptive method just as condoms and diaphragms are.
- This method does not protect against STIs.
- Patients using withdrawal should obtain emergency contraception in advance. (Note that patients who are less than 17 years old will need a prescription for EC.)
About Audrey Kelly, PharmD