5 myths about pulling out, busted

No, it doesn’t. You can still get a sexually transmitted disease (STD) such as HIV, chlamydia, gonorrhea, herpes, or syphilis while using this method.

Pull Out Method (Withdrawal)

The pull-out method is a form of birth control in which a man takes their penis out of a woman’s vagina before they ejaculate so fewer sperm get inside. It’s also known as coitus interruptus or the withdrawal method.

How Does the Pull-Out Method Work?

It isn’t as easy as it sounds. The man needs a lot of control to time it right. It doesn’t work if they can’t feel when they are close to orgasm or if they’re so caught up in the moment that they don’t pull out in time.

The best ways to use the pull-out method

Here are some tips to make it work better:

• Use it along with another type of birth control, like a condom or the pill.
• Use a spermicide, a chemical that kills sperm.
• Don’t rely on withdrawal alone on the days when the woman is most likely to get pregnant. You can keep track of which days are safest with an ovulation calendar.
• Have the man pee before sex to clear out any sperm that may have gotten an early start.
• Be consistent. Do it every time you have sex.
• When the man ejaculates, make sure none of the fluid gets on the woman’s upper thighs or groin. Sperm on your skin can work its way inside your vagina.

Pull-Out Method Effectiveness

Pulling out isn’t a very reliable way to prevent pregnancy. It works about 78% of the time, which means that over a year of using this method, 22 out of 100 women — about 1 in 5 — would get pregnant. By comparison, male condoms are 98% effective when used correctly every time.

Administrative spending is particularly problematic in United States hospitals, where it makes up about 25% of total hospital spending and accounts for hundreds of billions of dollars in healthcare spending annually, The Commonwealth Fund The percentage of total hospital spending devoted to administration is highest in for-profit hospitals, followed by nonprofit hospitals, teaching hospitals, and finally public hospitals. Outdated reimbursement and reporting methods are a big part of the administrative cost, says Salvo-Wendt. “Reimbursing in bundled payments instead of itemizing each service or component would produce instant savings of administrative costs.”

Can you get pregnant if your partner pulls out?

Yes, you can. But the pull-out method may work better than doing nothing.

Does the pull-out method prevent STDs?

No, it doesn’t. You can still get a sexually transmitted disease (STD) such as HIV, chlamydia, gonorrhea, herpes, or syphilis while using this method.

Benefits of the Pull-Out Method

Couples may choose this method if they wouldn’t mind a surprise pregnancy or because:

• They don’t want to use other types of birth control for religious or philosophical reasons.
• They need some kind of birth control right away, and it’s too late to use other methods.
• They don’t have sex very often.
• It’s free and convenient.
• It doesn’t involve any hormones or other chemicals.
• It has no side effects or health risks.
• You don’t need to see a doctor or get a prescription.

Disadvantages of the Pull-Out Method

Not only is it not very effective, withdrawal isn’t a good method of birth control because:

• It takes a lot of control for the man to pull out before ejaculation.
• The woman has no control over it at all.
• You may feel that it gets in the way of sexual pleasure.
• Even if they pee before sex, the man can still release fluid before they ejaculate. This pre-ejaculate does contain sperm.

What Should You Do if the Pull-Out Method Fails?

If you’re worried the method did not go as planned, talk to your doctor about emergency contraception, which should be taken as soon as possible after sex to try to prevent a pregnancy.

Show Sources

Bedsider: “5 myths about pulling out, busted.”

Feminist Women’s Health Center: “Withdrawal (‘Pulling Out’).”

Planned Parenthood: “Withdrawal (Pull-Out Method).”

Trussell, J. Contraception, May 2011.

Center for Young Women’s Health: “Contraception: Pros and Cons of Different Contraceptive Methods.”

Journal of the British Fertility Society: “Sperm content of pre-ejaculatory fluid.”

Mayo Clinic: “Withdrawal method (coitus interruptus).”

Contraception: “Better than nothing or savvy risk-reduction practice? The importance of withdrawal.”

CDC: “Contraceptive Guidance for Health Care Providers: Coitus Interruptus (Withdrawal).”

SexInfo Online: “Withdrawal.”

5 myths about pulling out, busted

Before he busts a nut, allow us to bust these withdrawal myths. (Sorry, we can’t resist puns.)

Dec 11, 2013

The withdrawal method, a.k.a. pulling out, sometimes gets a bad rap—some people don’t even consider it a “real” method of birth control, even though 60% of couples have used it at least once. Because pulling out is often dismissed as “better than nothing” by researchers, we don’t know as much about it as we do about some other methods. But before you write it off, make sure you’ve got your facts straight.

Myth 1: Pulling out doesn’t work, so don’t even bother.

Out of 100 couples who were withdrawal rock stars—meaning they pulled out correctly every time they had sex—about four of them would get pregnant in a year. But it can be a challenge to pull out for lots of reasons, and most people have days when they’re not feeling like rock stars of any kind. That’s why out of 100 average couples using withdrawal, 22 will get pregnant in a year.

It’s not that pulling out doesn’t work in principle—it’s that it’s challenging to pull out just right every single time. Condoms and the pill aren’t so different that way—they’re great in a world where we always use them perfectly—but the reality of our lives is often busy, complicated, and not so perfect. Still, pulling out is a lot better than nothing—in fact, it’s nearly as effective at preventing accidental pregnancy as condoms alone.

Myth 2: Pre-cum is safe—it doesn’t have sperm in it.

First off, we have very limited scientific information about pre-cum so there can be confusion about it even among experts. Three small studies from years ago found no sperm in pre-cum, but there were only 43 guys in all of these studies combined. Some of the men in the studies had health problems, and it appears that the pre-cum samples they provided were not analyzed immediately so it may have been it difficult to tell if their sperm were swimming normally.

A more recent study had 27 healthy guys, some of whom gave multiple samples of pre-cum. The researchers analyzed the samples immediately and found that about a third contained live, swimming sperm. Popular advice says that sperm found in pre-cum may come from a previous ejaculation and can be flushed out when a guy pees, but the guys in this study who had peed after their last ejaculation still had sperm in their pre-cum. The bottom line is that this study can’t tell us whether pre-cum can cause a pregnancy, but it does tell us that it might. It also suggests that pulling out may work better for some guys than others—but unless you have a pre-cum sample and awesome microscope skills, you can’t tell which group a guy is in. This may be part of why even withdrawal rock stars sometimes have accidental pregnancies.

Myth 3: Only irresponsible people use the “pull out” method.

Sixty percent of women ages 15-44 in the U.S. have used withdrawal at some point. In the most recent U.S. national survey, 5% of couples using any type of birth control were relying exclusively on pulling out. If you count couples using another method plus pulling out, about 10% of people use withdrawal. Because people sometimes don’t consider pulling out a method, they may not mention it when asked about birth control use, so even this number may be low. In other words, people of all ages in all types of relationships are using withdrawal to prevent pregnancy.

Myth 4: There’s nothing good about pulling out.

Pulling out may not be the most effective method, but that doesn’t mean it doesn’t have perks. No hormones, no cost, no advance preparation, no prescription, no visit to the store or clinic, can be used spontaneously, great option when you don’t have another plan… people have all kinds of reasons for using it. For women who have struggled with vaginal infections like bacterial vaginosis, pulling out may also help prevent recurrent infections.

Myth 5: Pulling out is easy.

It takes practice, learning, communication, and back-up plans to use withdrawal like a pro:

• Do some withdrawal dress rehearsals while your guy is wearing a condom. Does he know when he’s about to cum? Can he pull out in time? If not, consider another method.
• Know your STI status, and make sure your guy knows his. Withdrawal can work for pregnancy prevention, but it does not offer protection against STIs (sexually transmitted infections).
• Communicate! Talk about what the plan is in the event of an accident, an accidental pregnancy, or an STI.
• Have back up supplies. Keep emergency contraception around for those times when accidents happen, and condoms for times when pulling out doesn’t seem like the right choice for a particular guy.
• Know your cycles. If you have a smartphone, check outsome ofthe apps that help you track your fertile times. Consider using condoms in addition to pulling out during high fertility days of the month.

If effectiveness is your #1 priority, withdrawal might not be right for you—maybe not right now, maybe not ever. But a lot of your sisters are out there doin’ it for themselves, and not everybody hates it or gets pregnant on it. Is it perfect? Nope. But it is an option that you can use any time, anywhere.

Written by Yvonne Piper, MLIS, MS, RN, FNP

Yvonne Piper, MLIS, MS, RN, FNP has her dream job as a primary care provider at Lyon-Martin Health Services in San Francisco, CA. She has TA’ed two rounds of UCSF’s Coursera class on Contraception and loves helping her patients choose the best birth control method for their crazy-busy lives. When she isn’t at work she can be found lifting at her Crossfit box, hanging out with her pet rats, or volunteering as a trainer with San Francisco Sex Information (SFSI).

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