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Pulling out: The kung fu of contraception

What do the withdrawal method and the martial art known as Kung Fu have in common?

by Tina Raine-Bennett, MD, MPH

At some point, just about every couple will probably use withdrawal, aka “pulling out” or “coitus interruptus,” as a birth control method. It’s free and it doesn’t require a trip to the clinic or pharmacy. But withdrawal is birth control kung fu—it requires self-knowledge, serious discipline, and lots of practice.

The Basics

To use withdrawal, the guy removes his penis and ejaculates away from the vagina and the lips of the vagina. If a guy withdraws before ejaculation every time a couple has sex, about 1 in 25 couples will become pregnant over the course of a year [1]. In the real world, where mistakes sometimes happen, about 1 in 5 couples using withdrawal will become pregnant [2].

This number of pregnancies is about the same for couples using condoms for birth control. Use a condom correctly every single time and 1 in 50 will become pregnant; in the real world, 1 in 6 will [1]. But withdrawal, unlike condoms, offers no protection from sexually transmitted infections (STIs). If you use withdrawal in combination with another method, like condoms or fertility awareness, it can improve overall protection from pregnancy.

Getting a Black Belt

It sounds straight-forward... At the height of sexual stimulation—not too early or too late—the guy pulls out and doesn’t interrupt the orgasm that usually happens during ejaculation. To successfully use withdrawal, a guy must be able to tell when he is going to ejaculate and have the discipline to pull out in time. For a guy to know when he’s reached ejaculatory inevitability—the point of no return—takes experience.

Before using withdrawal for the first time or with a new partner, test it out when using another method. A guy should be able to demonstrate that he does not ejaculate very quickly, or before he realizes it. If you agree to practice pulling out when using another method, you can both see how you like it. If it doesn’t go well, you’re still protected. And if it’s important to you, you can keep practicing until the kinks are worked out.

When using withdrawal, you may have some concern about pre-cum, or pre-ejaculate, the clear fluid that accumulates at the tip of the penis when some men are aroused. Research shows that some guys do have sperm in their pre-cum, which could explain why even among couples that use withdrawal perfectly, four in a hundred have a pregnancy within a year.

Like kung fu, withdrawal should not be practiced when drunk!

For Non-Black Belts…

If the kinks don’t ever go away, or if you are sure that now is not the time to get pregnant, you may have greater peace of mind using a more reliable birth control method. There are other non-hormonal methods that offer much better protection from pregnancy, like the ParaGard IUD. It’s also possible for guys who are withdrawal kung fu masters to have the occasional accident or moment of uncertainty (“I think I pulled out in time...”). If you have any doubts about his timing, you can use emergency contraception within five days.

This article was updated on December 11, 2013.

References

[1] Hatcher RA, Trussell J, Nelson AL, Cates W, Stewart FH, Lowal D. Contraceptive technology. 19th ed. New York (NY): Ardent Media; 2007.

[2] Kost K, Singh S, Vaughan B, Trusell J, Bankole A. Estimates of contraceptive failure from the 2002 National Survey of Family Growth. Contraception 2008; 77: 10-21.

Tina Raine-Bennett, MD, MPH, is a Professor in the Department of Obstetrics & Gynecology at the University of California, San Francisco, and Medical Director of the New Generation Health Center. New Generation is a family planning and STD clinic for adolescents where Dr. Raine gets to do what she loves best: help young women.

what about the risks of precum?

2012-03-05 23:22:35 UTC

maqqie

is there any STIS in withrawal method?

2012-04-19 16:16:06 UTC

patience

There would be a reduced risk for the female partner from the decrease in bodily fluids left behind when compared to only using the pill, vaginal foam, Vaginal gel or a IUD. The risk for the male partner would be pretty much the same, because the time of contact would be pretty much the same. All things considered, if you are worried about contracting an STI from your partner, you should use a form of contraceptive that creates a physical barrier, or consider not having sex until you have both been tested and feel comfortable to discuss the results with each other.

2014-02-12 18:21:12 UTC

James

There would be a reduced risk for the female partner from the decrease in bodily fluids left behind when compared to only using the pill, vaginal foam, Vaginal gel or a IUD. The risk for the male partner would be pretty much the same, because the time of contact would be pretty much the same. All things considered, if you are worried about contracting an STI from your partner, you should use a form of contraceptive that creates a physical barrier, or consider not having sex until you have both been tested and feel comfortable to discuss the results with each other.

2014-02-12 18:21:12 UTC

James

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