SKIP AHEAD. . .
What is Coitus Interruptus?
No, this is not when you get caught getting down and dirty by an unsuspecting roommate! Coitus Interruptus, a fancy way of saying the pull out method or withdrawal, is the act of removing a penis from a vagina before ejaculation, or cumming, occurs. If any amount of semen comes into contact with the vagina or vulva, there is a possibility for pregnancy (6). Coitus Interruptus is used to prevent pregnancy by keeping the semen away from the vagina. The vagina is the starting line for the sperms’ race through the cervix and uterus to the fallopian tube. The finish line? Fertilizing the egg! With Coitus Interruptus, the thought is that the starting line is taken out of the equation.
People having this kind of sex may gravitate towards this method because they don’t want to use or don’t have access to (for a variety of reasons) other methods of contraception. Unlike some other practices, withdrawal is free, doesn’t require a prescription and doesn’t have any hormonal side effects, unless you get pregnant of course (10). It can also be used spontaneously, which can be super useful if you don’t have another plan in place. Though lots of folks use this technique at some point, pulling out requires enormous self-control and pretty much perfect execution, which is why it may not be the best option for some. It is also important to note here that STIs can still be contracted and it is also possible to get pregnant from pre-cum – important to keep in mind if you are planning on using the pull out method. More on this below!
How effective is it?
Pulling out can be a very effective form of birth control… if done absolutely correctly. To reiterate, doing it correctly is constituted as keeping any and all semen away from the vagina and vulva. To avoid any confusion, the vagina is the internal opening/birth canal while the vulva refers to all external organs (your labia, urethral opening, mons pubis, and clitoris). As a wise woman once said, if the vagina is The Lincoln Tunnel, the vulva is New York City.
As far as stats go, out of every 100 people who perfectly practice withdrawal, 4 of them get pregnant in a year (6). But, we are humans, and humans are not always perfect. So, of every normal, mistake-making, couple practicing this method of birth control, the numbers jump to something more like 22 out of every 100, which averages out to just a little bit more than 1 in 5 (6,10).
What are the risks?
The most obvious risk of pulling out is not doing it perfectly for one reason or another. This can happen for a myriad of reasons and lead to unintentional results. Some people don’t always have the best self-control, some people straight up forget, and some people experience premature ejaculation. And, if any semen ends up on the vulva (outer genitals), it is still possible that the sperm can make its way to the vagina (9,10). Even if it’s just pre-cum (pre-ejaculate fluid). It is possible for small amounts of sperm to make its way into this fluid. So, while uncommon, it’s not impossible, for pre-cum to cause pregnancy.
A tip (ha) in making sure semen doesn’t unknowingly make it’s way into a vagina before ejaculation? Make sure the tip of the penis is being cleaned and cleared before and after each new session to remove as much sperm as possible that may still be hanging around.
Something else to consider is that this method relies entirely on trust if you are the person with the vagina. Trust is an important aspect of any sexual encounter, but in letting somebody else be in control of your pregnancy prevention, it is especially so. The person with the penis needs to know exactly when they are going to ejaculate every time you use this method to avoid an unintended pregnancy. It is a lot of responsibility to be aware of while getting it on, so it’s wise to get on the same page with your partner before getting down to business.
If we’re not talking pregnancy, the biggest risk of only using withdrawal as birth control is that it does not protect you from any STDs (sexually transmitted diseases) or STIs (sexually transmitted infections) because no barrier is created between the genitals.
Dual protection methods
Dual Protection Method by definition is the act of using a barrier method, like condoms, with another form of birth control to prevent pregnancy, STDs, and STIs (1,2). So, in the case here, while you may be able to lower your chances of getting pregrant by using withdrawal, having a second layer of protection (like an IUD, using the Fertility Awareness Method, being on a pill, patch, implant or ring) would decrease your chances of pregnancy much more (3).
Conclusion? Pulling out makes many of the other forms of birth control more effective, and vice versa. By keeping semen away and out of the vagina and vulva, pregnancy is generally harder to achieve. But, because the pull out method has the highest risk out of the other preventative measures, if preventing pregnancy is vital to you, you may want to consider other options!
Busting some myths
Some of these topics may have been lightly touched on before, but here are the places where some folks have the most questions:
Pre-cum/ pre-ejaculate will not cause pregnancy.
The odds of this actually happening are slim, but not ENTIRELY impossible. This is important to remember if you are not using another method of birth control and don’t want to get pregnant.
Using the pull out method is entirely useless
Although pull-out is not the most effective way to prevent pregnancy, it is better than having no plan at all. Here at allbodies, we steer clear of the “shoulds” and “should nots” and instead give you the facts so you can make the choice best for you and your unique circumstance. If avoiding pregnancy is important to you, re-read the risks of the pull-out method as your sole protection plan, and assess if some extra protection might be useful.
Pulling out will prevent against STIs/STDs
Unless you are using a physical barrier of protection in some way, you cannot protect yourself against STDs and STIs simply by pulling out. Condoms are the only birth control method that can help prevent pregnancy and STDs/STIs in tandem.
Pulling out can cause infertility and impotence in men
No evidence exists that suggests that this may be the case (4). Shocker.
If you are pulling out, you can't have a vaginal orgasm
Def not true. Pregnancy and vaginal orgasm have no cause and effect relationship (4). You can still get that orgasm on! (Please do!)
Written by: Catherine Twomey
Medically Reviewed by: Danielle LeBlanc BScN RN (she/hers)
All content found on this Website, including: text, images, audio, or other formats, was created for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
1. “Dual Protection against Unwanted Pregnancy and HIV / STDs.” Sexual health exchange. U.S. National Library of Medicine, 1998. https://www.ncbi.nlm.nih.gov/pubmed/12294688.
2. Higgins, Jenny. “Pull out All the Stops: Doubling up with Withdrawal.” Bedsider, n.d. https://www.bedsider.org/features/752-pull-out-all-the-stops-doubling-up-with-withdrawal.
3. Lopez, Laureen M, Laurie L Stockton, Mario Chen, Markus J Steiner, and Maria F Gallo. “Behavioral Interventions for Improving Dual-Method Contraceptive Use.” The Cochrane database of systematic reviews. John Wiley & Sons, Ltd, March 30, 2014. https://www.ncbi.nlm.nih.gov/pubmed/24683022.
4. “Myths and Facts about… the Withdrawal Method.” IPPF, March 11, 2019. https://www.ippf.org/blogs/myths-and-facts-about-withdrawal.
5. Parenthood, Planned. “Fertility Awareness Methods: Natural Birth Control.” Planned Parenthood. Accessed September 8, 2019. https://www.plannedparenthood.org/learn/birth-control/fertility-awareness.
6. Parenthood, Planned. “Pull Out Method: Withdrawal Method: What Is Pulling Out?” Planned Parenthood, n.d. https://www.plannedparenthood.org/learn/birth-control/withdrawal-pull-out-method.
7. Parenthood, Planned. “What Are the Best Birth Control Options That Aren’t Hormonal?” Planned Parenthood. Accessed September 8, 2019. https://www.plannedparenthood.org/learn/teens/ask-experts/what-are-the-best-birth-control-options-that-arent-hormonal.
8. Peipert, Jeffrey F, Qiuhong Zhao, Laura Meints, Benjamin J Peipert, Colleen A Redding, and Jenifer E Allsworth. “Adherence to Dual-Method Contraceptive Use.” Contraception. U.S. National Library of Medicine, September 2011. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3622205/.
9. Piper, Yvonne. “5 Myths about Pulling out, Busted.” Bedsider, n.d. https://www.bedsider.org/features/310-5-myths-about-pulling-out-busted.
10. “Withdrawal Method (Coitus Interruptus).” Mayo Clinic. Mayo Foundation for Medical Education and Research, April 14, 2018. https://www.mayoclinic.org/tests-procedures/withdrawal-method/about/pac-20395283.