People have been doing it for centuries. We're talking about the pull-out method, aka the withdrawal method, aka as coitus interruptus. This is when the guy removes or withdraws his penis from the vagina before he ejaculates ("comes").
The withdrawal method may sound good in theory as a birth control method...if not for a little thing called pre-ejaculate, or precum, and the fact that it takes a good amount of self-control for a man to withdraw on time. You shouldn't use the withdrawal method on its own if you want to avoid getting pregnant. Here's why (hint: it's because pre-ejaculate can have sperm in it).
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Can you get pregnant from pre-ejaculate?
Yes, it's possible to get pregnant from pre-ejaculate, according to the Office on Women's Health. This is because when a guy's penis first becomes erect or "hard", some fluid (pre-ejaculate) might be at the tip of the penis and sperm can be released before he withdraws from the vagina. About 22 out of 100 women who only use the withdrawal method for a year will get pregnant.
What is pre-ejaculate?
Pre-ejaculateis a little bit of fluid (we're talking a few drops) that is released at the tip of a man's penis before he ejaculates, or "comes" (has an orgasm). You might not even notice pre-ejaculate. Health experts say that pre-ejaculate can contain sperm or germs that spread sexually transmitted infections.
The comings and goings of pre-ejaculate
If you really want to know the details on what is pre-ejaculate, here you go:
After an erection, pre-ejaculate passes through the male's urethra. Both urine and any sexual fluid travel through the male's urethra.
Luckily, men have something called the Cowper's gland. This gland produces a fluid that cleans the urethra track and allows sexual fluid to pass. The Cowper's gland is located at the beginning of the internal penis. The gland is also responsible for the production of pre-ejaculate and lubrication.
Researchers have found that pre-ejaculate occurs when the Cowper's gland produces a clear fluid before ejaculation.
What's the risk of pregnancy from pre-ejaculate
Your chances of getting pregnant because of pre-ejaculate depends on if there's sperm within the pre-ejaculate. Studies have been done to try to find how much sperm is in pre-ejaculate. Though different researchers might report different levels, the take-away is they've found sperm in pre-ejaculate. This is not just any sperm, but active or motile sperm that can impregnate a woman.
The National Health Service (NHS) from the UK says that pre-ejaculate can contain thousands of sperm. For context, a man's semen, or ejaculate fluid that's produced when he "comes", contains more than 300 million sperm.
All in all, the withdrawal method is not a good form of birth control; the CDC says that it has a 22% failure rate. You can think of it as out of 100 women who used the withdrawal method in a year, 22 of them got pregnant.
Can you get pregnant from pre-ejaculate even when you're not ovulating?
Ovulation is the most fertile time of a woman's menstrual cycle---specifically, when a woman ovulates, an egg releases from the fallopian tubes. But that doesn't mean you can't get pregnant during other times of your menstrual cycle. As mentioned before, pre-ejaculate can contain active sperm, in which case, if it does, it could fertilize a woman's egg.
Ovulation timing varies depending on the woman. The average ovulation period of a 28-day cycle is on day 14, but depending on cycle length, it could be before or after. Sperm can stay alive for 24 hours or up to 7 days, so depending on when you have sex and when your ovulation occurs, the timing of your ovulation cycle could theoretically increase or decrease your chances of getting pregnant.
Can you get pregnant from pre-ejaculate on your period?
Even while on your period, because sperm can stay alive for 24 hours up to 7 days, there is a chance you could become pregnant. As mentioned before, because pre-ejaculate sometimes has active sperm, this is a possibility.
Should I take a pregnancy test or emergency contraception?
Suppose you've already had unprotected sex and used the withdrawal method. Because pre-ejaculate can contain motile sperm, it's a little risky if you're trying to avoid pregnancy. In that case, you may want to consider additional measures if you are worried about pregnancy. Here are a couple of options:
When to use emergency contraceptives
Often called the "morning-after pill", it's best to take it as soon as possible after having unprotected sex to prevent pregnancy. You can use emergency contraceptives within 3 to 5 days of having unprotected sex, though it depends on the type of emergency contraception.
Here are the different types of emergency contraception and how long you have to use them:
For Plan B One-Step™ (or a generic version), take within 3 days (72 hours) after unprotected sex.
For Next Choice™, take 1 pill as soon as you can within 3 days, and the second pill 12 hours later
For ella™, take it within 5 days after unprotected sex. *
*Note: You can get Plan B One-Step™and Next Choice™ over-the-counter at a pharmacy, but you need to have a doctor's prescription for ella™.
An emergency contraceptive pill interrupts a woman's hormonal cycle, which disrupts fertilization. You shouldn't use this pill as your go-to method of birth control. You can get emergency contraceptives at your local pharmacy. You can also call your doctor if you want to learn more.
When to use a copper IUD after unprotected sex
Another option that can prevent unwanted pregnancy is inserting a copper IUD (Paragard™) within 5 days of unprotected sex. Of course, this would be if you want longer-term birth control as well.
One study found that using the copper IUD prevented unintended pregnancy more effectively than an emergency contraceptive pill.
Taking a pregnancy test
Depending on the brand and type, you can take a pregnancy test within eight to fourteen days of having unprotected sex.
If you have any questions or concerns, reach out to your OBGYN, doctor, or seek medical advice from your health provider.
Risks of using the withdrawal method
The failure rate with using the withdrawal (pull-out) method to prevent pregnancy is a lot higher than other methods of birth control. This is because sperm can be released even before a man withdraws out of the vagina.
One study found that during the first year of using the withdrawal method as a contraceptive, the probability of it failing is about 18%. Some researchers have even estimated the failure rate of only using the withdrawal method to be about 27%.
The other risk of using the withdrawal method is that it does not protect against sexually transmitted infections or sexually transmitted diseases. Most STIs are spread through vaginal, anal, or oral sexual contact. This means that using the withdrawal method, with no protection from a condom, does not protect again STIs/STDs. Contracting an STI/STD can be harmful to one's sexual health and wellbeing.
One study found that pre-ejaculate specifically could be a potential source for sexual transmission of HIV.
More reliable methods of birth control
To protect against unwanted pregnancy, you may want to consider a different form of birth control if you're currently using the withdrawal method. You won't be able to know for sure if any stray sperm found its way into pre-ejaculate. Also, the withdrawal method won't protect you from STIs.
To be on the safe side, you could choose among many different options for contraceptives, including:
- Birth control pills (either the combined pill or mini-pill)
- Male or female condoms
- Intrauterine devices (IUDs)
- Vaginal rings
If you are curious about other birth control methods or finding a birth control that works best for you, contact your medical provider or doctor.
Given that pre-ejaculate sometimes contains active sperm, and that the withdrawal method features other risks, you may want to consider another birth control method. There are multiple ways you can continue to have a safe, healthy sex life while preventing pregnancy, and we hope you feel empowered to choose a method that works best for you.
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