(Published July 2012)

Coitus Interuptus

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With this method, commonly called “withdrawal,” the penis is withdrawn from the vagina before ejaculation occurs.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.³⁶

Effectiveness

This method is somewhat effective. The failure rate is 22 percent with typical use.⁷
There is no evidence to support the common belief that pre-ejaculate fluid contains sperm.³⁷

Risks

The risk of unintended pregnancy for withdrawal is 22 percent.⁷

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 with typical use than some other methods
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.)