Health
Birth Control
Birth Control
July 20, 2022

How Effective Is The Pull Out Method Actually?

The withdrawal method can reduce chances of pregnancy, but precautions still matter.
Published on
July 20, 2022
Updated on
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Medically Reviewed by
6 minute read

The pull out (or withdrawal) method is a way to prevent pregnancy by keeping semen away from the vagina at the climax of sexual intercourse (1, 4). You can consider the name at face-value, since pulling out is essentially withdrawing the penis from the vagina before ejaculation occurs. Learn how effective the pull out method really is, and how to practice it safely and properly. 

The withdrawal method is about 88% percent effective for pregnancy prevention

According to Planned Parenthood, the effectiveness of the pull out method depends on executing it correctly each time you have sex. If you are able to keep any ejaculate (cum) away from the vagina during and after intercourse, the pull out method will be effective at preventing pregnancy. Only 4% of couples who use the pull out method perfectly every single time will get pregnant. 

But in truth, nobody is perfect, and it can be difficult to pull off withdrawal with 100% accuracy every time. So in reality, about 22% of people who rely on the pull out method will get pregnant every year (2).

The pull out method is not effective in preventing STIs

While the withdrawal method can reduce chances of pregnancy, it can’t be counted on to prevent STIs (1). This is because many STIs are spread through skin-to-skin contact. Think: genital warts or herpes. If you want to utilize the pull out method while preventing STIs, use condoms too (5). The pull out method can, however, reduce the risk of HIV as HIV can be transmitted through bodily fluids such as semen, vaginal or anal fluids, breast milk, and blood. 

How does the withdrawal method work? 

If you have a uterus and semen gets in your vagina, you might get pregnant. Ejaculating away from the vulva or vagina, or pulling out, can reduce the chances of sperm fertilizing an egg (1, 2, 4). If you’re using the withdrawal method, the penis needs to be all the way out of the vagina prior to climax, and any ejaculate needs to be aimed away from the vagina. While it sounds simple enough, it can actually be hard to do it right every single time, and it requires a lot of self-control.

To rely on the pull out method, the partner who has a penis must be willing to stop before cumming. This is usually when inhibitions are the lowest, and arousal has a significant effect on good decision-making (6). 

For most people, ejaculation comes hand in hand with orgasm, but this is not the same for everyone (7). In order to use the pull out method properly, you have to know your body’s sexual responses well enough to know exactly when semen will come out of your penis. If you’re concerned about your ability to understand your body, or knowing the signs an orgasm is impending so you have time to pull out, masturbation can be a great way to get to know how your body signals you’re about to ejaculate. You can also practice the withdrawal method using a condom, to reduce margin of error without one. 

3 reasons the withdrawal method can fail 

Here are three factors to be aware of that may cause the withdrawal method to fail and lead to pregnancy. Remember that while the pull out method may reduce the risk of HIV transmission, it is not effective in preventing STIs. 

1. The penis isn’t pulled out at the time of ejaculation. While the withdrawal method can be highly effective, it’s difficult to practice it perfectly every single time. If a person ejaculates viable sperm into the vagina, it can lead to pregnancy (2, 4). 

2. There may be viable sperm in precum. Precum, or Cowper’s fluid, is a small amount of ejaculate that is produced from the penis when a person is aroused. People with a penis may not even realize they’re making precum, since no physical sensation signals its release, and there is no control over the production of it. While it’s possible for some people’s precum to have no sperm, in others, precum presents sperm capable of fertilizing an egg. There is no way to tell if you or your partner has sperm in their pre-ejaculate, and because of this, inserting an unprotected penis into a vagina even before proper withdrawal carries the chance of pregnancy (8). 

Additionally, STIs like chlamydia, syphilis, and gonorrhea can be spread through precum. Keep this in mind, as the pull out method won’t be effective in preventing these diseases from spreading.

3. Ovulation during intercourse. Finally, the withdrawal method can fail if the partner who has a uterus is ovulating at the time of intercourse. When using the pull out method as your primary form of birth control, it’s smart to use an ovulation calendar to chart your cycle, and be prepared to incorporate another method like condoms or a spermicide when you think you might be ovulating. Even with perfect tracking and a regular cycle, sperm can live inside the uterus for up to five days, so if you’re looking to prevent a pregnancy, stay extra conscious about how you use birth control on the days before and after ovulation too (9). 

Consider additional precautions to prevent pregnancy 

One advantage of the pull out method is that it can make other forms of birth control more effective. For example, incorporating the pull out method while using condoms will lessen the likelihood that you’ll become pregnant. If you don’t plan on using condoms, it’s a good idea for anyone with a uterus to explore other forms of birth control, to supplement consistent use of the withdrawal method. When you’re planning on withdrawal as your first defense, consider having an emergency contraceptive, like Plan B, on hand in case of any mistakes (10). 

Pros and cons of the withdrawal method 

Depending on your situation and preferences, the pull out method may be a solid birth control option (2). For others, another method might feel right. Consider the pros and cons of using withdrawal below:

Pros Cons
✅ 88% effective at preventing pregnancy
✅ Free and always accessible
✅ Non-hormonal with no related side effects
✅ Supplements other forms of birth control
❌ Does not prevent STIs
❌ Difficult to execute effectively every time
❌ Requires self-control and knowledge of the body
❌ Variables like precum could make it less effective for pregnancy prevention

We asked, you answered: What do you think of the pull out method?

When surveyed about the choice to use or not to use withdrawal, here’s what our readers had to say:

“I’ve always felt like my body is very susceptible to medications. I try to tough out every headache I ever have. So when it came to birth control options, I wanted to avoid anything that included hormones for fear of how it might affect my body or mood. I use the pull out method in addition to tracking my cycle using an app and taking my temperature. My gynecologist recommended being super aware of the five days on either side of when I ovulate; she calls it the ‘no fly zone.’ I don’t want to get pregnant right now, so I’m very conscious of those high probability times, especially since I use the withdrawal method.” - Elizabeth

“I’m not ready to have a baby right now, and my partner isn’t ready to be a parent. Every month that I used the pull out method, I had so much stress that I was pregnant. I would lay up at night reading about how effective it was. Googling: ‘am I pregnant from precum?’ ‘can I get pregnant if he pulled out but then we had sex again?’ Eventually, I couldn’t handle the stress anymore. Not if I wanted to have enjoyable sex. I’m on the pill now and my mental health has definitely improved.” - Grace

“I like the pull out method because it doesn’t require any advance preparation. Unlike the pill you have to take every day, or the shot you have to go and get every three months, I don’t have to think about the pull out method before I think I’ll be having sex. I don’t have a consistent partner, so I don’t want worrying about this to be part of my routine. The pull out method has its advantages in that way.” - Natalie

“My girlfriend wanted to get off the pill because it really impacted her anxiety, and I wanted to support that. Let me tell you: when we first started consistently pulling out, it was tough. I wasn’t used to it. Now, I know to pull long before I’m going to ejaculate. Even though it shortens the sex, I know we’re being safe.” - Tyler

“I used to rely heavily on the pull out method because the hormonal birth control pill had negative side effects for me. I also didn’t love the feel of condoms. The pull out method worked well most of the time — emphasis on “most” as I was not 100% perfect. I ended up having to take Plan B a few times, which became expensive and also made me feel sick sometimes. I decided to get back on the pill to alleviate worry.” - Sarah

The bottom line 

The pull out method is accessible, reliable, and works as a birth control method if you’re on top of tracking your cycle and have perfect execution every time. If you don’t want to count on perfection to prevent a pregnancy, however, you may want to consider boosting the pull out method’s chances by using condoms, or using another type of birth control. Remember, there is no evidence the pull out method prevents the spread of STIs, so be sure you and your partner(s) get regularly tested or also use condoms. To explore other contraceptive options read our guide on birth control

Reviewed for Medical Accuracy

Elizabeth is a graduate student from New York, New York. She writes personal essays about identity, womanhood, and love.

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References

1. Freundl, G., Sivin, I., & Batár, I. (2010). State-of-the-art of non-hormonal methods of contraception: IV. Natural family planning. The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception, 15(2), 113–123. 

2. Planned Parenthood. What is the Effectiveness of the Pull Out Method? Available from: https://www.plannedparenthood.org/learn/birth-control/withdrawal-pull-out-method/how-effective-is-withdrawal-method-pulling-out

3. Arteaga, S., & Gomez, A. M. (2016). "Is That A Method of Birth Control?" A Qualitative Exploration of Young Women's Use of Withdrawal. Journal of sex research, 53(4-5), 626–632. https://doi.org/10.1080/00224499.2015.1079296

4. Amory J. K. (2016). Male contraception. Fertility and sterility, 106(6), 1303–1309. https://doi.org/10.1016/j.fertnstert.2016.08.036

5. Horner, J. R., Salazar, L. F., Romer, D., Vanable, P. A., DiClemente, R., Carey, M. P., Valois, R. F., Stanton, B. F., & Brown, L. K. (2009). Withdrawal (coitus interruptus) as a sexual risk reduction strategy: perspectives from African-American adolescents. Archives of sexual behavior, 38(5), 779–787. https://doi.org/10.1007/s10508-007-9304-y

6. Skakoon-Sparling, S., Cramer, K. M., & Shuper, P. A. (2016). The Impact of Sexual Arousal on Sexual Risk-Taking and Decision-Making in Men and Women. Archives of sexual behavior, 45(1), 33–42. https://doi.org/10.1007/s10508-015-0589-y

7. Mehta, A., & Sigman, M. (2015). Management of the dry ejaculate: a systematic review of aspermia and retrograde ejaculation. Fertility and sterility, 104(5), 1074–1081. https://doi.org/10.1016/j.fertnstert.2015.09.024

8. Kovavisarach, E., Lorthanawanich, S., & Muangsamran, P. (2016). Presence of Sperm in Pre-Ejaculatory Fluid of Healthy Males. Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 99 Suppl 2, S38–S41.

9. Li, K., Urteaga, I., Shea, A., Vitzthum, V. J., Wiggins, C. H., & Elhadad, N. (2021). A predictive model for next cycle start date that accounts for adherence in menstrual self-tracking. Journal of the American Medical Informatics Association : JAMIA, 29(1), 3–11. https://doi.org/10.1093/jamia/ocab182

10. Jones, R. K., Lindberg, L. D., & Higgins, J. A. (2014). Pull and pray or extra protection? Contraceptive strategies involving withdrawal among US adult women. Contraception, 90(4), 416–421. https://doi.org/10.1016/j.contraception.2014.04.016