The pull-out method—aka the withdrawal method or coitus interruptus—has been used at least once by nearly 60 percent of sexually active women in the US. It’s a way to (possibly) avoid pregnancy while avoiding hormonal birth control options.
But there’s a lot you should know about the pull-out method, especially if you are relying on it as your primary form of birth control. For one, this method doesn’t remove the risk of exposure to sperm in pre-cum. It also isn’t the best choice when it comes to safe sex and avoiding sexually transmitted infections (STIs).
I’m never going to tell you exactly what you should or shouldn’t do in your own bedroom—sex and contraceptive choices are personal—but I do want to make sure you are well-informed. Let’s look closely at the effectiveness, why pre-cum could still lead to pregnancy, and what to do if the pull-out method fails.
What is Pre-Cum?
Pre-cum (or pre-ejaculate) is the fluid released from the penis before ejaculation. It’s different from ejaculatory fluid (cum). There’s no way to control when and how much comes out—it happens when someone is turned on to provide lubrication for intercourse in the same way a vagina becomes lubricated when aroused.
Precum is also essential for sperm survival because it helps neutralize the acidic environment in the urethra so it can travel into the vagina to fertilize an egg for pregnancy.
Can You Get Pregnant from Pre-Cum?
Pre-cum doesn’t always contain sperm, but it can, which means it can lead to pregnancy even if withdrawal is perfectly planned. In one study, 11 out of 27 volunteers had sperm in pre-cum samples. While some studies found fewer samples of pre-cum with sperm, there’s no way to predict how much sperm will be present (if any).
Of course, ovulation (when the egg is released from the ovary) is necessary for pregnancy, so the timing matters too. If you track your cycle, knowing when you ovulate can help with pregnancy prevention. But sperm can survive up to five days in the female reproductive tract, so in theory, it’s possible to become pregnant even if you ovulate a few days before or after using pull-out if sperm were present in pre-cum.
How Much Sperm is in Pre-Ejaculation Fluid?
The amount of sperm found in pre-ejaculation fluid may be low compared to ejaculate fluid, at least according to one study. There aren’t very many studies on pre-cum that examine how much sperm is present, but the number likely varies from person to person.
How Effective is The Pull-Out Method?
With all the info about pre-cum in mind, let’s dive into the pull-out method. When completed “perfectly,” the failure rate (how often the technique doesn’t work) is estimated at around 4 percent—almost on par with condoms.
But since humans make mistakes, get caught up in the heat of the moment, or can’t control the release of pre-cum, the actual failure rate is likely much higher. Some studies suggest that withdrawal or pull-out can have a 20 percent failure rate. In other words, one in five couples using the pull-out method may become pregnant.
This failure rate is a big reason why the Fertility Awareness Method (FAM) fails sometimes. FAM (a way of tracking your cycle) is a powerful tool for taking charge of your fertility and understanding your body. But pull-out user error or not using backup methods when you know you’re fertile can lead to pregnancy.
Pull-out plus a backup method of birth control, like condoms, can prevent pregnancy during fertile windows (or all the time to practice safe sex—more on this below).
Reasons for High Failure Rate with the Pull-Out Method
So aside from the risk of pre-cum possibly containing sperm, the pull-out method may fail because:
- A partner may be unable to time withdrawal at just the right time.
- If the partner has been drinking alcohol, the timing may be impaired.
- Some men may “leak” sperm into pre-cum more than others
Reasons You Should Use Protection During Intercourse
A big reason to use protection (with or without withdrawal) is to avoid an unwanted pregnancy. Nearly half of pregnancies in the US are unplanned, so if becoming pregnant isn’t on your to-do list, the pull-out method is probably not your best birth control choice.
It may be less talked about, but preventing sexually transmitted infections (STIs) is just as important as pregnancy prevention. Pre-cum can contain STIs like HIV, and skin-to-skin contact can increase the risk of transmission of other types of STIs.
Protect yourself and your partner(s) from the risk of STIs by practicing safer sex with condoms.
What to do if the Pull-Out Method Fails?
If the withdrawal method is your preference, what happens when things don’t go your way? Here’s what to consider if the pull-out method fails:
Regularly Take Prenatal Vitamins
Even if pregnancy is not your endgame, I always suggest prenatal vitamins for every woman who could become pregnant. If the pull-out method fails, you have options (although the type of options you have can depend on where you live). Still, prenatal vitamins can help your body build up the nutrient stores needed for optimal hormone balance and health no matter what direction you go.
Prenatal Vitamin Benefits If Pregnant
Let’s say you didn’t plan on becoming pregnant, but pull-out fails, and even though it wasn’t part of your plan, you decide to continue the pregnancy. It can take months to build up nutrient stores to optimal levels to support the baby and mother. If you’ve already been taking prenatal vitamins, you won’t be left playing catch up.
Even if you already follow a balanced, nutrient-dense diet, taking prenatal vitamins is a must. You need more of certain nutrients like folate or choline for growth and development, and often diet alone isn’t enough. Think of a prenatal as the backup plan to grow a healthy baby.
Not all prenatal vitamins are created equal, though. You want a product that contains all the essential nutrients in bioactive forms (meaning your body can absorb and use the vitamins or minerals) without additives or artificial ingredients.
I know it can be confusing to sort through all the products, so I created Prenatal Plus. This complete blend includes active B vitamins, minerals, and antioxidants, providing your body with the essential nutrients for conception, pregnancy, and beyond.
Prenatal Vitamin Benefits if Not Pregnant
If pull-out fails and pregnancy happens, some women may opt for an abortion. It may seem counterintuitive, but prenatal vitamins can help in this scenario. It can take time to rebalance hormones following an abortion, but nutrients can be a significant support.
Once fertilization occurs, hormones like progesterone and estrogen rise. Following an abortion, these hormones need to return to normal levels, but it can take a few cycles. A prenatal vitamin can provide nutrients to help the body maintain healthy hormones and nourish the body following an abortion.
To further support nutrient repletion, check out my free hormone balancing meal plan.
Emergency Contraception—Plan B
If you think pull-out failed, and you don’t want to become pregnant, emergency contraception—aka Plan B or the morning-after pill—is an option.
Plan B pill is a form of emergency contraception that can be taken up to 72 hours after unprotected sex. It works by preventing ovulation, fertilization, and implantation in the uterus. It’s different from abortion because it prevents a pregnancy from occurring in the first place and is available over-the-counter at the pharmacy or drug store (learn more about how Plan B works here).
Pull-Out Method: Key Takeaways
The pull-out method could be a contraceptive choice for people in monogamous relationships, especially if you track your cycle and use extra protection during your fertile times of the month. Even if withdrawal is timed just right, pre-cum could contain sperm and lead to pregnancy. The pull-out method alone isn’t a great idea for people with multiple partners because it doesn’t protect against STIs.
Whether you choose to use the pull-out method or another form of contraception (or both), it’s essential to be informed to make the choice that keeps you safe and works best for your body and lifestyle. Not sure about all your contraceptive options? I break them all down here in my comprehensive contraceptive guide.
KEEPING IT REAL, WHILE KEEPING YOU EDUCATED
Featuring a 28 day plan to take back your cycle and dozens of charts, checklists, and diagrams to help along the way.
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- PUDNEY J.. Pre-ejaculatory fluid as potential vector for sexual transmission of HIV-1. The Lancet.. 1992. 340. 8833.