Also known as withdrawal, the pull out method is one of the most basic forms of birth control on the planet.

It’s primarily used during penile-vaginal intercourse.

To use this method, the penis must be withdrawn from the vagina before ejaculation occurs.

This prevents semen from entering the vagina, allowing you to avoid pregnancy without relying on another form of birth control.

Although the pull out method is pretty straightforward, it isn’t as easy as it sounds.

Communication is crucial

The pull out method isn’t risk-free, which means you and your partner should have a discussion beforehand about any potential risks — including what to do if this method fails.

You have to nail your timing

Contrary to popular belief, some research that pre-cumcan contain sperm.

This means that there’s still a slight risk of pregnancy even if withdrawal occurs before ejaculation.

You or your partner must know when you’re about to pre-cum or cum every single time, otherwise the pull out method won’t be effective.

Regular STI testing is a must

The pull out method doesn’t protect against sexually transmitted infections (STI).

This means — unless you’re in a committed relationship where all parties have been tested — it’s important to get tested each time you have unprotected sex.

If you’re in a committed relationship, get tested before engaging in unprotected sex, regardless of your sexual history.

If you’re not in a committed relationship, it’s important to practice safe sex and get tested before and after each sexual partner.

Even with perfect use, the pull out method isn’t 100 percent effective.

In fact, of people using the pull out method become pregnant.

This isn’t because the pull out method doesn’t work, but because it can be difficult to control various factors involved.

Different things can make the pull out method ineffective.

Pre-cum might contain sperm, which means that — even if you do successfully pull out every single time — there’s still a chance of pregnancy.

Plus, ejaculation timing isn’t always easy to predict. Even someone with good timing can slip up — and it only takes once to potentially cause pregnancy.

The pull out method isn’t perfect, but there are ways you can make it more effective over time.

How to make it more effective in the moment

  • Use spermicide. This over-the-counter (OTC) chemical should be applied an hour before sex. When used correctly, it can immobilize and kill sperm. This helps prevent fertilization.
  • Try a birth control sponge. Another OTC option, the birth control sponge uses spermicide to prevent pregnancy. The sponge can be used for up to 24 hours, so you can insert it in advance or leave it in for multiple sessions.

How to make it more effective in advance

  • Practice with a condom. Not only does wearing a condom protect against pregnancy and STIs, it allows you to practice the pull out method without any risk. This means the ejaculating partner can work on nailing the timing without worrying about unwanted pregnancy.
  • Track ovulation. The ovulating partner can also use the fertility awareness method to help prevent pregnancy. This means tracking when fertility occurs and avoiding the pull out method, or sex in general, during their fertile window.
  • Use it as a secondary — not primary — birth control method. Withdrawal can also be a great supplemental method. You can use it along with condoms, spermicide, or hormonal birth control — regardless of the time of month — to reduce pregnancy risk.
  • Consider keeping emergency contraception on hand. If the pull out method fails, using emergency contraception can help prevent unwanted pregnancy.

Aside from abstinence, no birth control method is perfect.

Here’s what could happen if the pull out method fails:

  • Pregnancy. Pregnancy is possible each and every time ejaculation occurs during sex. It only takes once to cause pregnancy. If you suspect you might be pregnant, take a pregnancy test after your missed period.
  • STIs. The pull out method doesn’t protect against STIs. If you suspect that you may have been exposed to an STI, talk to a doctor or other healthcare provider. STI screening tests produce the most reliable results between one to three months after unprotected sex.

Although some people may disregard the pull out method, it’s a great option for anyone looking for accessible and non-hormonal birth control.

Some of the benefits of the pull out method include:

  • It’s free. Not everyone can afford other forms of birth control, which means the pull out method is accessible to everyone.
  • It doesn’t require a prescription. You don’t have to pick up anything from the store or see a doctor to get a prescription. Another perk? You don’t have to worry about insurance coverage or making an appointment.
  • It’s convenient. The pull out method can be used spontaneously, which makes it an attractive option if you aren’t able to use your regular form of birth control.
  • It doesn’t have any side effects. Many forms of birth control can cause headaches, mood changes, and other unwanted side effects. The pull out method eliminates those completely!
  • It can enhance the efficacy of other birth control methods. Not everyone feels comfortable relying on a single form of birth control. Using the pull out method allows you to double up on protection, further reducing your risk of pregnancy.

Question:

Can the pull out method reduce my risk for bacterial vaginosis (BV)? I’m sensitive to condom materials, and I heard that withdrawal might help prevent recurrent infections.

— Anonymous



Answer:

It might! Semen is alkaline, and the vagina prefers to be slightly acidic. If there’s ejaculate inside the vagina, your vaginal pH will change. In other words, the presence of semen could trigger BV.

During your reproductive years, your vaginal pH is usually between 3.5 and 4.5. After menopause, the pH is about 4.5 to 6. BV tends to thrive in an environment with a higher pH — usually 7.5 or more.

The more semen in the vagina, the higher the pH; the higher the pH, the more likely BV is. But if you and your partner have nailed the timing, there won’t be any ejaculate to change the vagina’s pH level.

Janet Brito, PhD, LCSW, CST

Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

No form of birth control is perfect, and the pull out method is no exception.

However, it’s an accessible and practical form of birth control that can be used on its own or as a secondary form of protection against unwanted pregnancy.

If you’re relying on the pull out method, it’s important to remember that it doesn’t prevent STIs.

Plus, you need to perfect the timing to make sure withdrawal occurs each and every time you have sex. Otherwise, the pull out method is no longer effective.

Safety is one of the most important parts of any sexual encounter. Find what works for you, and enjoy!