anonymous on August 30, 2011

How effective is the withdrawal method?

My boyfriend and I have been having sex without a condom most of the time we have sex. We used a condom twice, but for the other 13 times, he just pulls out before he cums. It has been a couple weeks after my last is there a chance that I could be pregnant? How would I know?

answered by Lisa Oldson, MD on August 30, 2011

You asked a couple important questions. There are several birth control options, and a lot of people wonder about how they compare opposite the withdrawal method. While I’m happy to provide some research statistics, I would encourage you to discuss your options in depth with your doctor.

First, regarding pregnancy tests, you can either take a home pregnancy test (HPT) or see your doctor...or both. At-home tests tend to be most accurate about a week after you know you’ve missed your period, but some “early result” tests can provide an accurate test as early as the first day of a missed period. You can also go to your doctor for a urine or blood test to determine whether you are pregnant. Either way, if you think you may be pregnant, visit your doctor for confirmation and to learn more about your next steps.

Now, how effective is the withdrawal method in preventing pregnancy? While withdrawal is better than no birth control, it’s not a reliable method for preventing pregnancy. According to researchers from the Guttmacher Institute who calculated the effectiveness of several different types of contraception in the January 2008 issue of the journal Contraception, the withdrawal method (also called coitus interruptus) has a failure rate of about 18%.

What does that mean? Well, if 100 couples used the withdrawal method every time they had sex for a year, by the end of the year, 18 of those couples will have found out they’re pregnant. So there is indeed a chance that you are pregnant.

If you don’t want to get pregnant right now, talk with your doctor about more effective forms of birth control, and which option is best for you. For starters, condoms are an inexpensive and easy way to help protect yourself against pregnancy as long as you use them correctly every time you have sex. Condoms and dental dams also help protect against sexually transmitted diseases (STDs).

If you and your boyfriend don’t want to use condoms, another option you can discuss with your doctor is hormonal birth control. There are several different options available ⎼ pills that you take every day, a patch that you stick to your body and change every week, or a ring that you insert into the vagina and replace monthly.

Some other forms of hormonal birth control can be administered at a doctor’s office including a shot you get every month or quarterly. When used according to instructions, the Centers for Disease Control and Prevention (CDC) report that these types of birth control have less than a 1% failure rate, and can help prevent pregnancy without using a condom. (With “typical use,” which means allowing a margin of error for couples that make mistakes, the failure rate is around 9%).

There are other methods of contraception, including diaphragms, IUDs and others. I encourage you to speak with your physician to find out which form of contraception is best for you, keeping in mind that you can always add condoms to any other form of birth control in order to reduce your risk of STDs.

Remember, no matter what form contraception you use, hormonal birth control doesn’t protect against STDs. To be on the safe side, you and your boyfriend may want to get tested for common STDs so that, if either of you tests positive for an infection, you can treated and avoid possible long-term complications.

Once you know each other’s STD status, you and your boyfriend can start making appropriate choices to help prevent pregnancy and STDs...which may mean using condoms, as well as an effective form of birth control. If you don’t have a doctor to talk to about these issues, your local health department or Planned Parenthood will be able to help you.

For more information about STD prevention, risks, testing and practicing safer sex, see our Expert Guide to STDs.

Thanks for trusting us with your concern. I wish you and your boyfriend good luck and good health.

Related info:

Lisa Oldson, MD

Dr. Oldson is Medical Director of the Analyte Physicians Group. She is on staff at Northwestern Memorial Hospital, as well as Clinical Instructor at the Feinberg School of Medicine, Northwestern University. Her areas of expertise include STDs (with a particular clinical emphasis on herpes), women's health, preventive medicine, diabetes, obesity and weight management, and mood and anxiety disorders. Dr. Oldson was educated at Rush Medical College and completed her residency at Rush-Presbyterian-St. Luke's Medical Center in Chicago, IL.

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