Coitus interruptus, also known as withdrawal or the pull out method, is a method of contraception in which, during sexual intercourse, the penis is removed from the vagina prior to ejaculation, primarily to avoid introducing semen into the vagina. Coitus interruptus may also more generally refer to any extraction of the penis prior to ejaculation during intercourse. This method has been widely used for at least 2,000 years and was used by an estimated 38 million couples worldwide in 1991.^[1] Birth control is the practice of preventing or reducing the probability of pregnancy without abstaining from sexual intercourse; the term is also sometimes used to include abortion, the ending of an unwanted pregnancy, or abstinence. ... It has been suggested that Duration of sexual intercourse be merged into this article or section. ... The penis (plural penises, penes) is an external male sexual organ. ... The vagina, (from Latin, literally sheath or scabbard ) is the tubular tract leading from the uterus to the exterior of the body in female placental mammals and marsupials, or to the cloaca in female birds, monotremes, and some reptiles. ... Ejaculation is the ejecting of semen from the penis, and is usually accompanied by orgasm. ... Horse semen being collected for breeding purposes. ...

Effectiveness

Like many methods of birth control, reliable effectiveness is achieved only by correct and consistent use. Observed failure rates of withdrawal vary depending on the population being studied: studies have found actual failure rates of 15-28% per year.^[2] In comparison the pill has an actual use failure rate of 2-8%,^[3] while the diaphragm has an actual use failure rate of 10-39%.^[4][2] The condom has an actual use failure rate of 10-18%.^[2] (see Comparison of birth control methods) The Pill redirects here. ... The diaphragm is a cervical barrier type of birth control. ... This article is about the male contraceptive device. ... Different types of birth control methods have large differences in effectiveness, actions required of users, and side effects. ...

For couples that use withdrawal correctly at every act of intercourse, the failure rate is 4% per year. In comparison the pill has a perfect-use failure rate of 0.3%, while the diaphragm has a perfect use failure rate of 6%. The condom has a perfect-use failure rate of 2%.^[5]

The primary cause of failure of the withdrawal method is the lack of self-control of those using it. Poor timing of the withdrawal can result in semen on the vulva, which can easily migrate into the female reproductive tract. Some medical professionals view withdrawal as an ineffective method of birth control.^[6] In contrast, a recent study in Iran found that provinces with higher rates of withdrawal use do not have higher fertility rates, and that the contribution of withdrawal use to unintended pregnancies is not markedly different from that of other commonly used methods such as the pill or condom.^[7] The external genital organs of the female are collectively known as the vulva (plural vulvae or vulvas)[1]. In common speech, the term vagina is often used improperly to refer to the vulva or female genitals generally, even though, strictly speaking, the vagina is a specific internal structure, whereas the... This article is about the male contraceptive device. ...

It has been suggested that the pre-ejaculate ("Cowper's fluid"), fluid emitted by the penis prior to ejaculation, contains spermatozoa (sperm cells), which can easily pass into the upper female genital tract in the presence of cervical mucus.^[8] However, several small studies^[9][10] have failed to find any viable sperm in the fluid. While no large conclusive studies have been done, it is now believed the primary cause of method (correct-use) failure is the pre-ejaculate fluid picking up sperm from a previous ejaculation.^[11] For this reason, it is recommended that users of withdrawal have the male partner urinate between ejaculations, to clear the urethra of sperm, and wash any ejaculate from objects that might come near the woman's vulva (e.g. hands and penis).^[12] Pre-ejaculate on a human penis Pre-ejaculate, a more viscous higher flow variation Pre-ejaculate (also known as pre-ejaculatory fluid or Cowpers fluid, and colloquially as precum) is the clear, colorless, viscous fluid that is issued from the urethra of a mans penis when he is... Schematic diagram of a sperm cell, showing the (1) acrosome, (2) cell membrane, (3) nucleus, (4) mitochondria, and (5) flagellum (tail) A sperm cell, or spermatozoon ( spermatozoa) (in Greek: sperm = semen and zoon = alive), is the haploid cell that is the male gamete. ... Horse semen being collected for breeding purposes. ... The cervix (from Latin neck) is the lower, narrow portion of the uterus where it joins with the top end of the vagina. ...

Advantages

The advantage of coitus interruptus is that it can be used by people who have objections to or do not have access to other forms of contraception. (Some men prefer it so they can avoid possible adverse effects of hormonal contraceptives on their partners.^[13]) Some women also prefer this method over hormonal contraception to avoid adverse effects such as depression, mood swings, vaginal dryness, decreased libido, and headaches, among others. It has no monetary cost, requires no artificial devices, has no physical side effects, and can be practiced without a prescription or medical consultation.

Disadvantages

The method is largely ineffective in the prevention of STDs, like HIV, since pre-ejaculate may carry viral particles or bacteria which may infect the partner if this fluid comes in contact with mucous membranes. However, a reduction in the volume of bodily fluids exchanged during intercourse may reduce the likelihood of disease transmission due to the smaller number of pathogens present.^[10] Sexually-transmitted infections (STIs), also known as sexually-transmitted diseases (STDs), are diseases that are commonly transmitted between partners through some form of sexual activity, most commonly vaginal intercourse, oral sex, or anal sex. ... Species Human immunodeficiency virus 1 Human immunodeficiency virus 2 Human immunodeficiency virus (HIV) is a retrovirus that causes acquired immunodeficiency syndrome (AIDS, a condition in humans in which the immune system begins to fail, leading to life-threatening opportunistic infections). ... Pre-ejaculate on a human penis Pre-ejaculate, a more viscous higher flow variation Pre-ejaculate (also known as pre-ejaculatory fluid or Cowpers fluid, and colloquially as precum) is the clear, colorless, viscous fluid that is issued from the urethra of a mans penis when he is...

The method may be difficult for some couples to use. The interruption of intercourse may leave some couples sexually frustrated or unsatisfied.^[14]

Prevalence

Worldwide, 3% of women of childbearing age rely on withdrawal as their primary method of contraception. Regional popularity of the method varies widely, from a low of 1% on the African continent to 16% in Western Asia. (Data from surveys during the late 1990s).^[15]

In the United States, 56% of women of reproductive age have had a partner use withdrawal. In 2002, 2.5% were using withdrawal as their primary method of contraception.^[16]

See also

• Coitus reservatus
• Natural birth control

Coitus reservatus, also known as karezza, is commonly thought of as a form of sexual intercourse in which the man does not attempt to ejaculate within his partner, but instead attempts to remain at the plateau phase of intercourse for as long as possible. ... This article or section is in need of attention from an expert on the subject. ...

References