Effectiveness: 82 to 96 percent (4-27 pregnancies per 100 women each year).

What is it? Your partner pulls his penis out of your vagina before climax and ejaculation. Also called pulling out or coitus interruptus. Effectiveness depends on the male's self-knowledge and self-control.

How does it work? Your partner must pull completely out of your vagina before ejaculating (coming) to prevent sperm from entering your vagina and fertilizing an egg. Sperm near the vagina can travel inside and cause pregnancy. Contrary to public perception, pre-ejaculate (or pre-cum) usually does not contain sperm; the chance of pre-ejaculate picking up sperm in the urethra is lessened if the man urinates before having sex. Effectiveness increases when you work together.

STD protection: No; withdrawal reduces the risk of a man passing HIV to a woman, but you will still need to use condoms if you are concerned about STDs.

Benefits: It's always available and free. It can increase communication with your partner.

Disadvantages: Can be difficult for teens or others with little sexual experience to use. Drugs and alcohol may diminish the ability to withdraw on time. It's less effective for men who have multiple orgasms. Even if your partner withdraws, if any sperm gets in or near your vagina, you may get pregnant.

Availability: Always available.

Cost: Free

Notes: This is one of the few options available to men and is much more effective than not using any birth control. It requires self-control, experience and trust.


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