Key Points for Providers and Clients
• Always available in every situation. Can be used as a primary method or as a backup method.
• Requires no supplies and no clinic or pharmacy visit.
• One of the least effective contraceptive methods. Some men use this method effectively, however. Offers better pregnancy protection than no method at all.
Promotes male involvement and couple communication.
What Is Withdrawal?
• The man withdraws his penis from his partner’s vagina and ejaculates outside the vagina, keeping his semen away from her external genitalia.
• Also known as coitus interruptus and “pulling out.”
• Works by keeping sperm out of the woman’s body.
Effectiveness depends on the user: Risk of pregnancy is greatest when the man does not withdraw his penis from the vagina before he ejaculates with every act of sex.
• One of the least effective methods, as commonly used.
• As commonly used, about 27 pregnancies per 100 women whose partner uses withdrawal over the first year. This means that 73 of every 100 women whose partners use withdrawal will not become pregnant.
• When used correctly with every act of sex, about 4 pregnancies effective per 100 women whose partners use withdrawal over the first year.
Return of fertility after use of withdrawal is stopped: No delay
Protection against sexually transmitted infections: None
Side Effects, Health Benefits, and Health Risks
Who Can and Cannot Use Withdrawal
Medical Eligibility Criteria for Withdrawal
All men can use withdrawal. No medical conditions prevent its use.
• Can be used at any time.
Explaining How to Use
When the man feels close to ejaculating
• He should withdraw his penis from the woman’s vagina and ejaculate outside the vagina, keeping his semen away from her external genitalia.
If man has ejaculated recently
• Before sex he should urinate and wipe the tip of his penis to remove any sperm remaining.
Giving Advice on Use
Learning proper use can take time
• Suggest the couple also use another method until the man feels that he can use withdrawal correctly with every act of sex.
Greater protection from pregnancy is available
• Suggest an additional or alternative family planning method. (Couples who have been using withdrawal effectively should not be discouraged from continuing.)
Some men may have have difficulty using withdrawal
• Men who cannot sense consistently when ejaculation is about to occur.
• Men who ejaculate prematurely.
Can use emergency contraceptive pills(ECPs)
Explain ECP use in case a man ejaculates before withdrawing (see Emergency Contraceptive Pills, p. 45). Give ECPs if available.