Is pulling out safe?

Originally Published: May 16, 1997 - Last Updated / Reviewed On: January 9, 2009
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Dear Alice,

My girlfriend and I have begun having sex recently. The first few times we did, we used condoms. Lately, we haven't. I always pull out before I come. Is this still safe? Is it safe to re-enter after this? Someone told me that if we don't want to use a condom, we should use a spermicide. Is this safe by itself? I appreciate all that help. Thanx.

Dear Reader,

Let's first clarify what you are trying to prevent: sexually transmitted infections (STIs), pregnancy, or both? In the case of STIs, the answer is a resounding NO! Pulling out, or withdrawal, is not an effective method of preventing STIs because most disease-causing microorganisms do not depend on ejaculation for transmission.  A condom will only help prevent the spread of STIs if you put it on before sex and leave it on the entire time you are having sex.

If both of you have been tested before you started having sex with each other you may not be concerned about STIs. If you haven't been tested you may want to consider doing so. Students at Columbia can make an appointment through Open Communicator or by calling x4-2284. Columbia students can also get confidential HIV testing and counseling through the Gay Health Advocacy Project (GHAP). If you're not at Columbia, you can visit your health care provider or a health center such as Planned Parenthood for STI testing and related services.

If pregnancy is your concern, pulling out  is not the most reliable or forgiving form of contraception. Re-inserting your penis after you've ejaculated (outside the vagina) is not safe either. Within the first few hours after ejaculation, there is usually some sperm left in the urethra. The amount left behind is nowhere near the amount of sperm in the typical ejaculate, but it still presents a possibility of pregnancy.

Spermicides, used alone, have the highest failure rates of all methods of birth control — even higher than withdrawal! If pregnancy prevention is important to you, spermicide alone is not the best contraceptive for you. However, you could use a spermicide in addition to withdrawal. The spermicide would offer a "back-up" in the event that you do not pull out in time. Spermicides come in many forms — foams, creams, jellies, suppositories, and vaginal contraceptive films. Some spermicides are made specifically for use with diaphragms, cervical caps, and IUDs, while other spermicides have been adapted for use alone. Most drug stores and pharmacies sell a variety of spermicides — you and your girlfriend may want to experiment with a few to find one that works best. Of course, as with any contraceptive, make sure you read the directions carefully, especially since spermicides have a time frame within which they are effective.

As a primary means of contraception, withdrawal has several disadvantages. First, there's the pre-ejaculate fluid (pre-cum) on which withdrawal will have no effect since it's released well before you ejaculate. Pre-cum itself doesn't contain sperm, however it may pick up sperm left in the urethra from a previous ejaculation, and thus, does present a risk of pregnancy. Next, and perhaps more important, is the issue of consistency and self-control. Can you be perfectly consistent at withdrawing each time you have sex? If not, then what's done is done. Of course, you do have the option of emergency contraception (the Emergency Contraception Hotline is 1.888.NOT.2.LATE).

Withdrawal does have its advantages. It's free and always available. Second, no side effects are associated with this form of contraception. The estimated failure rate for typical use is around 20 percent. When practiced perfectly, some researchers estimate the failure rate to be around 5 percent. This means 5 to 20 women out of every 100 who use withdrawal as their contraceptive method get pregnant.

If you haven't already, perhaps you and your girlfriend could talk about your concerns and work toward reaching a mutual decision on what form(s) of contraception and/or safer sex you both want to use. Besides the issue of STIs, you need to assess how willing you are to risk having to deal with a pregnancy. Talk about what each of you thinks you would do if a pregnancy occurred. Withdrawal is definitely less effective than, say, the pill. But, if both of you are okay and comfortable with the risk involved, then you may decide that withdrawal is a good method for you. To make a decision like this, it is helpful to have as much information as possible. You could speak with a health care provider about your contraceptive options and choices. You will also find many questions related to birth control in Alice's Sexual Health archive.

Stay safe!

Alice

December 29, 2008

21497

Dear Alice,

I feel inclined to leave a note of gratitude to you as this acticle was very helpful. I was just google-ing the same question when I clicked on this link. It was very...

Dear Alice,

I feel inclined to leave a note of gratitude to you as this acticle was very helpful. I was just google-ing the same question when I clicked on this link. It was very informative as I am in the same situation and my girlfriend hates using condoms. Thank you so much for an accurate and easy to understand answer.

April 11, 2008

21432

To the reader:

I'm sitting here reading your post with my beautiful new baby boy. Answer to your question: pulling out DOES not work!!

To the reader:

I'm sitting here reading your post with my beautiful new baby boy. Answer to your question: pulling out DOES not work!!