How Effective is the Pull Out Method?

This article is also available in Spanish.

What is pulling out?

Also known as withdrawal, the pull out method is used to prevent pregnancy by removing the penis from the vagina before ejaculation happens. The pull out method is one of the oldest methods of birth control recorded, and while contraceptive technology has advanced pretty far since then, the pull out method remains, well, a little primitive.

How effective is the pull out method?

As with other birth control methods, the pull out method’s effectiveness comes down to how it’s used. With typical use, the pull out method is 80% effective. If used perfectly, the pull out method is 96% effective at preventing pregnancy. However, this is very hard to do, as perfect use involves predicting ejaculation and pulling out before it happens. 

Typical use effectiveness reflects how a birth control method is typically used, and in the case of the pull out method it’s lower than perfect use, since it’s not possible to always get that crucial timing right. An 80% typical use effectiveness means that, on average, 20 out of 100 couples using this method will get pregnant in a year of use. Find out more about the difference between typical and perfect use when it comes to birth control effectiveness. 

Does the pull out method work?

Even when the pull out method is used perfectly, there will always be a risk of unintended pregnancy. Of course, no birth control method is 100% effective, but some methods are closer to being fully effective than others… 

When withdrawal is timed right and is used perfectly, there is still a risk of pregnancy due to pre-ejaculate or pre-cum. This can enter the vagina before ejaculation and just like regular ejaculate it contains sperm, so can still cause pregnancy.

More birth control options

If you are already using, or thinking about using, the pull out method as a means of birth control, it’s worth knowing that you’ve got other options available, and many of these are more effective at preventing pregnancy than the pull out method. If you’re thinking about switching birth control, it’s worth having a conversation with your healthcare provider and read up on all your options before making a choice.

We know some couples choose withdrawal because they don’t want to use hormonal birth control methods or other contraceptive options, for various reasons. Below are a few alternative birth control methods that should be considered as a more reliable method than pulling out:

The copper IUD

One of the most effective birth control methods out there, the copper IUD is completely hormone-free. It’s more than 99% effective, due to there being very little human error involved as the copper IUD is fitted into the uterus by a healthcare professional, and it can stay there and be used as birth control for several years. 

If fitted up to five days after unprotected sex, the copper IUD can also be used as emergency birth control. This method is long-acting and invasive and it does have its own downsides, with some women reporting side effects like heavier periods and pain after the fitting.

Condoms

An over-the-counter birth control option that’s also used for protecting against sexually transmitted infections, condoms are 87% effective with typical use and are 98% effective at preventing pregnancy with perfect use. 

Latex-free condoms are now available for those with allergies, and the technology of condom design has come a long way since the early days. However, we know that not everyone wants to use condoms all the time, and for many couples, it makes more sense to opt for a different birth control method they’re more comfortable using. 

The mini pill/progestin-only pill

Unlike the regular combined pill, the mini pill doesn’t contain any synthetic estrogen. Instead, it contains progestin, a synthetic version of the sex hormone progesterone. This is useful for women who want to use a birth control pill, but for those whom synthetic estrogen isn’t an option. 

With perfect use, the mini pill is 99% effective at preventing pregnancy. With typical use, it’s 92% effective. Just like other hormonal birth control options, the mini pill is reported to have side effects for some women such as changes to libido and mood. 

Natural Cycles 

In 2018, Natural Cycles became the first FDA Cleared birth control app available in the US. It’s a combination of the basal body temperature method and an algorithm that learns the pattern of your unique menstrual cycle so you are aware of your own fertile window (that’s right, you can’t get pregnant every day of your cycle).

Natural Cycles is 93% effective with typical use and it’s 98% effective with perfect use. The method requires the use of condoms or abstaining from sex on fertile days - users of the app should know that using the pull out method on fertile days is classed as unprotected sex. 

So, how effective is the pull out method?

In reality, a method’s effectiveness comes down to how you go about using that method, and it’s a very individual thing. However, pulling out is consistently tricky to time, and even when used perfectly there is still some risk that cannot be reduced. We know the pull out method remains popular, partly because of its ease of availability, but also because there is a wider knowledge gap when it comes to our reproductive health options.

At Natural Cycles we do not advise the use of withdrawal as a means of birth control. Instead, we encourage individuals to research birth control methods and discuss contraceptive options with a healthcare professional to find one that best suits their lifestyle.

Take control of your fertility

More than 1.8 million women worldwide have already made the switch to Natural Cycles. As well as an FDA Cleared birth control method, Natural Cycles can also be used to plan a pregnancy when the time is right. 100% hormone-free and tailored to you, Natural Cycles puts you in control of your own fertility journey. Are you ready to join our community of Cyclers?