Medical Questions > Womens Health > Birth Control Forum

Withdrawal Method: The Facts?

Does pre-ejaculate contain active sperm cells?
Absolutely
Maybe
Probably Not
25%  25%  [ 2 ]
50%  50%  [ 4 ]
25%  25%  [ 2 ]
Total Votes : 8
I am currently researching the withdrawal birth control method and would like to sum up some of my findings, ask some questions, and hopefully generate some discussion.

I have spent a significant amount of time scouring the web and reading about withdrawal as a method of birth control. A study by the FDA (http://www.fda.gov/Fdac/features/1997/con ceptbl.html) states that, for typical users, withdrawal is 81% effective at preventing pregnancy. With perfect use, it can be as high as 96% effective. For comparison, the same study found that condoms are 86% effective for typical use, and 97% effective for perfect use. So, based on this study, the effectiveness of withdrawal is comparable to that of condom use. There may be other, more recent studies available from sources which are equally as reputable as the FDA, and if anyone knows where I can access these, please let me know.

One thing I would like to better understand is the causes of failure for this method. So far, I've found three primary causes of failure that seem pretty obvious and more or less agreed upon across the web:

a) Men sometimes aren't able to control themselves enough to withdraw before ejaculation starts, thus expelling semen before withdrawing, causing pregnancy b) When a man withdraws, semen may come into contact with the outer vaginal area during ejaculation and could enter the vagina, causing pregnancy c) Semen from a previous ejaculation may exist in the urethra, and could be picked up by pre-ejaculate during intercourse and expelled into the vagina, causing pregnancy

These failures can be avoided by a) withdrawing well before ejaculation instead of waiting until ejaculation is imminent, b) ejaculating away from the vaginal area, ensuring that no semen comes in contact with the vagina, and c) flushing the urethra of semen from a recent ejaculation by urinating.

There is one more cause of failure that is heavily debated across the web. Failure cause d) pre-ejaculate contains sperm and is expelled during intercourse, causing pregnancy. This is different than cause c) in that many arguments claim pre-ejaculate itself contains sperm, regardless of a recent ejaculation. The opposing arguments claim that since pre-ejaculate comes from the Cowper's gland, which is closer to the urethral opening than the ejaculatory ducts, it does not come into contact with sperm before ejaculation and therefore does not contain sperm when it is expelled through the urethral opening.

Keeping a rough tally of both sides, it seems more people make the statement that "pre-ejaculate contains sperm" than those that claim the opposite. However, I can't seem to find any studies or publications that provide scientific evidence supporting the presence of sperm in pre-ejaculate. Those who make this statement never cite references, which makes it difficult for me to trace its origin.

On the other hand, the opposing arguments have citations backing them up. For example, the following links refer to health-related journals whose findings support the "no sperm in pre-ejaculate" claim.

http://www.ncbi.nlm.nih.gov/pubmed/1228690 5 http://ehealthforum.com/health/topic122910 .html

I don't consider these to be definitive proof by any means since the studies were performed on small numbers of test subjects, but at the same time, I haven't yet found publications which report to the contrary of these.

One question that is worth discussing: If there is, in fact, sperm present in pre-ejaculate, how does it get there? Another question: If sperm is not present in pre-ejaculate, why isn't withdrawal 100% effective when used perfectly? Based on the FDA study mentioned above, sperm is obviously coming from somewhere. If "perfect use" means avoiding a), b), and c) above, and pre-ejaculate contains no sperm, why is there still a 4% failure rate? Could this be statistical noise?

I'm looking forward to the discussion.
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replied December 22nd, 2008
Opinion
Thank you, for this topic and article.

In my opinion, pre-ejaculate itself does not contain any sperm, but maybe urinating might not always get all sperm out of canal.

However, I think (only opinion), the withdrawal method means, that sperm still 'goes somewhere', from where it can stick to clothes, hands, especially bed-clothing, and somehow reach vagina after (which seems very unlikely - but as unlikely as 4% over a year). Debatable is, how perfect is perfect use?
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replied August 11th, 2011
Maybe the 4% is the result of men that try to control the climax to make the intercourse last longer. If he starts to climax but stops until the urge passes, then starts again, could some of the sperm filled semen flow out like a lubricant? When reading about pre-ejaculate, it appears that most of the situations were with younger men with less experience and quick exposure to it/his penis in a vagina.
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replied August 11th, 2011
Community Volunteer
I might be biased but as a scientist, I trust peer reviewed research long before I trust unverified reports by women on internet forums.

A man that ejaculates less than 2 ml of semen, with less than 40 million fairly healthy sperm are considered infertile. That means that it is very highly unlikely that he can impregnate a woman, even if he ejaculate inside her vagina, No amount of pre-ejaculate even come close to this. Not under any circumstances.

That does not mean that pre-ejaculate cannot make you pregnant, just that it is highly unlikely and pregnancy should not be expected. You will always get exceptions, and even infertile couples get pregnant every once in a while.

The problem with pull-out is for the man to successfully pull out in time. Some men are just better at controlling it.

There are a number of issues:

* A man is programmed to ejaculate inside your vagina. It gives him a lot of pleasure and it is vital to protect the species.
* Many men suffer from rapid or premature ejaculation. It is thought to be as high as 30%. Not always permanently, but pretty much unpredictable. They are taught all sorts of techniques to control their ejaculations. These techniques can allow sperm to leak out before they orgasm.
* Sexual response is not always predictable. If you just move slightly or say something in his ear, you can drive him to ejaculate.
* Men reach a point of inevitability where they can no longer control ejaculation. If he does not pull out a bit before he reach the point of no return, he will ejaculate inside you.
* Teens engaging in sex for the first few times are especially vulnerable to failure. They do not understand their own bodies and responses yet.

The perfect use failure rate for pull-out is pretty close to that of condoms, and some couples will never experience a failure. So it can work if applied correctly. Some couples using fertility awareness methods (FAM) or natural family planning (NFP) use pull-out only during non-fertile days of their cycles. This seems to be a good compromise.

The bottom ine is that if it is important for a woman to not get pregnant, she should use a method that she can control. Not to trust her partner to do something that does not come naturally to him. Ultimately she will end up with the baby, not him.
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replied August 12th, 2011
My ex and I used the withdrawal method this month. He claims that he didn't release anything inside but the hesitation, facial expressions of when he tried to capture control before continuing, and an odor make me feel that he wasn't able to hold everything back. He was still inside of me when he hesitated too. (When I was on BC the odor I smelled was the same odor that was there after he ejaculated inside of me.) Also, his really hard erection was not as stiff-not completely down, but heading down. I am not on BC anymore, it's been three months since I took any form of BC due to some reactions I was having to it. I guess time will tell if he did. (PS We both have been tested before unprotected sex for STDs.)

As far as the consequence of a pregnancy...I look at all babies as a blessing. I would have to change some things in my life but, being an older woman, I would be okay. If I'm not, then that's okay too.
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