7 Things Every Woman Should Know About The Pull-Out Method

Perhaps the pill threw your hormones out of whack, or the idea of having a foreign object like the implant or IUD in your body skeeves you out. We get it: Choosing a form of birth control takes a lot of trial and (hopefully not much) error.

Hormonal birth control options like the pill can come a litany of side effects from acne to bloating. And condoms can be a little awkward and uncomfortable for everyone. It’s beyond frustrating when you feel like all your options suck.

Perhaps that’s why even though we know it’s one of the least reliable forms of contraception, withdrawal or the “pull-out method” is just as popular as ever among women. In fact, according to one survey, 41 percent of women ages 18 to 24 reported practicing withdrawal and researchers estimate the actual number could be higher.

Maybe this news is shocking, but if you spend any time discussing your sex lives with your friends, you probably know at least one person who’s guilty of utilising this method, or maybe you do yourself. And if your sex life is more sporadic, perhaps the idea of triaging the situation with Plan B every once in a while doesn't sound half bad.

We all long for the day that women can avoid pregnancy without wreaking havoc on our bodies, but until science catches up with our desires, we’re stuck with what we’ve got. Obviously, birth control is a personal choice and we can’t tell you not to do, but if your goal is to actually prevent pregnancy, you’d be better off ditching the pull-out method and using condoms, the pill, NuvaRing, the Implant, or an IUD. Here’s why:

1. This method is only 78% effective

That may sound pretty good, but consider this: Out of the 18 different forms of birth control recognized by Planned Parenthood, the pull-out method comes in third to last in terms of effectiveness after spermicide (71 percent) and tracking your ovulation cycle (76 percent). Contrastingly, hormonal birth control methods are all over 90 percent effective. And if you want to be hormone and foreign-object-free, condoms are 85 percent effective.

2. It requires skill

The reason the effectiveness is so low is because this method presents a lot of room for human error, says Mary Jane Minkin, M.D. and clinical professor at the Yale School of Medicine. Many men indeed cannot withdraw immediately and the first few drops of semen that emerge from the penis are the most loaded with sperm, she says. Remember, it only takes one sperm to fertilise an egg. In order to practice this method properly, your partner has to pull out before ejaculation and ejaculate away from your genitals.

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3. It doesn’t prevent STIs

You may be thinking that the 7 percent discrepancy between condoms and the pull-out method isn’t enough to warrant a change in methodology, but remember that the pull-out method doesn’t prevent STIs, says Minkin.

That’s because even if you were practicing it accurately, some STIs like genital warts and herpes are transferred via skin-on-skin contact. Additionally, STIs chlamydia, syphilis, and gonorrhea can be carried in pre-cum, according to Planned Parenthood.

“I would strongly encourage any couple relying on withdrawal to at least get some condoms, which are a heck of a lot more reliable and do help protects against STIs,” she says.

4. The amount of men doing it is on the rise

According to a recent survey from the CDC, men have been increasingly using the pull-out method over the last decade. The average use of withdrawal among men nearly doubled from 9.8% in 2002 to 18.8% in 2011 to 2015. The survey found that on average, this method was used by 23 percent of men who had never been married. Contrastingly, only 13 percent of men who cohabited with their partner utilised the pull-out method. This report didn’t speculate why men have become increasingly inclined to use this method.

5. It’s free

"The fact that the pull-out method doesn’t cost anything is the only advantage I can think of," says Minkin. Indeed, condoms and female contraception aren’t always free, but neither are pregnancies, child care, or STI treatment medications. Basically, you have to decide between a smaller bill now or a big bill down the road.

6. Some people use it to double up

As we’ve reported before, many women use the pull-out method in addition to other contraception (the pill, condoms, etc.) as a back-up. Minkin says it’s difficult to tell if this methodology is actually helpful and that your primary contraception is doing most of the heavy lifting in this case.

7. Accidents happen

In order for this method to be effective, you have to get it right every single time. If you’ve been relying on this method for some days in between pills or when you couldn’t find a condom, it’s best to be on the safe side and seek over-the-counter emergency contraception immediately, says Minkin.

If you’ve been utilising the pull-out method, set up an appointment with your GP or your gynecologist to go over reliable methods of contraception.

This article originally appeared on Women's Health US.