4.2.3  Coitus interruptus (withdrawal or pulling out) method

Coitus interruptus or withdrawal is a traditional family planning method in which the man withdraws or pulls out his penis from his partner’s vagina and ejaculates outside, keeping his semen away from her genitalia.

Mechanism of action of withdrawal method

Coitus interruptus prevents fertilisation by stopping contact between spermatozoa in the sperm and the ovum or egg.

Advantages of withdrawal method

It is important for you to teach this method as part of natural family planning methods. It costs nothing and requires no devices or chemicals. It is available in any situation and can be used as a back-up method of contraception.

Disadvantages of withdrawal method

It has several disadvantages. Interruption of the excitement of sexual intercourse may result in the incorrect or inconsistent use of this method, as well as decreasing sexual pleasure for both partners. A high failure rate may be due to a lack of self-control, and semen containing sperm may leak into the vagina before the person ejaculates. There is a further possibility of premature ejaculation by the man. In addition, the couple is not protected from STIs, including HIV.

Effectiveness of withdrawal method

It is the least effective method because it depends on the man’s ability to withdraw before he ejaculates. However, it is about 73% effective if used correctly (Family Planning: A Global Handbook for Providers, WHO, 2007).

4.2.2  Lactational amenorrhoea method (LAM)

Summary of Study Session 4