Coitus interruptus
5373
225649957
2008-07-14T18:59:54Z
Faigl.ladislav
1429591
cs + sk iw added
{{Infobox Birth control
|name = Coitus interruptus
|image =
|width =
|caption =
|bc_type = Behavioral
|date_first_use = Ancient
|rate_type = Failure
|perfect_failure% = 4
|typical_failure% = 15-28
|duration_effect =
|reversibility = Yes
|user_reminders = Dependent upon self-control. Urinating between acts of sexual intercourse helps clear sperm from urethra.
|clinic_interval = None
|STD_protection_YesNo = No
|periods =
|benefits = No side effects
|weight_gain_loss =
|risks =
|medical_notes =
}}
'''Coitus interruptus''', also known as '''withdrawal''' or the '''pull-out method''', is a method of [[contraception]] in which a couple has [[sexual intercourse]], but [[semen]] is [[ejaculation|ejaculated]] outside of and away from the [[vagina]]. ''Coitus interruptus'' may also more generally refer to any extraction of the penis prior to ejaculation during intercourse. This method has been widely used for at least 2,000 years and was used by an estimated 38 million couples worldwide in 1991.<!--
--><ref>{{cite journal |author=Rogow D, Horowitz S |title=Withdrawal: a review of the literature and an agenda for research |journal=Studies in family planning |volume=26 |issue=3 |pages=140–53 |year=1995 |pmid=7570764 |doi=10.2307/2137833}}, which cites:<br>
:[[Population Action International]] (1991). "A Guide to Methods of Birth Control." Briefing Paper No. 25, Washington, D. C.</ref>
== Effectiveness ==
Like many methods of birth control, reliable effectiveness is achieved only by correct and consistent use. Observed failure rates of withdrawal vary depending on the population being studied: studies have found actual failure rates of 15-28% per year.<!--
--><ref name="kippley">{{cite book | first=John | last=Kippley | coauthors=Sheila Kippley | year=1996 | title=The Art of Natural Family Planning | edition=4th addition | publisher=The Couple to Couple League | location=Cincinnati, OH | id=ISBN 0-926412-13-2 | pages=p.146 }}, which cites:<br>
:{{cite journal |last=Guttmacher Institute |title=Choice of Contraceptives | journal = The Medical Letter on Drugs and Therapeutics | volume = 34 |pages=111–114 |year=1992 | doi = 10.1016%2Fj.%3Ca | doilabel = 10.1016/j.%3Ca }}<br> {{cite book | first=RA | last=Hatcher | coauthors=Trussel J, Stewart F, et al | year=1994 | title=Contraceptive Technology | edition=Sixteenth Revised Edition | publisher=Irvington Publishers | location=New York | id=ISBN 0-8290-3171-5 }}</ref> In comparison [[combined oral contraceptive pill|the pill]] has an actual use failure rate of 2-8%,<!--
--><ref name="pill">{{cite journal | author=Audet MC, Moreau M, Koltun WD, Waldbaum AS, Shangold G, Fisher AC, Creasy GW | title=Evaluation of contraceptive efficacy and cycle control of a transdermal contraceptive patch vs an oral contraceptive: a randomized controlled trial | journal=JAMA | year=2001 | pages=2347–54 | volume=285 | issue=18 | pmid=11343482 | url=http://www.contraceptiononline.org/slides/slide01.cfm?q=pearl+index&dpg=6 | format=Slides of comparative efficacy] | doi=10.1001/jama.285.18.2347}}<br><!--
-->{{cite web | author =Guttmacher Institute | authorlink =Guttmacher Institute | url =http://www.agi-usa.org/pubs/fb_contr_use.html | title =Contraceptive Use | work =Facts in Brief | publisher =Guttmacher Institute | accessdate =2005-05-10}} - see table ''First-Year Contraceptive Failure Rates''</ref> while the [[IUD]] has an actual use failure rate of 0.8%.<!--
--><ref name="cont tech 18" /> The [[condom]] has an actual use failure rate of 10-18%.<!--
--><ref name="kippley" /> (see [[Comparison of birth control methods]])
For couples that use withdrawal correctly at every act of intercourse, the failure rate is 4% per year. In comparison the pill has a perfect-use failure rate of 0.3%, and the IUD has a perfect-use failure rate of 0.6%. The condom has a perfect-use failure rate of 2%.<!--
--><ref name="cont tech 18">{{cite book | first=RA | last=Hatcher | coauthors=Trussel J, Stewart F, et al | year=2000 | title=Contraceptive Technology | edition=18th Edition | publisher=Ardent Media | location=New York | id=ISBN 0-9664902-6-6 | url=http://www.contraceptivetechnology.com/table.html }}</ref>
The primary cause of failure of the withdrawal method is the lack of self-control of those using it. Poor timing of the withdrawal can result in semen on the [[vulva]], which can easily migrate into the female reproductive tract. Some medical professionals view withdrawal as an ineffective method of birth control.<!--
--><ref>{{cite journal |author=Creatsas G |title=Sexuality: sexual activity and contraception during adolescence. | journal = Curr Opin Obstet Gynecol | volume = 5 | issue = 6 |pages=774–83 |year=1993|pmid = 8286689}}</ref> In contrast, a recent study in Iran found that provinces with higher rates of withdrawal use do not have higher fertility rates, and that the contribution of withdrawal use to unintended pregnancies is not markedly different from that of other commonly used methods such as the pill or [[condom]].<!--
--><ref>{{cite paper |author=Amir H. Mehryar, A. Aghajanian, B. Delavar, H. Eini-Zinab, & Shahla Kazemipour |title=Continuing use of a traditional method (withdrawal) in a high contraceptive prevalence country, Iran: Correlates and consequences |publisher=Ministry of Science, Research and Technology, Iran |date=2005 |url=http://iussp2005.princeton.edu/download.aspx?submissionId=50785 |accessdate=2006-09-14 }}</ref>
It has been suggested that the [[pre-ejaculate]] ("Cowper's fluid"), fluid emitted by the penis prior to ejaculation, contains [[spermatozoa]] ([[semen|sperm]] cells), which can easily pass into the upper female genital tract in the presence of [[cervical mucus]].<!--
--><ref>{{cite web |title=Withdrawal (coitus interruptus) |work=Reproductive Health Online: The Reading Room |publisher=JHPIEGO |url=http://www.reproline.jhu.edu/English/6read/6multi/tgwg/Tgwi__e.htm#TopOfPage |accessdate=2007-07-29 }}</ref> However, several small studies<!--
--><ref>{{cite journal |last=Zukerman |first=Z. | coauthors = Weiss D.B. Orvieto R.
|title=Short Communication: Does Preejaculatory Penile Secretion Originating from Cowper's Gland Contain Sperm? | journal = Journal of Assisted Reproduction and Genetics | volume = 20 | issue = 4 |pages=157–159 |year=April 2003 | pmid = 12762415
| doi = 10.1023/A:1022933320700 }}<br>
{{cite journal |author=Free M, Alexander N |title=Male contraception without prescription. A reevaluation of the condom and coitus interruptus |journal=Public Health Rep |volume=91 |issue=5 |pages=437–45 |year=1976 |pmid=824668 |url=http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1440560&blobtype=pdf |format=PDF |accessdate=2007-03-06}}</ref><!--
--><ref name="HIV study">{{cite journal |title=Researchers find no sperm in pre-ejaculate fluid | journal = Contraceptive Technology Update | volume = 14 | issue = 10 |pages=154–156 |year=October 1993 | pmid = 12286905 | doi = 10.1016/j.<a | doilabel = 10.1016/j.<a }}</ref> have failed to find any viable sperm in the fluid. While no large conclusive studies have been done, it is now believed the primary cause of method (correct-use) failure is the pre-ejaculate fluid picking up sperm from a previous ejaculation.<!--
--><ref>{{cite web |title=Withdrawal Method |work=Planned Parenthood |date=March 2004
| url =http://www.plannedparenthood.com/health-topics/birth-control/withdrawal-pull-out-method-4218.htm |accessdate=2008-03-28 }}</ref> For this reason, it is recommended that users of withdrawal have the male partner urinate between ejaculations, to clear the urethra of sperm, and wash any ejaculate from objects that might come near the woman's vulva (e.g. hands and penis).<!--
--><ref>{{cite web |last=Delvin |first=David |title=Coitus interruptus (Withdrawal method) |work=NetDoctor.co.uk |date=2005-01-17 |url=http://www.netdoctor.co.uk/sex_relationships/facts/coitusinterruptus.htm |accessdate=2006-07-13 }}</ref>
== Advantages ==
The advantage of coitus interruptus is that it can be used by people who have objections to or do not have access to other forms of contraception. (Some men prefer it so they can avoid possible adverse effects of hormonal contraceptives on their partners.<ref>{{cite journal|author=Ortayli, N et al|title=Why Withdrawal? Why not withdrawal? Men's perspectives.|journal=Reproductive Health Matters|year=2005|issue=13|volume=25|pages=164–73|pmid=16035610|doi=10.1016/S0968-8080(05)25175-3}}</ref>) Some women also prefer this method over hormonal contraception to avoid adverse effects such as depression, mood swings, vaginal dryness, decreased libido, and headaches, among others. It has no monetary cost, requires no artificial devices, has no physical side effects, and can be practiced without a prescription or medical consultation.
== Disadvantages ==
The method is largely ineffective in the prevention of [[STDs]], like [[HIV]], since [[pre-ejaculate]] may carry viral particles or bacteria which may infect the partner if this fluid comes in contact with mucous membranes. However, a reduction in the volume of bodily fluids exchanged during intercourse may reduce the likelihood of disease transmission due to the smaller number of pathogens present.<ref name="HIV study" />
The method may be difficult for some couples to use. The interruption of intercourse may leave some couples sexually frustrated or unsatisfied.<!--
--><ref>{{cite web |title=Coitus Interruptus (Withdrawal) |work=Abstinence & Natural Birth Control Methods |publisher=Sexually Transmitted Disease Resource |date=2006 |url=http://www.sexual-health-resource.org/natural_birth_control.htm#withdrawal |accessdate=2006-09-05 }}</ref>
== Prevalence ==
Worldwide, 3% of women of childbearing age rely on withdrawal as their primary method of contraception. Regional popularity of the method varies widely, from a low of 1% on the African continent to 16% in Western Asia. (Data from surveys during the late 1990s).<!--
--><ref>{{cite paper |title=Family Planning Worldwide: 2002 Data Sheet |publisher=Population Reference Bureau |date=2002 |url=http://www.prb.org/pdf/FamPlanWorldwide_Eng.pdf |format=PDF |accessdate=2006-09-14 }}</ref>
In the United States, 56% of women of reproductive age have had a partner use withdrawal. In 2002, 2.5% were using withdrawal as their primary method of contraception.<ref>{{cite journal | last= Chandra |first=A | coauthors = Martinez GM, Mosher WD, Abma JC, Jones J. |title=Fertility, Family Planning, and Reproductive Health of U.S. Women: Data From the 2002 National Survey of Family Growth |publisher=National Center for Health Statistics | journal = Vital Health Stat | volume = 23 | issue = 25 |year=2005 |url=http://www.cdc.gov/nchs/data/series/sr_23/sr23_025.pdf |format=PDF |accessdate=2007-05-20 }} See Tables 53 and 56.</ref>
== See also ==
* [[Coitus reservatus]]
* [[Natural birth control]]
== References ==
{{reflist}}
{{Birth control methods}}
[[Category:Behavioral methods of birth control]]
[[Category:Contraception for males]]
<!-- The below are interlanguage links. -->
[[cs:Přerušovaná soulož]]
[[da:Afbrudt samleje]]
[[de:Coitus interruptus]]
[[es:Coitus interruptus]]
[[eo:Interrompita koito]]
[[fr:Coït interrompu]]
[[it:Coito interrotto]]
[[lt:Nutrauktoji sueitis]]
[[nl:Coitus interruptus]]
[[ja:膣外射精]]
[[pl:Stosunek przerywany]]
[[pt:Coito interrompido]]
[[ru:Прерванный половой акт]]
[[sk:Prerušovaná súlož]]
[[sl:Coitus interruptus]]
[[fi:Keskeytetty yhdyntä]]
[[sv:Coitus interruptus]]