Withdrawal

Myths:
 
·         Correct Method Use
·         Effectiveness
·         Health Risks and Side Effects
·         Infections
·         Mechanism
·         Sexual Desire and Sexual Pleasure
·         Who Can Use the Method
 
Myth: Correct Method Use
Some people have misconceptions about how to use withdrawal correctly. For example, people incorrectly believe that the clear fluid that comes out of a man’s penis before he ejaculates (pre-ejaculate fluid) can cause pregnancy.
 
Fact:
The pre-ejaculate fluid itself does not contain sperm. As the pre-ejaculate leaves the body, however, it may pick up sperm from a previous ejaculation that remains in the urethra. One study found small clumps of sperm in the pre-ejaculate fluid of some men. Though only a few hundred sperm were present, they could theoretically pose a low risk of pregnancy.
 
Such small amounts of sperm can likely be flushed out with urination, although no research has verified this. If a man using withdrawal has ejaculated recently, he should urinate and wipe the tip of his penis to remove any remaining sperm before having sex again.
 
Counseling Messages:
As it leaves the body, there is a chance that the pre-ejaculate fluid could pick up a very small amount of sperm remaining in the urethra from a previous ejaculation. Men using withdrawal should urinate prior to having sex because this could help flush out any remaining sperm and reduce the risk of pregnancy. (USA)
 
The fluid before ejaculation may have sperm cells. It is difficult to tell if this pre-ejaculate is leaking out of the penis; therefore, the withdrawal method may sometimes lead to pregnancy. (Singapore)
 
One cannot be sure that there are no spermatozoids in the fluid present before ejaculation. If you want no risk of pregnancy, you should not use withdrawal.  (Switzerland)
 
Pregnancy is possible if ejaculated semen contains sperm. Initial ejaculations of clear fluid from the urethra could also contain sperm, though the amount is very small. (Viet Nam)
 
It is best not to rely solely on this method because even in the fluid before ejaculation there may be some sperm. (Iran)
 
There [usually] is not an adequate amount of active sperm in the pre-ejaculatory fluid to fertilize an egg. Thus, pregnancy is prevented.  (Myanmar)
 
 
Myth: Effectiveness
Some people have misconceptions about the effectiveness of withdrawal.
 
Fact:
Withdrawal is one of the least effective contraceptive methods as it is commonly used, although it offers better pregnancy protection than no method at all. The effectiveness of withdrawal depends on the man’s ability to correctly withdraw with every act of sex.
 
With common practice, 27 out of 100 couples using withdrawal will experience a pregnancy during the first year of use. When practiced correctly and consistently, withdrawal is more effective. About 4 out of 100 women will become pregnant over the first year if their partners properly withdraw with every act of sex.
 
Counseling Messages:
Withdrawal is not as effective as other methods of contraception such as condoms, IUDs, and hormonal contraceptives. This method is also not able to prevent STIs and HIV/AIDS. Premature ejaculation or residual semen can cause pregnancy. (Nigeria)
 
Control over ejaculation is not so definite and the withdrawal method is known to be the least effective form of birth control. This is due to the fact that some men find it difficult to control the point of ejaculation and accidentally release sperm into the vagina. (Singapore)
 
The effectiveness of the withdrawal method in preventing pregnancy is about 96% [if practiced correctly with every act of sex; as commonly practiced, withdrawal is 73% effective, on average]. (Australia)
 
If the man can withdraw before the beginning of ejaculation, the method may be rather efficient. The risk is smaller than using no protection at all, but you cannot be sure not to get pregnant if you use withdrawal. (Switzerland)
 
Withdrawal can be 96% effective upon the condition that males withdraw immediately before ejaculation [during every act of sex. As commonly practiced, withdrawal is 73% effective, on average.]. Oral contraceptives are usually very effective, often times up to 100%. (Viet Nam)
 
Withdrawal is not a good contraceptive method, though its use is commonly widespread. It has a high risk for STIs and is mildly effective in preventing pregnancy, not to mention the interference in sexuality it brings. Of course it is not as effective as oral contraceptives, which are one of the most remarkable methods available nowadays, but it is better than not using any contraceptive method. (Argentina)
 
This method is not as effective as oral contraceptives because the semen may escape to the vagina. (Yemen)
 
 
Myth: Health Risks and Side Effects
Some people incorrectly believe that using withdrawal will cause health risks and side effects, such as cancer, headaches, or blindness.
 
Fact:
Withdrawal does not have any physical side effects for men or women.
 
Counseling Messages:
Withdrawal does not cause cancer, blindness, and headaches or result in any health risks. (Viet Nam)
 
This method will not cause any side effects like cancer or blindness. (Yemen)
 
Unprotected intercourse [and not withdrawal] can cause infertility due to STIs, which are very frequently asymptomatic. (Argentina)
 
 
Myth: Infections
Some people mistakenly believe that withdrawal prevents the transmission of sexually transmitted infections (STIs).
 
Fact:
Withdrawal does not prevent the transmission of STIs. Lesions or ulcers on the genitals can transmit various infections. Other STIs can be passed from one partner to the other through skin-to-skin contact. If either partner is at risk, the couple should use condoms.
 
The semen of HIV-positive men contains HIV-infected cells and is the primary way that HIV is transmitted through sex. Using withdrawal may reduce the risk of transmitting HIV because the woman is not exposed to semen. Even with withdrawal, however, there is a risk of HIV transmission because the pre-ejaculate fluid may also contain HIV. Studies of heterosexual couples found that the transmission of HIV from male to female was decreased by one-half or more when withdrawal was practiced compared with intercourse with ejaculation inside the woman. No studies have examined whether withdrawal reduces female-to-male transmission of HIV.
 
Counseling Messages:
Germs may be present in the vagina or on the penis even if there is no ejaculation. They also may be present in the fluid coming out of the penis before ejaculation; therefore withdrawal does not provide complete protection, neither for the man nor for the woman, if one is infected [with an STI]. (Switzerland)
 
Withdrawal cannot prevent STIs since the possibility of contracting STIs exists when one comes into contact with fluid released from the genital organs of individuals with STIs. (Viet Nam)
 
Any act of penetrative sexual intercourse should be protected by a barrier method. In Argentina we recommend correct and consistent use of male condom. No matter whether it is oral, anal, or genital sex, it should always be protected by condoms. (Argentina)
 
 
Myth: Mechanism of Action
Some people have misconceptions regarding how withdrawal prevents pregnancy, such as incorrectly believing that withdrawal prevents pregnancy by preventing the female from having an orgasm.
 
Fact:
Practicing withdrawal is not directly related to a female orgasm. Also, conception does not depend upon whether or not a woman has an orgasm. Withdrawal prevents pregnancy by preventing sperm from entering the vagina. 
 
Counseling Messages:
Withdrawal prevents sperm from encountering eggs, thus preventing pregnancy. Having an orgasm does not necessarily result in pregnancy. (Viet Nam)
 
If you practice the withdrawal method correctly there is no dissemination of sperm into the vagina. Thus, pregnancy is prevented. (Myanmar)
 
 
Myth: Sexual Desire and Sexual Pleasure
Some people incorrectly believe that withdrawal will make men infertile, impotent, or weak, or decrease their sex drive.
 
Fact:
There is no evidence to suggest that withdrawal will make men infertile, impotent or weak, or that it will decrease their sex drive.
 
Counseling Messages:
Withdrawal does not reduce male sexual desire or fertility; however, males generally do not like using this method since it makes them tense and uncomfortable during sexual intercourse. Nevertheless, in cases where females are not allowed or able to use oral contraceptives or in situations when males are allergic to condoms, the traditional contraceptive method of withdrawal is advisable. In Viet Nam, many couples are effectively using withdrawal techniques. Withdrawal is inexpensive and can be used by all couples, thus serving as a better contraceptive method than nothing at all. (Viet Nam)
 
Withdrawal will not make the male infertile or weak and no harm to the genital organs should be expected from its use. But, we always have to consider the risk of STIs that are very frequently asymptomatic [without symptoms] and could cause different degrees of disease to the genital organs of women and men alike. (Argentina)
 
 
Myth: Who Can Use the Method
Some people incorrectly believe that withdrawal is appropriate only for certain people, for instance, only people whose cardiovascular systems function well.
 
Fact:
No medical conditions prevent the use of withdrawal. While all men can use this method, its effectiveness depends on the user. Men who ejaculate prematurely or who cannot sense consistently when ejaculation is about to occur may have difficulty using withdrawal.
 
Learning to properly withdraw can take time. Couples may want to use another method until the male feels he can correctly withdraw with every act of sex.
 
Counseling Messages:
Withdrawal can be used by any couple engaged in sexual activity. It is among the most popular methods of contraception. This method can be effective if the couple is determined to follow it correctly and withdrawal occurs before ejaculation (and no semen enters the vagina). (Viet Nam)
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