Question: Pulling out before ejaculating might be better than nothing, but how effective is this method? Wouldn’t pre-cum pose a pregnancy risk?
Research on Pulling Out
The withdrawal method – also called “pulling out” – has received a lot of attention recently thanks to a research study that suggested that it was as effective at reducing the risk of pregnancy as male condoms.
This finding was confusing for many people as it is commonly believed, by many women and men, that couples can become pregnant from a man’s pre-ejaculatory fluids, which are also called pre-cum.
The truth is a little trickier than that.
The Way It All Works
Here’s the deal: a man’s pre-ejaculatory fluids may or may not contain any (or many) sperm. Pre-ejaculatory fluids are clear fluids that come from small glands inside of a man’s body, including glands called the Cowper’s glands. These pre-ejaculatory fluids are released into a man’s urethra when he becomes aroused and they help to lubricate the urethra. The few studies addressing sperm in pre-ejaculatory fluids have been conflicting. Some research has found that no sperm were found in men’s pre-ejaculatory fluids. However, at least one study has found that some men seem to have some sperm in their pre-ejaculatory fluids. This led the latter research team to speculate that “some men repeatedly leak sperm in their pre-ejaculatory fluid while others do not.” And while the researchers noted that the number of sperm in the pre-ejaculatory samples “was very low”, they also noted that it was unclear how much or how little of a risk of pregnancy the sperm might pose, “except that the chances would not be zero.” 
Also, some men produce more pre-ejaculatory fluid than others and they may be able to see it come out of their penis while they are aroused. Others don’t produce as much pre-ejaculatory fluid and it may not be noticeable to them at all.
Reasons to Avoid Unprotected Sex
That said, most healthcare providers and sexual health educators still discourage people from having unprotected sex for several reasons.
First of all, couples can still pass infections to one another.
Second, just because a man plans to pull his penis out of his partner’s vagina before he ejaculates does not mean that he will be able to. Many men ejaculate more quickly than they would like. Men may feel as though they have control over when and where they ejaculate, but they may suddenly feel very excited during sex or a certain position may stimulate their penis in a way they didn’t expect and they may come without meaning to.
Therefore, the withdrawal method is not effective at preventing pregnancy for all men. It may work quite well for men who can routinely and reliably control the timing of their ejaculate. However, it probably does not reduce pregnancy risk for those men who find it challenging to control when and where they ejaculate.
The bottom line is that if a man and his partner would like to avoid pregnancy, they would be wise to choose a highly effective method of birth control – for example, the IUD, birth control implant, hormonal birth control pills, the birth control shot, birth control ring, or birth control patch are some options. Also, consider using condoms! Not only do the help reduce pregnancy risk, but they are the only device that reduces the risk of sexually transmitted infections (STI) such as HIV, chlamydia, and gonorrhea.
Ask your healthcare provider for more information about these and other birth control methods.
To learn more about condoms, the withdrawal technique and other methods of birth control, check out Planned Parenthood’s website.
Reviewed and updated on April 30, 2017 to include additional research reference and contraceptive options.
 Killick, S.R., Leary, C., Trussell, J., and Guthrie, K.A. (2011). Sperm content of pre-ejaculatory fluid. Human Fertility, 14(1), 48-52.