Talk:Coitus interruptus

This

This article talks about the failure rate of "the pill" as if there was only one oral contraceptive. Please provide data on which "pill" is being referred to.

is it necessary to list all those slang terms at the beginning of the article?--Alhutch 02:09, 6 October 2005 (UTC)

grateful

i am so greatful to have finally found a site that will list the failure rate of couples who practice withdrawal successfully and consistently! it is also a relief to have found a site that does not employ the scare tactic.

this is excellent information

Research?

Could the editor indicating research suggesting the absence of live sperm in Cowper's fluid please elaborate? I've read articles to the contrary.

one way to know for sure - test someone's under the microscope

I don't think that testing one man's pre-ejaculate under a microscope to check for the presence of viable sperm could conclusively indicate that the same result could then be expected from every fertile man's pre-ejaculate or even that the same result could be expected from the same man's pre-ejaculate in future. Several men's pre-ejaculate would need to be tested on several different occasions, under several different circumstances in order to identify whether there is a predictable pattern of the presence or absence of viable sperm in pre-ejaculate.--A vivid dreamer 07:08, 11 May 2006 (UTC)

---

This wikipedia artical claims:

..."modern research[1] has shown that in fact there are no viable sperm in the fluid, and the primary cause of failure of this method of contraception is the lack of self-control of those using it: interrupting just at climax can be psychologically difficult, as it goes against the natural instinct to ejaculate deeply within the vagina."

(here is the link to the "modern research")

- The report doesn't show that it is a "fact" that there are no viable sperm in pre ejaculate fluid.
- The report says, "A larger study is needed to verify these results."
- The report also says, "If these results are confirmed, they may dispel the myth that pre ejaculate fluid contains sperm." This indicates that these findings are NOT confirmation that there is no viable sperm in pre ejaculate fluid, and that further research is needed before it could be confirmed.
- The report does not say how many pre ejaculate fluid samples were tested.
- The study was designed to "determine whether HIV was or was not present in pre ejaculate fluid", not to test whether sperm was present in pre ejculate fluid. A study designed specifically to test for sperm in pre ejaculate fluid would be needed to ensure that the experiment involves the right conditions for the experiment to be considered valid.
- The report DOES NOT SAY that "the primary cause of failure of this method of contraception is lack of self-control of those using it", in fact, the report makes NO mention as to what the primary cause of failure is.
--A vivid dreamer 10:59, 30 April 2006 (UTC)

"Typical" effectiveness - common misunderstanding

It is commonly misunderstood that user effectiveness, sometimes called typical effectiveness, is the effectiveness to be expected from any group using the method.

The actual definition of user effectiveness is the effectiveness only of couples that use the method inconsistently or incorrectly. It has no relationship to how many couple actually use the method correctly or not.

The link I deleted seemed to have this misunderstanding - it cited the high user failure rate of withdrawal as evidence that the method is rarely used correctly. But the user failure rate is unrelated to how many couple use the method correctly (or not).Lyrl 17:26, 6 May 2006 (UTC)

I always understood that user-effectiveness was a measure of the whole user-base population with results less than the idealised method-effectiveness because of incorrect usage to a greater/lesser extent by some/many users (i.e. not the effectiveness rates in the sub-set of all users who incorrectly use). Hence user-effectiveness gives an idea how well a method is likely to work in the population at large (some using well and others less well), rather than the method-effectiveness which is the idealised outcome found in trials when extensive education is given and continues to be given. The importance of "user-rates" is not to apportion blame to a couple if conception occurs, but to give a more realistic measure of how effective/ineffective a method might be to a couple considering between contraceptive options. In this regards it is similar to the poor results generally seen for new specialised chronic leg ulcer dressings which often seem to effect resolution in the same 6months period as the current pre-existing dressings, yet under research conditions with multiple home visits every day so much better claims may be made for the product. David Ruben ^Talk 22:42, 6 May 2006 (UTC)

That is the common understanding, and what naturally comes to mind with a name like "typical". But from a chart listing typical failure rates [1]:

* "Typical Use": refers to failure rates for women and men whose use is not consistent or always correct.

I have also seen this definition used in books discussion contraceptive effectiveness. It is the only definition I have seen spelled out, actually; usage of the term the other way (as "whole user-base population") seems to always imply the definition.Lyrl 00:14, 9 May 2006 (UTC)

To be honest I still read the two headings for the chart ("Typical Use": refers to failure rates for women and men whose use is not consistent or always correct and "Perfect Use": refers to failure rates for those whose use is consistent and always correct.) as NOT meaning spliting users in the population at large into those who self-report poor or good adherence to a method's technique. Instead I read these as a plain English abbreviations of descriptions that might be more fully set out as: "Typical Use": that which might be expected in the population at large, outside of the supervision & monitoring of a research study environment, where adherence to methodology may be less than optimal and "Perfect Use": that which may be idealised achieved with optimal adherence to method technique under the supervision & monitoring of a research study environement. Now maybe I am over interpreting and qualifying the heading descriptors and so changing from the former to latter meanings - are your aware of any link that more fully describes the original studies that gave rise to this summarising table (i.e. where the terms will be more fully defined) ? David Ruben ^Talk 01:20, 9 May 2006 (UTC)

It appears you are correct. I have not been able to find anything on the internet, but this is from The Art of Natural Family Planning by John and Sheila Kippley, p.141:

This cogent system was developed by James Trussel, Ph.D., and colleagues:

Actual-use surprise pregnancy rate: the surprise pregnancy rate which includes all pregnancies in a study and all months (or cycles) of exposure.

Perfect-use surprise pregnancy rate (also known as "Method-related surprise pregnancy rate"): the surprise pregnancy rate which includes only those pregnancies occuring during months (or cycles) when the method was followed according to all the rules. The rate uses only the exposure for cycles in which the rules were followed perfectly.

Imperfect-use surprise pregnancy rate: the surprise pregnancy rate which includes only those pregnancies occuring during months (or cycles) when at least one of the rules of the method was not followed. This rate uses only the exposure for cycles in which at least one of the rules of the method was not followed. This rate uses only the exposure for cycles in which at least one of the rules was not followed.

Many studies calculate a "User-related" surprise pregnancy rate. The Actual-use rate will typically be higher than the User-related rate because only pregnancies occuring when rules were not followed are included in the numerator of the calculation for User-related rates; all pregnancies are used in the numberator for actual-use rates. The denominator (all months of exposure) is the same for both calculations.

Later in the chapter they have a table that with a header Typical (Actual) Use - so I must have been mistaken when I interpreted typical use as equivalent to imperfect use.Lyrl 22:23, 9 May 2006 (UTC)

Perfect Use

There is a sentence in this wikipedia article that reads, "for the couples that use this method correctly at every act of intercourse, the failure rate is 4% per year". Before this discussion, it read, "for the couples that use this method correctly at every act of intercourse (which some people say is near-impossible), the failure rate is 4% per year." (or something very similar to that), and there was a link to a webpage that expressed this view.

I share David Rubin's understanding of the definition of "perfect use" (i.e. '"Perfect Use": that which may be idealised achieved with optimal adherence to method technique under the supervision & monitoring of a research study environement'). That is, I understood "perfect use" to only be achieveable under very specific conditions that are perhaps difficult to achieve in everday life.

Lyrl, the defintion of "perfect use" that you quoted (i.e. 'the surprise pregnancy rate which includes only those pregnancies occuring during months (or cycles) when the method was followed according to all the rules. The rate uses only the exposure for cycles in which the rules were followed perfectly.') refers to "rules" of the withdrawal method. Does the book offer more information about what these "rules" are? If so, perhaps we could use this information to consider whether it is realistically possible for people to achieve "perfect use" in everyday life, or whether "perfect use" is only consistently achieveable under scientific research conditions.

I think it's important to address this in the wikipedia article because it seems that a lot of people assume that they can (and do) use the withdrawal method "perfectly", where as, if this is actually very hard to achieve in everyday life, people may be putting themselves at a higher risk of becoming pregnant than they realise.

So in summary, I guess I'm suggesting that in the article, we include a specific description of what "perfect use" involves. How do people achieve this "perfect use"? --A vivid dreamer 07:13, 10 May 2006 (UTC)

Perfect use of withdrawal: actually withdraw at every act of intercourse. I believe the ability to do this varies greatly from man to man, and probably has an inverse correlation to age.

The article already states that the "coitus interruptus is unreliable, because of the difficulty of controlling the process of ejaculation" and "The difficulty of using the method correctly makes it a poor choice of birth control for many couples." Also, the link provided by vivid dreamer did not support the claim that it was impossible to use the method correctly: the link said perfect use hardly ever happens, not that such use was impossible or near-impossible. I believe the rarity of correct use is sufficiently addressed by the statements already in the article.Lyrl 21:14, 10 May 2006 (UTC)

I am not suggesting (nor suggesting that the article should claim) that it is "impossible to use the method correctly", but rather that perfect use can't be expected on every occasion. This was the link [2]. The words used are:

"if 100 women use the withdrawal method all the time and always do it perfectly (which is almost impossible), 4 women will become pregnant in a year."

And my suggested wording for this article was:

"for the couples that use this method correctly at every act of intercourse (which some people say is near-impossible), the failure rate is 4% per year".

I don't think that either of these statements are saying that it's "impossible to use the method correctly", just that it's almost impossible for it to be done correctly everytime.

You give the definition, "Perfect use of withdrawal: actually withdraw at every act of intercourse", surely perfect use would at least also include urinating before sex and washing the penis/hands.

Fair enough, the article does already cover the fact that the method is difficult to use correctly. However, I do have a concern that people read these statistics about "perfect use" and set out in earnest to implement this "perfect use", in the belief that because they (personally) have done it successfully in the past it should therefore be achieveable again (i.e. they believe the man has "mastered the art" of withdrawing before ejaculation and assume he will therefore be able to always repeat this in future), and this is perhaps an unrealistic expectation as the link says it's almost impossible to do it perfectly all the time. I guess the questions are: if people are diligent, how often is it reasonable to expect perfect use? and, what percentage of the people in the 'actual (typical) use' statistic were trying as hard as they could to implement 'perfect use'?.

If 'actual (typical) use' refers to "the surprise pregnancy rate which includes all pregnancies in a study and all months (or cycles) of exposure" (as you quoted from The Art of Natural Family Planning by John and Sheila Kippley), surely one could assume that a requirement of the participants in the study was to sincerely attempt to use the method as "perfectly" as they can, otherwise the statistics would reflect people who use "no method/chance" in combination with "withdrawal method", rather than just "withdrawal method" on it's own.

I think it's only responsible and fair for this article to qualify statistics about "perfect use" with the information that it is "almost impossible" to achieve perfect use every time, even if people set out out with the sincere intention to follow all the rules, all of the time. --A vivid dreamer 02:32, 11 May 2006 (UTC)

This website [3] answers some of our questions. Amongst many things of interest, it says, "there is no such thing as a "perfect" use of withdrawal". --A vivid dreamer 11:23, 11 May 2006 (UTC)

The most recent link provided seems to refer to "no such thing as perfect use" to mean that no method of birth control is foolproof. This is true, in that even sterilization has a failure rate - only complete abstinance, removal of the ovaries, or removal or the testes can be considered 'perfect' birth control. But there are some couples who use withdrawal successfully for decades to plan their family - for those couples, it is a very effective method. I know of two support groups for women whose partners use withdrawal as their primary birth control. [4][5]

Motivation certainly does affect the failure rate of withdrawal. The Kippley's book I reference above has a table from the Guttmacher Institute that gives 'Low' and 'High' effectiveness referring to rates amoung women in the USA more and less likely than average to use the method correctly and consistently. The typical failure rate for withdrawal in the lower motivation group is 27.8% per year. The typical failure rate for withdrawal in the higher motivation group is 14.7% per year. Note that even the higher motivation group still used withdrawal in combination with no method/chance, otherwise their failure rate would be listed as the method failure rate rather than the typical failure rate.

Both typical and correct-use failure rates for withdrawal are comparable to barrier methods of birth control. The diaphragm has a 6% method failure rate, and a 12-38.9% typical failure rate (from the same Guttmacher reference). Spermicide alone has a 6% method failure rate, and a 21.6-25.6% typical failure rate. While diaphragms and spermicide are not considered ultra-effective like an IUD or sterilization, they are certainly good compared to no birth control at all (85% pregnancy rate per year). The diaphram and spermicide Wiki entries do not have ANY warnings about being difficult to use correctly, or having low failure rates, while this page already has two. I don't believe more warnings are necessary for this article. Lyrl 03:39, 13 May 2006 (UTC)

I see what you mean about there being no truely perfect birth control. And yes, I agree that is what was meant by the writer in the link I provided when s/he said that withdrawal method is never "perfect". I missed that meaning the first time I read it.

You suggest that since the the higher motivation group in the study still had a failure rate of higher than 4%, they should still be described as using "no method/chance" with "withdrawal"... but I would imagine that due to being part of a study, they would have been required to give withdrawal method their "best attempt". There is a difference between knowingly and deliberately being "slack" with the method, and trying diligently to do the method correctly but falling short of perfect due to unintentional (and possibly unconscious) human error. I think if the people in the study were sincerely trying to use the withdrawal method properly, but still did not achieve a "perfect" (4% failure rate) standard, then their method could still be described as "withdrawal method" and NOT "no method/chance in combination with withdrawal method". I think that the later is only the case if the couple is knowingly and deliberately being slack.

I understand the 14% failure rate of the highly motivated group of participants, and this writer's [6] opinion that "always doing it perfectly" is "nearly impossible", to mean that even really motivated, well-meaning people fall short of using withdrawal "perfectly" (to the 4% failure rate standard) as a result of accidents, not through lack of trying.

If the diaphram and spermicide Wiki articles don't mention that these methods are difficult to use and have high failure rates in comparison with other birth control methods, then clearly these articles need more information added to them. The lack of complete information in those articles is no reason to leave information out of this article. I don't think this is about "warning" people, as much as it is about "providing facts" so that people can make informed choices. There is literature that informs us that it is difficult to consistently achieve a "perfect" (i.e. 4% failure rate standard) of withdrawal method, why should this information be left out of this article? It is illogical to say that this information should be omitted because other warnings are already included. Stating that "coitus interruptus is unreliable, because of the difficulty of controlling the process of ejaculation" and "The difficulty of using the method correctly makes it a poor choice of birth control for many couples", does not adequately cover the point that "it is difficult (even for motivated and diligent couples) to consistently achieve a "perfect" (i.e. 4% failure rate standard) of withdrawal method".--A vivid dreamer 08:15, 13 May 2006 (UTC)

You are right that couples are still users of the withdrawal method even if they do not use it perfectly. That is how studies report the failure rates, for barrier methods also. Even really motivated, well-meaning people fall short of actually putting a condom on when they intend condoms to be their sole method of birth control. Correct use of a condom yields a 3% per-year pregnancy rate. Typical use of condoms includes couples who intend to use condoms but don't actually put them on, and is reported at 9.8% per year for higer-motivated groups and 18.5% per year for lower-motivated groups.

I understand your distinction between barrier methods that are applied before intercourse begins, or hormonal methods whose application is unrelated to coitus, and withdrawal which is practiced near the height of physical sensation. But for every user-dependent method, there is a group of users that method is inappropriate for. Method and typical failure rates do not say which bc method is best for a particular person or couple. If a woman can't remember to take a pill at the same time every day, but is diligent about inserting a diaphragm before every act of intercourse, for her a diaphragm is going to have a lower failure rate than the pill. For some couples, the man is very talented at withdrawal and other bc options are not good for them. I guess I'm just hesitent at implying that withdrawal is never a good option for any couple.

As a last word to vivid-dreamer, you have put alot of your time an research into this discussion, and I would like to thank you for your thoughtfulness in replying to my comments.Lyrl 03:38, 14 May 2006 (UTC)

Contradiction in article and reference needed

The article makes two different claims of what "the primary cause of failure" of the withdrawal method is:

1. "The primary cause of failure of this method of contraception is the lack of self-control of those using it: interrupting just at climax can be psychologically difficult, as it goes against the natural instinct to ejaculate deeply within the vagina." (There is no reference provided for this statement).

and,

2. "it is now believed the primary cause of method failure is the pre-ejaculate fluid picking up sperm from a previous ejaculation."

So that both these ideas can be preserved in the article, perhaps the wording could be something along the lines of, "Some of the causes of failure of the withdrawal method include pre-ejaculate fluid picking up sperm from a previous ejaculation and lack of self-control", unless we actually know that specifically one of these things is the primary cause of failure. --A vivid dreamer 08:30, 11 May 2006 (UTC)

The primary cause of typical failure is not actually pulling out. The primary cause of method or correct use failure is believed to be picking up sperm from a previous ejaculation.Lyrl 03:39, 13 May 2006 (UTC)

References

Inconsistency between this article and another wikipedia article and Possible bias in wording in this article

In the wikipedia article titled "Sexual Intercourse"[7] (in the section of the article headed, "Sexual Reproduction"), it says:

"Coitus interruptus, or withdrawal of the penis from the vagina just before the man's orgasm, typically has a high failure rate, as sperm are usually present in pre-ejaculate in sufficient quantities to pose a significant risk of pregnancy."

Where as, this ("Coitus Interruptus") wikipedia article seems to imply contrary information. This article states:

"It has been suggested that the pre-ejaculate ("Cowper's fluid"), fluid emitted by the penis prior to ejaculation, contains spermatozoa (sperm cells), and is easily drawn into the vagina by capillary action. However, several small studies 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 failure is the pre-ejaculate fluid picking up sperm from a previous ejaculation."

In my opinion, this wording definitely has a bias towards the opinion that pre-ejaculate does not contain viable sperm (rather than a more neutral wording such as, "there are two different opinions on this matter, opinion 1 is: sperm present and opinion 2 is: sperm is not present.") Perhaps the bias is justified, considering we only have links to reports about two studies which have tested pre-ejacuate, and neither of these studies have found any viable sperm present. But on the other hand, we only have knowledge of two studies (i.e. not a large number of studies), and both were relatively small studies.

My questions:

Q1. Do other people agree that this wording has a bias towards the opinion that pre-ejaculate does not contain viable sperm?

Q2. Do people think that the two small studies are enough to warrent giving a strong impression (within this article) that pre-ejaculate does not contain viable sperm?

Q3. Can anyone offer any references to information about studies that have been done which have found viable sperm in pre-ejaculate? (If so, I think it's important to make reference to this information.)

If there is no indication that there has been studies that have found viable sperm in pre-ejaculate, then I guess there is good reason to place emphasis on the two studies that this article gives reference to; that is, if the two small studies are the only studies that appear to have been done to test for the presence of viable sperm in pre-ejaculate, then what the studies have to say is pretty significant in comparison to widely made assumptions(?) that pre-ejaculate DOES contain viable sperm.

If this article is going to give the information that has a bias towards the opinion that there is no viable sperm in pre-ejaculate (rather than the information that there is currently debate around whether viable sperm is present), I just want to be sure that this information is accurate. The main reason I query this point is that it seems to be very commonly accepted (and stated on various webpages [8] [9] [10]) that pre-ejaculate can contain viable sperm (though, as I've already expressed, whether or not this commonly held view is based on real evidence is another question). I guess it's possible that these websites are just giving a "simple answer" by saying that pre-ejaculate can contain viable sperm, when really what they might mean is that pre-ejaculate could push viable sperm that was sitting in the urethra from that man's last ejaculation, into the vagina. --A vivid dreamer 11:13, 11 May 2006 (UTC)

This webpage [11] says that three small studies have been done (none finding sperm in pre-ejaculate), it provides hard copy references, however it doesn't give links to internet references. Does anyone have access to these hard copy references? --A vivid dreamer 11:13, 11 May 2006 (UTC)

The hypothesis that pre-ejaculate does not contain sperm is backed up by modern research (albeit very small studies). The hypothesis that pre-ejaculate does contain sperm is, as far as I am aware, speculation that gained credibility through repetition rather than actual evidence. I agree that any studies which found viable sperm in pre-e would be very important to how this article should be worded. I am unaware of any such studies at this time.

I believe all three studies are referenced in this article (the Contraceptive Technology Update link summarizes the first two studies, and the Zuckerman link is the third one).Lyrl 12:07, 13 May 2006 (UTC)

Regarding Q3, I have found this study ( http://www.ncbi.nlm.nih.gov/pubmed/21155689 ) which states there was sperm in some of the subjects. It definitely should be added to this article. TheMeanGreenMachine (talk) 18:17, 26 September 2013 (UTC)

References

subjective...

Someone who reads the article will get the next idea: "It is usable, free and if I orinate first there's no problem"...

I think it's obvious that Coitus interruptus isn't an anticonception method...

To add more it isn't placeful for both members of the couple.

Proposed Infobox for individual birth control method articles

Let's all work on reaching a consensus for a new infobox to be placed on each individual birth control method's article. I've created one to start with on the Wikipedia Proposed Infoboxes page, so go check it out and get involved in the process. MamaGeek (Talk/Contrib) 12:12, 14 June 2006 (UTC)

Pearl Index und NPOV

Coitus interrupus has a pearl index of at least 10 (variing from 10 to 38 depending on sources), while the pill has one of at the most 0.9 (variing from 0.1 to 0.9). This index is based on statistics of actual couples trying to use that method, not some dream numbers that are divided in people doing it "right" and people doing it "wrong". In the pearl index any sort of usage error is counted it. This shows that either coitus interruptus just is not safe or that it is a lot harder to get right than taking the pill. You can make up any sort of numbers if you just say that people who get pregnant were not paying attention. Fact is that anywhere outside of religious organisations people are told that the coitus interruptus is far too risky to be the only method of contraception. Fact is also that using the pill is not that hard. Even a fourteen year old can reliably take a pill at a certain time of the day. This is not the case with coitus interruptus, which requires one of the couple to take action while they are really busy. This page may lead people to believe that this is a safe method of contraception and I do not see a single generally accepted source to back that up. The pearl index on the other hand is well reputed, if the statistic includes enough couples - which today mostly is the case. I believe this article is in need of an expert. --84.178.94.50 18:54, 17 June 2006 (UTC)

I don't know where you got your numbers on the pill, but the reference provided in this article (information linked online via Planned Parenthood) shows a Pearl Index of 8 for the pill. I believe that number is for POPs rather than the combined pill, but at least one study (described here) found a Pearl Index of 10.5 for the combined pill. The Pearl Index is hugely influenced by the population being studied.

The typical failure rate (Pearl Index of 27) and method failure rate (Pearl Index of 4) cited in this article are both also from Contraceptive Technology, a highly respected medical source.

On the Pearl Index being well reputed: Life cycle tables are much more accurate than the Pearl Index. The Pearl Index has a number of drawbacks that make comparisons of numbers from different studies inaccurate. Most researchers don't have the motivation to gather data for life cycle tables, though, so we're stuck with Pearl Index numbers for most contraceptive methods.

I am unaware of any religious organization that promotes coitus interruptus. The Catholic Church considers it a form of masturbation and a sin.

And finally, on the pill being "not that hard." I was on the pill for five months when I was 19. I forgot at least one pill every week. The method was unreliable for me, and I am not alone in that. Lyrl 19:29, 17 June 2006 (UTC)

History section

Why are we bothering to mention the reference without explaining the entire story of Onan (you know, all that stuff about god punishing him for spilling his seed, etc.)? As it is, the mention is confusing. Kasreyn 05:32, 18 June 2006 (UTC)

Nobody's gotten around to adding it? Be bold and expand the story yourself. Lyrl 14:10, 18 June 2006 (UTC)

That's the thing... I don't really feel we should even be referencing the story of Onan. I would prefer it be removed. Kasreyn 09:09, 29 June 2006 (UTC)

It's the most famous reference to the method. Why do you feel it's off-topic to this article? Lyrl 23:14, 29 June 2006 (UTC)

Not really off topic, but what is it doing in the history section? The Bible isn't historically accurate. No one knows for sure if Onan really lived or if that event really occurred. We could put it in a section on "religious perspectives on coitus interruptus", which could be filed under the "popular opinion" section, but I'm not sure how notable it is. Do many people even really believe in the story any more, ie., avoid the method specifically because of the story? Is it still a living religious tradition, or is it mostly-forgotten baggage? I don't know. Kasreyn 23:26, 29 June 2006 (UTC)

The Bible is not historically accurate, but the text is very old. Description of withdrawal in the Bible is proof, not that Onan actually existed, but that people practiced withdrawal two thousand years ago (as claimed in the intro paragraph). The idea of talking about religious perspectives is intersting, though. Lyrl 02:22, 8 July 2006 (UTC)

Infobox benefits

The infobox currently says withdrawal is acceptable under some religious doctrines. I'm not aware of any religion that promotes withdrawal as birth control; the Catholic Church considers it a form of masturbation and a sin. Is there some religion that accepts withdrawal but limits other forms of birth control?

If not, what should go in the infobox instead? Lyrl 22:38, 21 June 2006 (UTC)

Typical effectiveness - which number to use?

The text currently cites 27% as a typical failure rate (with source). The infobox has 19% as a typical failure rate (no source listed in the infobox, but the editor listed it in the edit history). Shouldn't the article consistently use one number or the other?

I've seen another study that found a 14% failure rate. These are all from studies of different populations, which can be expected to give different failure rates. I do not have access to details of any of the studies, however, and so have no basis to judge which one is the most applicable to the general population.

Any thoughts on which number would be better to use? Or should we do something like "studies have found actual failure rates from 19-27%"? Lyrl 22:24, 10 July 2006 (UTC)

I like your last idea. Until and unless we determine that one or more of the studies/sources are untrustworthy, let's represent the entire range of cited figures. Kasreyn 04:22, 11 July 2006 (UTC)

advantages: objections

Not all people who have "objections to birth control" can use this method. If one has an objection to birth control on the grounds that sex is solely for (attempted) reproduction, then this method would not satisfy his or her criteria.

"poor choice"

i rephrased that sentence/took those words out because (even if it's a quote) it's a value judgement. we do not see in any other birth control article that any form of bc is a "poor choice." (although, for any and all of them we could cite someone who says a method is a poor choice or a good choice...) Cindery 16:10, 6 September 2006 (UTC)

false

This article is a farce. —The preceding unsigned comment was added by Pagrimm (talk • contribs) 08:51 18 September 2006 (UTC)

A little more specific? Luna Santin 08:54, 18 September 2006 (UTC)

"pregnancy rate" rather than "failure rate"

Note discussion at Talk:Birth control#"pregnancy rate" rather than "failure rate" re replacing occurrences of "failure rate" with "pregnancy rate". I would also like to see the same change on this page. Please make any comments there. --Coppertwig 04:02, 8 January 2007 (UTC)

"Dependent upon self-control of man."

That and the lone paragraph here. "The method may be difficult for some men to use. The interruption of intercourse may leave the affected parties dissatisfied, as some males have stated that the act is analogous to walking out of a theater just before the end of a climactic movie."

I definitely feel we need to say it also depends on the self control of the woman. If a woman is on top, it's up to her to interrupt the intercourse and pull out, and even during other forms of sex a woman might wrap arms and legs around a partner sufficiently strong to prevent coitus interruptus. Therefore, I feel this should be included. Jaimeastorga2000 10:41, 6 March 2007 (UTC)

I see your point. However, it seems likely that male self-control is significantly more of a factor, and I'm hesitant to make changes that would draw importance away from that aspect. While on the male end there is the risk of accidental failures, the situations where the female causes failure (not interrupting when instructed to, physically preventing interruption) seem more like intentional sabotage. As a positive thinking person, I believe that accidents are much more common that sabotage. I Googled a little bit to see if anyone has written anything relevant to this topic, and did find a 1976 paper that found no sperm in pre-e (I had previously thought that was first discovered in 1993!), but no luck on the male/female aspect of failure responsibility. Lyrl ^Talk _C 02:32, 7 March 2007 (UTC)

Though I too, have been unable to find a source for this through googling, I just wanted to refute the idea that a female causing failure is any more sabotaging than a man (I too, believe accidents are much more common than sabotage and people often do things with good intentions). If a man doesn't withdraw, he must either have felt so much pleasure he was unable to pull out, or he orgasmed too fast without even noticing. If a woman, riding a man, doesn't stand up as soon as instructed to, she might too be feeling too much pleasure to comply immediately and unintentionally cause ejaculation in her vagina. Also, if practicing sex in a position in which she has arms or legs hugged around the man, then too, she might feel so good with his body pressed against hers and with him inside her that she might be unable to stop hugging and cause an unwanted ejaculation. In the case of either gender's cooperation, to stop ejaculation requires a physical act (pulling out, standing up, letting go) and they might, without enough self-control, be unable to do that. I do not see how it is more malicious for one to do so than the other. Jaimeastorga2000 13:00, 10 March 2007 (UTC)

Good points. We could just change "men" to "couples". I'm not entirely happy with it, as it seems to divide the responsibility equally - while I think the man's role in using this method is significantly larger than the woman's. But I can't currently think of anything else, and that would work. Lyrl ^Talk _C 15:28, 10 March 2007 (UTC)

Sowwie, I kinda forgot about this what with school and all. ^_^; That being said, we could change "men" to "couples" and add between parenthesis "(specially of men)," though then it's me who is not entirely happy... what do you think? Jaimeastorga2000 13:12, 7 April 2007 (UTC)

The parenthetical may make the sentences too awkward. How about just removing the phrase "of man" in the infobox (shortening that phrase), and changing it to "couples" in the text? Lyrl ^Talk _C 21:20, 7 April 2007 (UTC)

Sounds good to me. Will you do the honors, or shall I? Jaimeastorga2000 20:26, 8 April 2007 (UTC)

Go ahead :) Lyrl ^Talk _C 23:02, 8 April 2007 (UTC)

All done. ^.^ Jaimeastorga2000 00:34, 9 April 2007 (UTC)

"Messy?"

Where exactly does the man ejaculate after penis removal? Shouldn't this be mentioned? 85.75.26.1 18:41, 19 April 2007 (UTC)

It can vary widely. I do not believe the choice of towel, breasts, fellatio, etc. would add encyclopedicly to this article. Lyrl ^Talk _C 23:16, 19 April 2007 (UTC)

Cheers for the swift answer. However, again I believe the article ends in a "you know what happens next..." kind of way. Some people might not know what happens next. Moreover, there are a lot of things in Wikipedia which would never be part of an encyclopedia, like TV shows, website info, etc. In my opinion Wikipedia is an Omnipedia, but this page is not appropriate for such discussions. Again, thanks for the answer 85.75.26.1 12:47, 20 April 2007 (UTC)

Benifit???

Can anyone correct the spelling mistake on the right-side box of the article. It should read "benefits" not "benifits". Thanks. Lixy 15:10, 3 May 2007 (UTC)

Good

It's a great article.

Introductory paragraph

This edit was recently made to the opening paragraph, with the edit summary, "attempting for a more natural flow in the sentence". The edit added four words and two commas to the first sentence in the article. I feel that the addition of commas, especially, makes the sentence more difficult to read and understand. On "natural flow" grounds, I believe the previous version was superior.

This edit also changed "extraction of the penis" to "disengagement of the genitals" in the article's second sentence. This sentence refers to ejaculation by the owner of the penis, and I feel referring to the penis in the sentence (rather than the generic "genitals") makes this more clear.

Others' thoughts? Lyrl^Talk _C 00:23, 25 June 2008 (UTC)

Calling the method ineffective in intro?

This article currently has an "efficacy" section, where statistics are given on failure rates, reasons for failure are discussed, and it is also mentioned that some view the method as ineffective.

A recent edit added the bit about some viewing the method as ineffective to the introductory paragraph. Without any statistics or reasons for failure as context, I believe this presents a biased view of withdrawal as a method. I would like to either add a balancing comment (perhaps, "while the failure rate of withdrawal is comparable to some barrier methods such as the diaphragm, some medical professionals view it as an ineffective method of birth control"), or remove that bit from the introduction altogether.

What do others think? Lyrl^Talk _C 11:23, 28 June 2009 (UTC)

Catholic Church teaching

As someone has already noted above, the Catholic Church has consistently opposed the practice of coitus interruptus, and this was the case long before condoms became popular. In a sense, the Church thinks that condoms are just a sophisticated modern form of coitus interruptus. The religious issues surrounding this practice continue to be socially relevant, and so they arguably deserve to be included in the article. ADM (talk) 17:59, 23 July 2009 (UTC)

I'm not aware of any current notable issues involving the Catholic Church and withdrawal that would merit a separate section on the topic (a la the section on the RCC and the AIDS crisis in the condom article). The impact of the RCC's position on the prevalence of withdrawal should certainly be included in the "History" section of this article. Unfortunately, no one has yet written a history section. Do you know of any reference material that could be drawn upon to create a history section? Lyrl^Talk _C 20:57, 23 July 2009 (UTC)

Sentence didn't make sense

I edited this sentence because it didn't make sense:

"Perhaps the oldest documentation of that withdrawal was used to avoid pregnancy is the story of Onan in the Hebrew Bible."

The change I made was reverted.

The reason I changed this sentence was the words "of that" don't make sense the way they are used.

I suggest the sentence be changed either to:

"Perhaps the oldest documentation of withdrawal use to avoid pregnancy is the story of Onan in the Hebrew Bible."

OR

"Perhaps the oldest documentation of the use of withdrawal to avoid pregnancy is the story of Onan in the Hebrew Bible." —Preceding unsigned comment added by 121.213.206.215 (talk) 08:17, 31 August 2009 (UTC)

hey

what is the cordova gladwin incident, i've never heard of such a thing 04:31, 16 April 2010 (UTC)~ —Preceding unsigned comment added by 141.139.51.185 (talk)

Other effects of "The Pill"

The Pill has also been claimed responsible for an increase in acne in pill users; "Women who do take the birth control pill and who notice that their acne is getting worse should discuss the situation with their doctor. Different types of oral contraception have differing levels of hormones and one side effect of some contraception is an increase in acne. Switching to another brand may bring acne back under control." ref: http://pregnancyguide.theazonway.com/birth-control-pills-pregnancy-and-acne-a-complete-how-to-guide/ — Preceding unsigned comment added by 189.136.121.85 (talk) 21:40, 8 April 2012 (UTC)

The pill also decreases acne in some users. What does that have to do with improving this article about withdrawal? Zodon (talk) 02:29, 9 April 2012 (UTC)

Perfect Use Confusion

I don't understand why "perfect use" wouldn't be a zero percent failure. I've checked the cite and I see the numbers, but there is nothing there that states how or why anyone would get pregnant if the method was performed perfectly every time. I'm not trying to include original research here, but if I pull out each and every time I have sex, and make sure to urinate often between sex acts, then no one is getting pregnant. this article itself states pretty clearly that there is no evidence of sperm originating from pre-cum, and the article for cowper's gland says nothing about the glands even REMOTELY being capable of producing sperm.

If someone becomes pregnant while practicing coitus interruptus, then the method could not have been used "perfectly." that just seems like common sense to me. — Preceding unsigned comment added by Ztmike (talk • contribs) 00:49, 8 May 2012 (UTC)

Perfect use reflects what is actually found in studies where you have people use the method according to the instructions, and you see how often they get pregnant. It is a measurement of what really happens. Certainly one can come up with theories about how or why (and test those theories). But there are many things that happen that we do not fully know why.

In this case the reference given is an older edition of Contraceptive Technology. The latest (20th) edition notes that some studies found sperm in pre-ejaculate fluid, while some others did not. So the article could use some updating.

Also note that perfect use does not mean some magical realm where nobody makes mistakes. Zodon (talk) 05:37, 8 May 2012 (UTC)

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External links modified

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Coitus Interruptus in 'Animals'?

From a quick search, there seems to be no research done in this area. It is, however a logical question, as humans must have known of the consequences of conception for 200,000 years, as pure survival knowledge. It would be a highly interesting addition to this article if it could be found, I think.

Henrik Erlandsson 19:12, 3 April 2019 (UTC) — Preceding unsigned comment added by HenrikErlandsson (talk • contribs)