Healthy Living

Tuesday, December 15, 2009

Follow Up: Jumping Into Withdrawal Again

I recently wrote a post about withdrawal as a method of contraception. It's garnered a lot of comments (thanks to everyone who commented!), many of them in passionate disagreement with my post.  The negative comments centered on three areas:  1) Teens shouldn't be encouraged to use withdrawal, 2) withdrawal doesn't protect you against STDs, and 3) withdrawal doesn't work as a method of birth control.  Since the first post focused mainly on the method of withdrawal itself, I'd like to follow-up and talk about these areas in more detail.
  • Teens and birth control. I agree that many teenage boys may not have the self-awareness or self-control to be able to pull out before orgasm.  But there are some boys who can...and many men in their 30s who can't.  I don't make assessments of a guy's self-control solely based on his age.  And it's up to women to talk with their partner about pulling out, and decide whether or not the method would work for them, regardless of his age.
  • Only condoms protect you against STDs. No matter what your primary method of birth control is, the only way of preventing or reducing the chance of STDs during intercourse is to use condoms.  And this holds true even if you or your partner has been sterilized.
  • Withdrawal is not as effective as other methods of contraception. Totally true.  But effectiveness is not the only factor when a woman chooses a method of birth control--if it was, all women would be using the IUD!  So many other things also matter:
          COST.  Do you have insurance?  What methods does it cover?  What's your copay, and is it affordable?

          DOCTOR ACCESS.  Can you get back to your doctor when you need to for the next prescription or injection, or does work or child care make that difficult (or impossible)?

          PAST EXPERIENCE.  If you've had bad side effects with a method in the past, it may make you less likely to try it (or a similar method) again in the future.  And if you hear enough bad stories from friends or on the internet, it also may make you wary of trying something new.

          RELIGION.  Some women may only be able to use natural family planning (rhythm) or withdrawal, to stay true to their religious beliefs.

         PARTNER'S WISHES.  In many relationships, both members of the couple decide what form(s) of birth control to use.

          FREQUENCY OF SEX.  If you're having sex once a month or less, you may not want to use a daily/weekly/monthly method of birth control.

In my ideal world, all women would be using an IUD to protect against pregnancy, and condoms to prevent and reduce the risk of infection.  Of course, all women would also be in fantastic committed relationships as well (if that's what they want)!  And birth control would never fail...but fail sometimes it does.  As several commenters pointed out, the only two perfect methods of contraception are abstinence and hysterectomy.  But since these are not the best options for most of us, I want women to have the most information possible when making decisions about their contraception and their health.

What factors went into your decision to use your birth control method?

You can read more about contraception and sexual health at Gynotalk.

[photo credit: Getty Images]
 
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From the Community…

Comments 1-10 of 70
  • 's Avatar
    Posted by Tue Sep 8, 2009 9:10am PDT

    Ive used "the belly button method" for years, when in a steady relationship. As for new or casual relationships I would always choose a more reliable method of birth control, and protection from possible stds.

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  • Lizbeth's Avatar
    Posted by Lizbeth Tue Sep 8, 2009 9:42am PDT

    Dr. Kate, thanks for the follow up. I am a happily married (most of the time) woman who wishes to never have kids. I'm 31. Tell me more about IUD's. I have always been afraid of them, but my husband is more afraid of a vasectomey and we've been using condoms with spermacide faithfully for 11, blissfully child-free years. (we got married in our mid twenties, but have been together since I was 19)

    I'd just like to hear more about why you think IUD's are perfect for every woman. How about women with endometrial family histories?

    I'm still looking forward to getting 'fixed' :)

    Thanks again.

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  • realitygirl13's Avatar
    Posted by realitygirl13 Tue Sep 8, 2009 12:30pm PDT

    I am a 24 year old, married, career focused woman with plans for children in the near future. I went for the pill because I wanted something incredibly reliable, but that I could come off of for pregnacy without a huge gap in ovulation time. I recently came off the pill because my husband and I would like to try for a family in the next few months. However, I want to give my body time to normalize and "breath", if you will, before conceiving, so over the next few months we are giving the natural family planning method as well as the "withdraw" method a try. I am taking prenatal vitamins now, just incase, but hopefully these methods will prove preventative for a few months.

    I am reading a book called "Taking Control of your Fertility" in order to understand application of natural family planning better. It claims if done correctly, it is as effective as any other method, we'll see :)

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  • haley's Avatar
    Posted by haley Wed Sep 9, 2009 9:25am PDT

    definately look into a vasectomy Lizbeth. I think your husband will end up really enjoyinh the benefits after it is done, my husband got a vasectomy three years ago because we have no desire for kids and it's just so freeing never to have ot worry about anything except hte FUN parts of having sex.

    My husband says the worst part of the procedure was that they shaved off some of his down-there hair and it itched a lot growing back! Also made sure to baby him a lot a day or two afterwards, you know how men are.

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  • Lucy's Avatar
    Posted by Lucy Wed Sep 9, 2009 10:35am PDT

    Thanks, Dr. Kate. Really appreciate the open info.

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  • Lizbeth's Avatar
    Posted by Lizbeth Wed Sep 9, 2009 12:21pm PDT

    hahaha, thanks haleysname. It's so true. Well, in 30 days we'll have health insurance from my job, so I'll start campaining again :)

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  • ComedyFan's Avatar
    Posted by ComedyFan Wed Sep 9, 2009 2:41pm PDT

    Note to everyone: There is sperm in PRE-ejaculatory fluid. Meaning: it is absolutely possible to become pregnant before the man orgasms, and even possible to get pregnant by fooling around and no total insertion. That is why pulling out is Bull.

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  • jenny155's Avatar
    Posted by jenny155 Wed Sep 9, 2009 3:48pm PDT

    I liked the "belly button method" comment...everyone has their own version of withdrawal...my husband and I use the "towel method" and my sister uses the "sock method" or "baby wipes method" lol...I'm not encouraging this method for teenagers or unmarried people or saying it is a reliable method, but I'm just being my goofy self!

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  • Kimber's Avatar
    Posted by Kimber Wed Sep 9, 2009 7:19pm PDT

    Thank you for pointing out that there is sperm in pre-ejaculatory fluid, ComedyFan. I think that is a huge misconception that people have. Pulling out does not keep all the little swimmers at bay.

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  • Silence*Tells*All's Avatar
    Posted by Silence*Tells*All Wed Sep 9, 2009 7:19pm PDT

    ComedyFan: you need to read her 1st post.

    Dr. Kate: Thanks for this post!!! It was a great follow-up!!! In my last post I noted to other users that the withdrawl method was often used as a last resort and is indeed better than nothing at all. Everyone was so quick to attack and not read the KEY WORDS and FACTS. I liked how you noted the overall effectivness compared to other b.c. KEEP UP THE GOOD WORK!!!!

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