Myths Surrounding Pre-ejaculate and Pregnancy

Posted on by Paul Turek, MD
Fluid drops
A different, and mighty, drop of fluid (Courtesy: Alexander Gray, Unsplash)

Pulling out is a very commonly used contraceptive. Officially called coitus interruptus, this ancient method of birth control is also an inexpensive, organic, and hormone-free. Pulling out is defined as removing the erect penis from the vagina and vulva before ejaculation. Believe it or not, 60% of reproductive-aged women in the U.S. who have had intercourse have used withdrawal for contraception at some time. And, nearly 5% of women use pulling out as their primary method of birth control. Despite its worldwide popularity and ease of use, studies on the effectiveness of withdrawal for birth control are as scarce as puddles in the Gobi Desert.

Pre-Ejaculate: A Mighty Drop

Anatomically, up to half a teaspoon of pre-cum or pre-ejaculatory fluid is released from the male urethra during sexual arousal, prior to ejaculation. Its origin is thought to be from Cowper’s glands and the Glands of Littre, which open into the urethra along its length, or from the prostate. The fluid contains numerous enzymes needed to liquefy the semen after ejaculation and it lubricates the urethra before sperm-laden semen pours forth during ejaculation. The problem with pre-cum is that it can leak out of the penis right before ejaculation and just before withdrawal takes place. This leads to the million-dollar question of whether this little dollop of fluid can lead to pregnancies.

A Dab’ll Do You

Here are the myths surrounding this mysterious biological fluid and its associated tantric sexual behavior.

  • It contains sperm. From the few available studies on this body bouillon, the results are… mixed. The best study examined pre-cum from 27 volunteers who rubbed their pre-cum onto petri dishes before ejaculation. The fluid was then formally examined for sperm. It revealed that 40% of men had pre-cum containing sperm. The problem here is that men can’t really be taught how to judge and collect pre-ejaculate, so many may have failed to predict the moment and essentially collected the early ejaculate. Oh well, it is what it is.
  • Men cannot (always) control when it happens. Two skillsets are required to make pulling out an effective contraceptive: predicting the moment before ejaculation and pulling out in time. This takes self-awareness, body knowledge, self-control, and coordination, which are not typically present in the heat of the moment.
  • No STD protection. Chlamydia, gonorrhea, HIV, and the other 9 or so sexually transmitted diseases are free to pass between bodies with this form of contraception. No barriers here.
  • It can lead to pregnancy. It really boils down to this, doesn’t it? Even if you’ve mastered the technique, if there’s sperm in that fluid, then there’s a pregnancy risk for sure. In fact, pulling out has a Pearl Index (typical use failure rate leading to pregnancy) of 15-20% in real-world use, which is pretty similar to that of condoms (15%) and birth control pills (10%). When used perfectly though, pulling out fails in only 4% of cases, which puts it just behind condoms (2%) and well behind vasectomy (<0.1%).

Putting the sperm-in-pre-cum issue aside, coitus interruptus needs no tool that nature hasn’t already given us, except rigorous and unerring self-control. Come to think of it, who among us has rigorous, consistent, and unerring self-control? As Aldous Huxley once said: “Consistency is contrary to nature, contrary to life. The only completely consistent people are the dead.” Bear this is mind as you choose your contraceptive.