Medically reviewed by Mary Lucas, RN
Written by Our Editorial Team
Last updated 8/01/2020
A common question among sexually active people has to do with birth control and pulling out, so today, that’s what we’re talking about.
Pulling out (also known as the withdrawal method) and the birth control pill can both reduce your risk of becoming pregnant from sex. However, they’re two very different methods of birth control, each with their own advantages and disadvantages.
If you currently use the withdrawal method with your partner and are thinking of starting the birth control pill, you’ve probably wondered how birth control and pulling out compare in terms of effectiveness and safety.
Below, we’ve compared the pull out method and the birth control pill, covering everything from the advantages and disadvantages of each method to the potential side effects you could face depending on your choice of birth control.
Better known simply as “the pill,” the hormonal birth control pill protects you from pregnancy by increasing your levels of estrogen and/or progestin hormones.
There are two different types of birth control pill available today. The combined birth control pill uses a combination of estrogen and a progestin hormones to stop you from ovulating, making it almost impossible for your partner’s sperm to come into contact with an egg.
Combined birth control pills also affect your cervical mucus, creating a natural barrier inside your vagina that makes it harder for sperm to travel into your cervix and uterus.
The progestin-only birth control pill only contains one type of hormone. This type of birth control pill works by increasing the amount of progestin hormones in your body, thickening your cervical mucus and stopping your partner’s sperm from entering your cervix and uterus.
Unlike the combined pill, the progestin-only pill doesn’t always stop you from ovulating, although it can prevent some ovulation.
We’ve covered the main differences between these pills in more detail in our guide to combined and progestin-only birth control.
Used according to the instructions, the combined and progestin-only pills are both very effective at stopping you from becoming pregnant. If you take your pill at the same time every day without ever missing a dose, your birth control pills will be 99 percent effective at preventing pregnancy.
In “real life” conditions, meaning you occasionally take a pill late or forget to take a pill, the birth control pill will be 91 to 92 percent effective at stopping you from becoming pregnant.
The biggest advantage of the birth control pill is that it’s quick and easy to use. If you take your pill on time every day, you’ll be protected against pregnancy without having to worry about any other forms of contraception.
The pill is also fast-acting. Most combined birth control pills start working with seven days, while some birth control pills can start protecting you from pregnancy the day you start using them, if you’re on or recently finished your period.
It’s also easy to keep track of your birth control pill cycle. Almost all birth control pills come with a printed calendar, allowing you to monitor your cycle and easily take the right pill for each day of the month.
The pill also has benefits beyond its ability to stop you from becoming pregnant. Taking the pill can help to ease many of the negative symptoms of your period, such as cramps, discomfort, period pain and nausea.
Many women also experience a shorter, lighter and easier period after they start using the birth control pill.
If you use a combined birth control pill, you might also notice improvements in your acne. The hormones in combined birth control pills can make your skin less oily, helping to get rid of acne breakouts and prevent hormonal acne from affecting you.
Currently, the FDA has approved three combined birth control pills as treatments for hormonal acne. We’ve listed these medications and their skin-related benefits in our guide to birth control and acne.
Beyond its contraceptive and acne prevention benefits, the birth control pill also has a range of health benefits. The hormones in the birth control are linked to improvements in bone strength and a possible reduction in your risk of developing osteoporosis as you age.
The pill can also reduce your risk of developing endometrial and ovarian cancers, some vaginal infections and cysts in your ovaries and breasts.
The birth control pill has a few disadvantages, ranging from side effects to the inconvenience of having to take a pill daily.
From a side effect perspective, both combined and progestin-only birth control pills are safe and have only a few common side effects. The most common side effects from birth control are fluid retention, nausea, breast tenderness and spotting between periods.
We’ve explained these side effects in more detail in our guide to birth control side effects, with scientific data on how common each side effect is.
Although rare, birth control pills can also cause a slight increase in your risk of developing blod clots. This risk is highest if you’re aged above 35 and smoke cigarettes. We’ve explained these risks in more detail in our guide to birth control and smoking.
Another uncommon potential side effect of its ability to affect your sex drive. Our guide to birth control and your sex drive goes into more detail about how birth control pills could cause you to feel more or less interested in sexual activity.
There are also practical disadvantages of the pill. First, in order to stay protected, you’ll need to take the pill at the same time every day. This can be impractical for a variety of reasons—busy schedules, hectic lives, forgetfulness, etc. These things happen to the best of us.
The birth control pill also doesn’t protect you from STDs, meaning you’ll need to use a condom or other barrier-based form of birth control, or get STD tested with your partner if you’re worried about the risk of catching a sexually transmitted infection.
Pulling out stops you from becoming pregnant by preventing your partner’s semen from coming into contact with your vagina.
While it might seem unsophisticated, the pull out method is a surprisingly effective way to avoid pregnancy if done correctly. According to Planned Parenthood, when done correctly by you and your partner, the pull out method success rate is surprisingly high: 96 percent effective at preventing you from becoming pregnant.
The trick to a good pull out method success rate, however, is learning how to pull out correctly: For the pull out method to be as effective as possible, your partner will need to take their penis out from your vagina before they ejaculate. You’ll also need to make sure that no semen comes into contact with your vagina accidentally after your partner ejaculates.
But remember that thing we said about learning how to pull out correctly being the stick in the mud? Unfortunately, compared to the pill, condoms and other birth control options, the pull out method is easy to get wrong. In a “real life” setting, the pull out method success rate drops to only about 78 percent effective as a form of contraception. Woof.
The biggest advantage of pulling out is that it’s convenient. You don’t need any condoms, birth control pills or other items to practice the pull out method. Instead, your partner just needs to pull out before they ejaculate.
This means the pull out method is free, easy to practice and always an option, even if you don’t have any other forms of birth control available.
Since the pull out method doesn’t require any medication, it’s also completely free of negative side effects. Because you don’t need to wear a condom if you practice the pull out method, it can also make sex more pleasurable if you don’t like the feeling of a condom.
Finally, the pull out method is a great complement to other forms of birth control. If you use the pill, the ring, the patch, an IUD or condoms, telling your partner to practice the pull out method can further lower your risk of becoming pregnant.
The pull out method also has several disadvantages. The biggest of these is that it’s extremely easy to get wrong. If your partner fails to pull out in time and ejaculates inside your vagina, you have a significant risk of becoming pregnant.
This means it’s best to have emergency contraception available or at the ready if you use the pull out method as your primary method of birth control.
The pull out method also puts all control over preventing pregnancy in the hands of your sexual partner. This makes it especially important that you trust your partner to pull out in time, even in the heat of the moment.
Finally, the pull out method doesn’t protect you from any STDs. If you and your partner use the pull out method as your primary method of birth control, you’ll both need to get tested for STDs to make sure you’re not at risk or transmitting any sexually transmitted infections to each other.
From an effectiveness standpoint, the debate between birth control and pulling out is pretty clear cut. Taking the pill i far more effective than relying on the pull out method as your form of birth control.
Used perfectly, the pill is 99 percent effective at preventing pregnancy, whereas the pull out method is only 96 percent perfect. Under “real life” circumstances, the pill is even more effective than pulling out, with a 91 percent to 92 percent effectiveness rate compared to the 78 percent success rate from the pull out method.
Simply put, using the birth control pill is a significantly better method of birth control than relying on the pull out method.
However, the most effective way to stop yourself from becoming pregnant is to practice both the pull out method and use birth control. By taking the pill and asking your partner to pull out before ejaculating, you’ll reduce your risk of becoming pregnant to almost zero.
If you currently use the pull out method as your primary form of birth control, it’s worth looking into the benefits of the birth control pill.
Did you know that the birth control pill can prevent acne and improve your skin? Our guide to birth control and acne goes into more detail on how birth control can make your skin less oily and get rid of acne breakouts.
You can also learn more about the potential side effects of birth control in our guide to common and uncommon birth control side effects.
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