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Coitus interruptus, also known as withdrawal, pulling out or the pull-out method, is an act of birth control during penetrative sexual intercourse, whereby the penis is withdrawn from a vagina prior to ejaculation so that the ejaculate may be directed away in an effort to avoid insemination.
Withdrawal method, pulling out: 20 (1 in 5) [45] 4 (1 in 25) Behavioral: Withdrawal: Every act of intercourse: Symptoms-based fertility awareness ex. symptothermal and calendar-based methods [38] [note 6] [note 7] TwoDay method, Billings ovulation method, Creighton Model: 24 (1 in 4) 0.40–4 (1 in 25–250) Behavioral
The withdrawal method (also known as coitus interruptus) is the practice of ending intercourse ("pulling out") before ejaculation. [97] The main risk of the withdrawal method is that the man may not perform the maneuver correctly or in a timely manner. [97] First-year failure rates vary from 4% with perfect usage to 22% with typical usage. [24]
The withdrawal method, also known as coitus interruptus or pulling out, is a behavior that involves halting penile-vaginal intercourse to remove the penis out and away from the vagina prior to ejaculation. [51] [52] Withdrawal is considered a less-effective contraceptive method, with typical-use failure rates around 20%.
Post-ovulation methods (i.e., abstaining from intercourse from menstruation until after ovulation) have a method failure rate of 1% per year. The symptothermal method has a method failure rate of 2% per year. Cervical mucus–only methods have a method failure rate of 3% per year. Calendar rhythm has a method failure rate of 9% per year.
When a woman takes COCP, the hormones in the pills prevent both ovulation and shedding of the endometrium (menstruation). Traditionally, COCPs are packaged with 21 active (hormone-containing) pills and 7 placebo pills. During the week of placebo pills, withdrawal bleeding occurs and simulates an average 28-day menstrual cycle.
It is believed that combined hormonal contraceptives work primarily by preventing ovulation and thickening cervical mucus. Progestogen-only contraceptives can also prevent ovulation, but rely more significantly on the thickening of cervical mucus. Ormeloxifene does not affect ovulation, and its mechanism of action is not well understood.
It is thus a progesterone withdrawal bleed. As there is no progesterone in the anovulatory cycle, bleeding is caused by the inability of estrogen—which needs to be present to stimulate the endometrium in the first place—to support a growing endometrium. Anovulatory bleeding is hence termed 'estrogen breakthrough bleeding'.
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