Pull-out method – reliable or not?

Pull-out method – reliable or not?

Dubravko Lepušić

Dubravko Lepušić

prof., PhD

I have regular intercourses with my girlfriend, but not very often, approximately once in 7 days, but we make the most of that day (multiple intercourses in one day). Lately, we have stopped using condoms as a contraceptive, and for contraception purposes, we use the pull-out method. Even doctors themselves have contradictory opinions about this type of contraception, let alone various “scientific” research that we can read on the Internet. Some claim that this method is almost as reliable as a condom, it is just a matter of self-control, because the fluid that comes out during intercourse does not contain spermatozoa, others claim that sperm from the previous intercourse can remain in the “channels”, which can fertilize the egg cell. I am interested in the expert opinion on how reliable is this method of contraception, if risk of sexually transmitted diseases and self-control are taken out of the equation? Namely, we have recently started practicing intercourse and now we are trying to inform ourselves as much and as well as possible. 

Thank you in advance.

The pull-out method is certainly an unsafe method of contraception and is certainly a worse choice than using a condom, for example.

There are two reasons for that: firstly, since it is a purely subjective method, it depends on whether you will manage not to ejaculate or not. Sometimes you will succeed and sometimes you will not (you will “go” a bit too far) and secondly: it does not protect against sexually transmitted diseases like a condom. In addition, as you state, during repeated sexual intercourse, there is a possibility that the remaining ejaculate in the urethra enters the vagina during this repeated sexual intercourse.

Therefore, my recommendation is to use condoms as protection against unwanted pregnancy as well as protection against sexually transmitted diseases. If you still more prefer the pull-out method (expert term is coitus interruptus), then you must know that there is a possibility of sexually transmitted diseases and that this is a method that should definitely be combined with avoiding the so-called risky days (ovulation days or the so-called fertile days, which is the middle part of a menstrual cycle). In this second case (avoiding fertile days); the assumption is that your girlfriend has mostly regular cycles because otherwise it is difficult to calculate when her fertile days are.

I took a morning-after pill, but my period is late

I took a morning-after pill, but my period is late

Nives Šikanić Dugić

Nives Šikanić Dugić

primarius, MD, spec. gynaecologist, MSc

Dear doctor, the first day of the last menstruation was on April 12th. I had intercourse on April 27th. A condom slipped during intercourse and my partner is not sure if some of his sperm ended up in me. I took ellaOne pill 15 hours after that happened because I did not want to risk anything. I should have gotten my period 3 or 4 days ago, but it is late. What should I do? I ask for your opinion. Is it possible that I am pregnant and that the pill did not work? I vomited twice one day last week. In addition, my stomach is hard. I have some weird feeling as if I am about to get my period, but nothing is happening for 4 days now. Is there a possibility I am pregnant?

After taking ellaOne, as an emergency contraceptive, menstruation can occur normally, but also a few days earlier, as well as be delayed up to 8 days. If it is more than 8 days late, it is necessary to take a pregnancy test or contact your gynaecologist. EllaOne pill is a very effective emergency contraceptive, but its effectiveness is not 100%. You did everything well, and as only 4 days have passed, I advise you to wait a few more days and if menstruation does not come, follow the instructions above.

Advice regarding birth control pills

Advice regarding birth control pills

Nives Šikanić Dugić

Nives Šikanić Dugić

primarius, MD, spec. gynaecologist, MSc

I am 17 years old and have a boyfriend with whom I had intercourse. Last month my period was late, I was very scared and I thought I was pregnant. In the end, I was not pregnant, but I became very afraid of getting pregnant. Can I use birth control pills? Do I really have to go to the doctor for pills or are there some I can buy myself. I have heard that pills can make you fat, and I would not want that. Are there some pills that do not make you fat? What would you recommend to me? Thank you very much.

In adolescence, it is necessary to use the safest methods of protection against pregnancy, and that is hormonal contraception. With such safe protection, you will no longer be afraid of a possible pregnancy. Since you have already had sexual intercourse, you need to contact a gynaecologist for an examination that begins during the first year after becoming sexually active. The gynaecological examination is painless, a swab is taken from the cervix (the PAP test), and you will also receive a recommendation for taking laboratory testing. After that, the gynaecologist will give you detailed instructions on which type of contraceptive pills you will use, and he / she will make appointments for your later regular check-ups. Modern birth control pills have a low content of hormones, they do not make you fat, and the gynaecologist will explain all this in detail.

Our condom broke!

Our condom broke!

Nives Šikanić Dugić

Nives Šikanić Dugić

primarius, MD, spec. gynaecologist, MSc

I had intercourse with a boyfriend and since the condom broke, I took the morning-after pill. The next day I was supposed to get my period. However, 4 days have passed, and I still have not gotten it. Is it possible that I am pregnant? In addition, I used drops for a fungal infection, so is that perhaps a reason the pill did not work?

The day-after pill / post-coital contraception is used to prevent pregnancy at a time when conception is facilitated, which means at the time of ovulation. If the morning-after pill is taken before or later after ovulation, in this case the day before the expected period, it can disrupt the normal cycle, so the period can be both early and late. If your period is more than 8 – 10 days late, take a pregnancy test to rule out pregnancy. The method of emergency contraception is very effective, but we know that no contraception is one hundred percent safe.