For many years withdrawal of the penis from the vagina just before ejaculation has been used to avoid pregnancy. In several investigations, made in the days before the pill became available, it was found to be the most usual method adopted. It relies, of course, on the ability of the man to recognize the sensations which occur in his genitals just before ejaculation, and for him rapidly to withdraw his penis from the vagina and ejaculate outside. This requires great self-control, as the man will often want to keep his penis in the woman’s vagina for as long as possible to obtain the greatest amount of pleasure. As the first spurt of semen, which contains the most spermatozoa, may either be ejaculated during withdrawal or may spurt into the vaginal entrance, the risk of pregnancy, is high, and the pregnancy index is 35 per 100 woman-years.
Coitus interruptus has been said to lead to pelvic discomfort in the woman, who is stimulated but not relieved, and in the man, who has to withdraw at a moment when he would penetrate more deeply. Over long periods it was said to cause mental disorders. There is no evidence that coitus interruptus leads to either of these diseases, or indeed to any disease at all, but it is not a very satisfying method for men or women. If a couple have used coitus interruptus successfully for years and it suits their particular sexual needs, there is no reason for them to change, but they should remember that the method is not very efficient, because spermatozoa are often found in the secretions which seep out of the penis before ejaculation occurs.
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