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Recommendations for Contraceptive Use |
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Withdrawal (coitus interruptus) |
Classification of Selected Procedures
for Withdrawal (Coitus Interruptus)
| Procedure |
Class |
Rationale |
| Pelvic examination (speculum and
bimanual) |
C |
A physical exam is not required
for the use of withdrawal. A pelvic exam is not required for the man's partner1. |
| Blood pressure |
C |
Blood pressure screening is not
required for use of withdrawal1. |
| Breast examination |
C |
A breast exam is not required
for the use of withdrawal1. |
| Sexually transmitted disease
(STD) screening by lab tests (for asymptomatic persons) |
C |
Clients at risk for STDs (by
personal history or socio-demographic risk factors) should be offered STD screening, where
possible. |
| Cervical cancer screening |
C |
Cervical cancer screening is not
needed for the safe use of withdrawal 1. |
| Proper infection prevention
procedures |
C |
Proper infection prevention
procedures are not applicable to withdrawal. |
Specific counseling points for
withdrawal (coitus interruptus):
- efficacy
- STD protection (when/as appropriate)
- requires high motivation and self-control
|
A |
- Accurate client education is essential for effective use of
withdrawal (coitus interruptus).
- Many FP programs do not teach withdrawal. Couples choosing
withdrawal should be offered information on how to use the method effectively.
- Appropriate counseling at the time of method selection can
lead to improved client satisfaction and continuation.
- Withdrawal can be used if the man can predict when he is
going to ejaculate and is able to ensure that his ejaculate does not come in contact with
his partner's genitalia.
- Withdrawal may be less acceptable if the man is prone to
pre-mature ejaculation.
- Clients should be informed about the risks of contracting
and transmitting STDs.
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KEY:
Class A = essential and mandatory or otherwise
important in all circumstances, for safe and effective use of the contraceptive method
Class B = medically/epidemiologically rational in
some circumstances to optimize the safe and effective use of the contraceptive method, but
may not be appropriate for all clients in all settings
Class C = may be appropriate for good preventive
health care, but not materially related to safe and effective use of the contraceptive
method
Class D = not materially related to either good
routine preventive health care or to the safe and effective use of the contraceptive
method
Citations for Procedures Table:
- World Health Organization. Improving
access to quality care in family planning: medical eligibility criteria for contraceptive
use. Geneva: WHO, 1996.
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