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Comment by loeg | Hacker News Reader

> clinical trials measured rates as high as 90-99%.

This is in the same range as, like, pulling out, for what it's worth.

I have always been amazed at how effective the pull out method was. I had sex for years with my wife and always pulled out. 2x a week for probably 10 years. After we decided to have a kid, she was pregnant in a month.

Really incredible how effective such a simple solution is

I haven’t pulled out in 25 years. What’s the point in sex if you can’t keep going to completion?

Completion can mean many different things for different people.

What's the point? Well, the other 99% of the experience and all its pleasure, intimacy and sensation adds up to a lot more than those few seconds of ejaculation.

Not sure what you mean. It is to completion, you pull out right before completion and finish immediately outside. It’s all about timing.

Apologies for tmi

Yeah same experience as that, and being a bit more careful around fertile times of her cycle.

Was completely effective for us.

To be fair, I think most normal people in a relationship use this method, but if you tell people on the Internet about it, they get upset for some reason.

Most normal people? The implied judgement aside, that is wildly untrue. Most people (80+ % who are not trying for a child) use birth control, this is an easy stat to look up. Maybe people “get upset” because you’re making things up?

I'm not saying it's a very common method (maybe, maybe not), but cycle timing is often included in "birth control" stats and used as a secondary measure with other forms of birth control.

You can just look up these numbers, of various forms of birth control. That exclude cycle timing.

And none of them say it’s “most people”. Perhaps some unmeasured population uses it as a secondary method, that’s total speculation and kind of beside the point

Are we (or the grandparent) talking most people at one point in time, or most people at any time during their life? If it's the latter, then I do think it's a valid claim, but I haven't seen any stats that cover those sorts of numbers. Eg have more than 50% of people in a committed relationship never used the timing method? Most of the couples I am good friends with have used the cycle timing method when they want another kid, want to delay it, but are open to having one sooner. This is also commonly combined with secondary measures, such as condoms, pulling out, or even abstinence during the fertile window (why measure cycle timing if you're not changing your behavior, using another method, based on the observation).

The 80% using contraceptive methods stat includes pulling out as a contraceptive method.

no, this doesn’t seem to be the case. more than 80% of those avoiding pregnancy use condoms, pill, tied tubes, vasectomy, iud, etc… this 80% does not include withdrawal. [0]

5.8% rely on withdrawal.

[0] https://www.guttmacher.org/fact-sheet/contraceptive-method-u...

The 80% claim must include withdrawal, because their claim is that the population not using any method has only a 15% non-pregnancy rate within a year. But withdrawal has a much higher 80-96% rate of non-pregnancy within a year.

https://www.guttmacher.org/fact-sheet/contraceptive-use-unit...

> Sexually active couples who do not use any method of contraception have approximately an 85% chance of experiencing a pregnancy over the course of a year.

Therefore, withdrawal is a method of contraception.

the 80% does not include withdrawal. the numbers are here [0].

80+% rely on things like pill, condom, tied tubes, etc...:

23.9: tube ligation/implants

16.4: pill

13.2: condom

12.0: iud

8.50: vasectomy

2.6: implant

2.1: injectable

1.2: vaginal ring

.4: patch

80.3% rely on the contraceptions listed above.

The remaining rely on: withdrawal, emergency contraception, family planning, etc...:

5.8%: withdrawal

2.6%: family planning

0.2%: emergency contraception

0.2%: other

11%: no method

the 80% does not include withdrawal.

[0] https://www.guttmacher.org/fact-sheet/contraceptive-method-u...

To be fair, that isn’t correct at all.

i could be misinterpreting what you mean by “most normal people” but it’s a wildly strange use, most people who aren’t seeking pregnancy use some form of contraceptive [0], the pill, condoms, etc… it’s almost 90% of sexually active and its been this steady since 2002.

> … who were not seeking pregnancy, 88% were using a contraceptive method in 2016, and this proportion has remained steady since 2002.

it seems most normal people are using contraceptives.

> …they get upset for some reason

im sure very few people are “upset” about this. are you misinterpreting someone correcting your overestimations as if they’re being upset?

[0] https://www.guttmacher.org/fact-sheet/contraceptive-use-unit...

Pulling out counts as a contraceptive method for that stat.

oh, indeed, thanks. only like 5.8%. and only 2.6 rely on family planning. more than 80% are using pills, condoms, iud, vasectomy, etc.

again, “most normal people” are not relying on pulling out. most people, by a significant amount, are relying on other methods.

Couples using this method tend to be mostly fine with any "failure". They might want a child but not now, or are not completely sure but would do their best if it happens.

Couples who clearly don't want children typically have already discussed their stance in the couple and will be way more thorough about birth control. That's typically not the demographic that will YOLO it, so I guess you'd get much more pushback on that front ?

I agree and want to add that the scenarios you point out could also be for a single couple at different points in time. Risk tolerance changes over time with different circumstances.

What? This is the definition of anecdotal evidence. It’s not very effective at all in practice, statistically.

> For every 100 people who use the pull out method perfectly, 4 will get pregnant.

> But pulling out can be difficult to do perfectly. So in real life, about 22 out of 100 people who use withdrawal get pregnant every year — that’s about 1 in 5.

https://www.plannedparenthood.org/learn/birth-control/withdr...

These are not hard stats to look up.

> For every 100 people who use the pull out method perfectly, 4 will get pregnant.

Are those 4-in-100 distributed randomly?

Did the pregnancies result despite 100% adherence to the method, or was there occasional failure to adhere?

There's a big difference between a method being ineffective from the perspective of a health care provider, and a method being ineffective in absolute terms.

A provider has to care about what broad cross sections of people will actually do, rather than what they say they will do.

If you're an individual person who knows they can adhere to the method perfectly, the fact people on average cannot or will not adhere perfectly has no particular relevance to you.

I have no horse in this race, but the same difference in the meaning of "efficacy" arises in all sorts of aspects of health care, like advice on diet and exercise, or the prescription of specific exercises for physical therapy.

I’m sure the majority of individuals practicing think they can be/are perfect adherents. Statistically they are wrong.

some are likely correct, however

The stats are not hard to look up, but they do seem somewhat hard to gather. The site you linked doesn't reference a study, but I imagine that asking a bunch of people if they pulled out "perfectly", even for quite stringent definitions of "perfectly" will result in quite a lot of variance.

I'm not trying to no-true-Scotsman birth control methods, just pointing out that it's hard to draw meaningful conclusions when all you have is people's word.

So, it can be very effective but a whole lot of people apply it terribly and stupidly.

Everyone assumes they’re the smart one applying it “right”. Statistically they’re not.

96% efficacy is pretty good; more or less on par with condoms.

The similarity is not the same.

If no semen is emitted, the chance of pregnancy is null (more about it in my other comments).

Plus 90–99% suppression of ejaculation has been recorded and suggested that it has a potentially high contraceptive efficacy, so that is way better than withdrawal.

Experiment, maybe it affects you in a way that you get 99%, which would make it a very efficient hormone-free male birth control pill.

Side-note: personally I prefer IUDs, and/or a medication that has been extensively studied, so this pill can wait.

The "as typically used" quoted figure for pulling out ("withdrawal") is 80% success, but the ideal use figure is 96-98%. If you know a little bit about yourself and also aren't going back to back without peeing, you can do a lot better than the 80% figure. (Also yeah, it's amusing that both of these figures are more or less identical to male condoms.)

(Meta-comment: probably best to keep everything in "success" percentage figures for direct comparison, instead of switching to failure percentages for some figures.)

I edited my comment.

Yea similar with tracking ovulation dates. Seems like pretty bad EV for messing with my nervous system.

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