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External Condom vs Withdrawal

A side-by-side comparison of two birth control methods — efficacy, cost, how they work, and who shouldn't use them.

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Side-by-side comparison

  • External Condom A barrier method worn over the penis that also lowers the risk of STIs, available over the counter.
  • Withdrawal The man withdraws his penis from the vagina before ejaculation to reduce the chance of sperm reaching the egg.
Method
External Condom A barrier method worn over the penis that also lowers the risk of STIs, available over the counter.
Withdrawal The man withdraws his penis from the vagina before ejaculation to reduce the chance of sperm reaching the egg.
EfficacyExternal Condom 87% typical use

Least effective: under 90 out of 100 people successfully prevent pregnancy per year.

Withdrawal 80% typical use

Least effective: under 90 out of 100 people successfully prevent pregnancy per year.

CostExternal Condom $0–$2 per unit Insurance: VariesWithdrawal $0
DurationExternal Condom Single useWithdrawal Per act
ReversibilityExternal Condom ReversibleWithdrawal Reversible
STI protectionExternal Condom YesWithdrawal No
How it worksExternal Condom

A sheath worn over the penis that keeps sperm from entering a partner's body. Latex and plastic condoms also block contact with semen and vaginal fluids that can carry STIs.

Withdrawal

The man withdraws his penis from the vagina before ejaculation to keep semen out of the vagina. Pre-ejaculate may contain some sperm. A 2024 pilot study found sperm in about 13% of pre-ejaculate samples, though roughly 75% of participants had no sperm in any sample.

PrescriptionExternal Condom Not required Over-the-CounterWithdrawal Not required Self-Directed
Side effectsExternal Condom
  • Allergic reaction to latex in people with a latex allergy
Withdrawal None reported
Who shouldn't use thisExternal Condom
  • Known allergy to latex (use polyisoprene or polyurethane instead)
Withdrawal
  • Partner unable to withdraw consistently before ejaculation
  • Need for highly effective contraception

Key differences

With typical use, 13 in 100 people using External Condom get pregnant in a year, vs 20 in 100 with Withdrawal (both least effective). How long it lasts: External Condom, single use; Withdrawal, per act. STI protection: only with External Condom. External Condom: costs $0–$2 per unit. Withdrawal: costs $0.