Skip to main content

Female Sterilization
vs
Withdrawal

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

Side-by-side comparison

Method
Female Sterilization

Female Sterilization

A permanent surgical procedure that blocks or removes the fallopian tubes to prevent pregnancy.

Withdrawal

Withdrawal

The man withdraws his penis from the vagina before ejaculation to reduce the chance of sperm reaching the egg.

Efficacy99.5% typical use

Most effective: over 99 out of 100 people successfully prevent pregnancy per year.

80% typical use

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

Cost$0–$6,000

Insurance: Usually

$0

Insurance: Varies

DurationPermanentPer act
ReversibilityPermanentReversible
STI ProtectionNoNo
How it works

Surgical disruption (clipping, banding, cauterization, or complete removal) of the fallopian tubes prevents eggs from reaching the uterus and sperm from reaching the egg.

The man withdraws his penis from the vagina before ejaculation to keep semen out of the vagina. Pre-ejaculate may contain some sperm, which is why perfect use is not 100%. A 2024 pilot study found sperm in about 13% of pre-ejaculate samples, though roughly 75% of participants had no sperm in any sample.

PrescriptionRequired Prescription requiredOTC No prescription / OTC
Available Products2 productsNo branded products yet
Side effects
  • Surgical risks (bleeding, infection, organ damage)
  • Anesthesia side effects
  • Ectopic pregnancy (small but serious risk if failure occurs)
None reported
Who shouldn't use this
  • Medical instability for general anesthesia or laparoscopy
  • Uncertainty about future fertility desires
  • Partner unable to withdraw consistently before ejaculation
  • Need for highly effective contraception