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Pill
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
Pill

Pill

No non-hormonal birth control pill is FDA-approved in the US. Ormeloxifene (centchroman) is approved and used in India.

Withdrawal

Withdrawal

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

EfficacyLimited evidence see details

Limited evidence: no verifiable efficacy data available.

80% typical use

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

CostContact provider

Insurance: Varies

$0

Insurance: Varies

DurationWeekly pill (ongoing)Per act
ReversibilityReversibleReversible
STI ProtectionNoNo
How it works

Ormeloxifene (centchroman) is a selective estrogen receptor modulator (SERM) that prevents pregnancy by inhibiting implantation of a fertilized egg in the endometrium. It does not suppress ovulation and does not contain estrogen or progestin. It is not FDA-approved in the US.

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 Products1 productNo branded products yet
Side effects
  • Menstrual irregularities (delayed or altered periods; common, about 8-12% of users)
  • Headache
  • Nausea
  • Abdominal discomfort
  • Breast tenderness
None reported
Who shouldn't use this
  • Polycystic ovarian disease (PCOS)
  • Recent history of jaundice or hepatic impairment
  • Renal impairment
  • Cervical hyperplasia or chronic cervicitis
  • Pregnancy
  • Hypersensitivity to ormeloxifene
  • Partner unable to withdraw consistently before ejaculation
  • Need for highly effective contraception