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Spermicide
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
Spermicide

Spermicide

A chemical gel, foam, or film inserted into the vagina before sex to disable sperm, available over the counter.

Withdrawal

Withdrawal

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

Efficacy79% typical use

Least effective: under 90 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$1–$3 /per unit

Insurance: Varies

$0

Insurance: Varies

DurationSingle use (effective for 1 hour; duration varies by formulation, check product label)Per act
ReversibilityReversibleReversible
STI ProtectionNoNo
How it works

A chemical (usually nonoxynol-9) immobilizes or kills sperm on contact. Inserted into the vagina before sex.

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.

PrescriptionOTC Over-the-counterOTC No prescription / OTC
Available Products2 productsNo branded products yet
Side effects
  • Vaginal or penile irritation
  • Increased risk of UTI
  • Allergic reaction (rare)
None reported
Who shouldn't use this
  • Sensitivity to nonoxynol-9
  • Active vaginal irritation or infection
  • High risk of HIV exposure (frequent use may increase transmission risk)
  • Partner unable to withdraw consistently before ejaculation
  • Need for highly effective contraception