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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.

Last verified October 11, 2026Updated October 11, 2026

Side-by-side comparison

Spermicide A chemical gel, foam, or film inserted into the vagina before sex to disable sperm, 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	Spermicide A chemical gel, foam, or film inserted into the vagina before sex to disable sperm, available over the counter.	Withdrawal The man withdraws his penis from the vagina before ejaculation to reduce the chance of sperm reaching the egg.
Efficacy	Spermicide 79% 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.
Cost	Spermicide $16–$18 per package Insurance: Varies	Withdrawal $0
Duration	Spermicide Single use, one dose before each act of sex (gel works for up to 1 hour; film goes in 15 minutes to 3 hours before sex)	Withdrawal Per act
Reversibility	Spermicide Reversible	Withdrawal Reversible
STI protection	Spermicide No	Withdrawal No
How it works	Spermicide A chemical (usually nonoxynol-9) immobilizes or kills sperm on contact. Inserted into the vagina before sex.	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.
Prescription	Spermicide Not required Over-the-Counter	Withdrawal Not required Self-Directed
Side effects	Spermicide Vaginal or penile irritation Increased risk of UTI Allergic reaction	Withdrawal None reported
Who shouldn't use this	Spermicide Sensitivity to nonoxynol-9 High risk of HIV exposure, or HIV in you or a partner (frequent use may increase transmission risk)	Withdrawal Partner unable to withdraw consistently before ejaculation Need for highly effective contraception

Key differences

With typical use, 21 in 100 people using Spermicide get pregnant in a year, vs 20 in 100 with Withdrawal (both least effective). How long it lasts: Spermicide, single use, one dose before each act of sex (gel works for up to 1 hour; film goes in 15 minutes to 3 hours before sex); Withdrawal, per act. Spermicide: costs $16–$18 per package. Withdrawal: costs $0.