Vasectomy
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
Vasectomy

Vasectomy

A permanent outpatient procedure that blocks the vas deferens so sperm cannot enter the semen.
Withdrawal

Withdrawal

The man withdraws his penis from the vagina before ejaculation to reduce the chance of sperm reaching the egg.
Efficacy99.85% 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–$3,500

Insurance: Usually

$0

Insurance: Varies

DurationPermanentPer act
ReversibilityPermanentReversible
STI ProtectionNoNo
How it works

A clinician cuts, seals, or blocks the vas deferens so sperm cannot mix with semen during ejaculation. The body absorbs the sperm, and the semen remains normal in appearance and volume.

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 Procedure (in-person)OTC No prescription / OTC
Available ProductsNo branded products yetNo branded products yet
Side effects
  • Mild pain or swelling for a few days
  • Bruising or bleeding at the site
  • Sperm granuloma (small lump, usually harmless)
  • Chronic post-vasectomy pain syndrome (rare, 1-2%)
None reported
Who shouldn't use this
  • Uncertainty about future fertility desires
  • Active local or systemic infection
  • Bleeding disorder
  • Partner unable to withdraw consistently before ejaculation
  • Need for highly effective contraception