Coitus Interruptus

[MooseIBe]

Okay so I don't like being on the pill, makes me anxious and shit. Neither of us really like condoms, don't fancy the idea of an IUD being present all the time, am sure I would never be able to fit a cap right, etc etc etc. So, my bf and I tend to practice the withdrawal method now. Is this reliable? We were always taught in sex education classes, yawn, that it wasn't and that you'd inevitably wind up pregnant if you used this method. Is that really true tho? Seems to me that if you do it right, ie make sure you always DO pull out, then it's likely to be pretty reliable. What say you all?

[SharonDee]

So, my bf and I tend to practice the withdrawal method now. Is this reliable? We were always taught in sex education classes, yawn, that it wasn't and that you'd inevitably wind up pregnant if you used this method. Is that really true tho?No, this is not reliable. You have the pre-cum issue, which is what you were probably warned about in your sex ed classes.

Then there's the times when he'll get so hot and bothered that he might find himself unable to pull out in time. That happened to me once... and the result will be twenty years old in November. :D

At the time my contraceptive of choice had been the sponge. I heard they're making those again; if so, I highly recommend them. If I was fuckin' fertile men, that's what I'd prefer.

[Waluigi]

As the old saying goes . . . What do you call people who use the withdrawal method? Parents.

SharonDee covered the main two reasons why withdrawal doesn't work, i.e., secretions before the actual ejaculation, and ejaculation beginning before the penis is out of and away from the vagina.

I recommend you talk to your doctor about finding a different variety of birth control. Some of them have some nasty side effects in women, whereas others might be fairly mild. Yasmin is the one we use, and to basically no ill effect.

[MooseIBe]

I have a prescription for yasmin .. makes me anxious just like all the others. Also, I never remember to take it :D

I have heard that joke yeah - nearly posted it myself, in fact, to stop anyone else doing it :D - but am not sure that it's true. For one thing, if he DID - and it's never happened - forget to pull out, I could get the morning after pill. For another, some men 'leak' before ejaculation a great deal more than others; some frankly don't seem to at all (don't ask me how I know but trust me, I do :)).

[livius drusus]

One of my best friends from high school got pregnant the second time she had sex thanks to the withdrawal "method". It's not at all reliable, Moose. Sperm is microscopic. A man doesn't have to be drooling ropes of pre-cum in order to impregnate before actual ejaculation. A little dab will do ya, as the commercial says.

[MooseIBe]

*looks faintly worried by this*

[livius drusus]

Here's (http://www.plannedparenthood.org/pp2/portal/files/portal/medicalinfo/birthcontrol/pub-birth-control-03.xml#withdrawal) what Planned Parenthood says about it, Moosie.

Of every 100 women whose partners use withdrawal, 27 will become pregnant during the first year of typical use. Of every 100 women whose partners use withdrawal, four will become pregnant during the first year of perfect use.

Pre-ejaculate can contain enough sperm to cause pregnancy. Pregnancy is also possible if semen or pre-ejaculate is spilled on the vulva.

You might want to browse their whole BC section (http://www.plannedparenthood.org/pp2/portal/files/portal/medicalinfo/birthcontrol/pub-birth-control-01.xml) to see what works best for you.

[wei yau]

*looks faintly worried by this*

Hmmm, I can understand your worry. But, here's something on the bright side...I'm pretty sure this method is exactly how I came to be. And I'm a pretty good guy.

Seriously, the withdrawal method is very, very dangerous, for all the reasons already given in this thread.

[LiveToRide]

I guess I don't need to tell you how unreliable the withdrawal method is...My result from that method will be 16 in June.
As an alternative, have you looked into the patch? I was on this for 7 months, and was pretty happy with it. But take into consideration the placement. When you put it high up on your ass cheek, your jeans and/or underwear can catch on the edges and cause it to peel away from your skin. I found the best place was on my shoulder blade, but this was mostly during the colder months, and didn't show. If you wear tank tops and such, you'll be able to see it.
Overall, this was a great form of BC. Look into it! Good luck!

[Sweetie]

*cough* and my result from such a method is nine.

[Trinity]

Okay so I don't like being on the pill, makes me anxious and shit. Neither of us really like condoms, don't fancy the idea of an IUD being present all the time, am sure I would never be able to fit a cap right, etc etc etc. So, my bf and I tend to practice the withdrawal method now. Is this reliable? We were always taught in sex education classes, yawn, that it wasn't and that you'd inevitably wind up pregnant if you used this method. Is that really true tho? Seems to me that if you do it right, ie make sure you always DO pull out, then it's likely to be pretty reliable. What say you all?
I Have always heard that every basketball player dribbles before he shoots. :smugnod:

[Bullet]

LTR and I don't worry about it at all. I got fixed about 8 months ago, and I did not even know I was broken!! Apearently that's what causes babies, the man is broken and needs to get fixed. And if he has kids, his wallet will be broke too.

I also have fathered a child with the withdrawel method. :eek: And I swear I pulled out in time every time.

[Soubrette]

Seems to me that if you do it right, ie make sure you always DO pull out, then it's likely to be pretty reliable. What say you all?

You're brave :)

I have a friend who used this method for a couple of years as well as the rhythm method as she had very regular periods.

She swears by that method but first - she and her partner have an unplanned baby girl of which she is pretty sketchy about how their contracteption method failed.

And second she was very ambivalent (after having the first accidental one) as to whether she wanted another one. When after a few years she decided definitely not - then her partner had a vasectomy.

I use the dep-po injections because I do not want children at this time of my life, I have two lovely ones already :) and I've a crap memory. My desire not to become pregnant outweights its downsides 100% :)

Good luck in your quest for birth control :)

Sou

[MooseIBe]

Heh I am certainly having a rethink after reading all this. That said, about the stat that says that 4 in every 100 women who use the method 'perfectly' will become pregnant in one year actually does seem to indicate to me that it works at least a little bit. I mean, aren't the stats for condoms about the same? (I will have to set aside half an hour later to have a good browse through Liv's link).

I considered the depo injection but my sister - who is five months pregnant currently, so not a great one to take contraceptive advice off - said it made her gain weight and feel moody all the time.

I suppose, as I only see my bf every few months currently, I could try taking the pill only for the month that contains the week that he is here. That said I am not sure if it's a great thing for your body to go off and on it like that. I will have to ask my doc.

[Godless Dave]

I suppose, as I only see my bf every few months currently, I could try taking the pill only for the month that contains the week that he is here. That said I am not sure if it's a great thing for your body to go off and on it like that. I will have to ask my doc.

That won't work either. You have to be on the pill for four weeks before it starts working.

Condoms really aren't that bad. Putting a condom on a few times a month is certainly less hassle than changing diapers several times every day.

[MooseIBe]

No, you don't have to be on the pill for four weeks before it starts working :). The combined pill starts working the day you take it (I had one type where you had to wait 7 days before being covered, but the last two I have had were effective from the first day).

[Godless Dave]

That must be a fairly new development, or else they give out different information in the US.

[MooseIBe]

I don't think it's all THAT new :). But that's what it says on the leaflet anyway. Are you sure you're not thinking of the progesterone only pill?

[Waluigi]

Different types of BC have different waiting periods.

The first one we tried required a seven day wait. Or, if you started taking it during your period, it was effective as soon as the period was over. I'm not sure what the Yasmin says.

Not that it matters now, we've been using it for years.

The so-called "natural" methods (rhythm, withdrawal) will decrease your chances of pregnancy, but not to the point that they can be considered effective birth control. The best bet is a combination of methods (for example, pill + condoms + withdrawal). But at some point, you're just taking the fun out of it. :)

[MooseIBe]

heh I wouldn't go as far as using the pill, condoms AND withdrawl, though I've tended to combine withdrawal with rhythm and occasionally the morning after pill. I suppose I will have to go back in yasmin .. I have a year's worth sitting around downstairs. Better check the best before date mind ... it's been there a while!

[Beth]

I got on the depo shot right after my daughter was born. I had bad reactions to it. I was on it for a year because I did not want to get pregnant again, but then my daughter insisted that I get off of it after having persistent phantom flu symptoms. My favorite pill was ortho-cept. I had the least amount of reactions to that particular pull than I did to a number of various pills, including Yasmine.

My husband tries to pull that bullshit withdrawl method on me. I ended up preggers because I was stupid, but fortunately I miscarried very early.

I am happiest on both the pill and using a condom, but I cannot take the pill while on my current meds. Also, don't trust anal sex. Semen can leak out of the anus or spill out of the penis on withdrawl and you can still end up with sperm in an area that you don't want it to be.

[MooseIBe]

Heh I've never TRIED anal sex even :). Though I suppose it might be worth a shot...

I've never heard of ortho cept but I could ask my doctor I guess. I am on anti depressants .. is there any likelihood of a bad reaction between the two?

[Beth]

Antidepressants null the birth control pill's effectiveness similar to what antibiotics do. If you got on the pill, there is a good chance you'll end up pregnant because of the antidepressant. You also might have some serious fetal defects in the baby.

[Waluigi]

Antidepressants null the birth control pill's effectiveness similar to what antibiotics do. If you got on the pill, there is a good chance you'll end up pregnant because of the antidepressant. You also might have some serious fetal defects in the baby.
Some antidepressants are safe to use concurrently with birth control. Most aren't, though.

As always, the best thing to do is read the label and disclosures, and talk to your doctor.

[MooseIBe]

seriously?? I don't recall reading anything in the leaflet about that! I am on prozac, does anyone know conclusively if that is safe?

(wait, it MUST be safe because I have a friend who took it throughout her pregnancy..)

[Gurdur]

....(wait, it MUST be safe because .....
Oh, man. MooseIBe, I really like you as a person, but you must develop a bit more caution, please.

Anyway:
From here (http://www.babycentre.co.uk/expert/2343.html)

Question: Is it safe to take Prozac during pregnancy?
BabyCentre Editorial Team: It appears to be. Researchers have examined the effects of Prozac (commonly used to treat depression and other problems) in more than 1,000 pregnant women and found that those women were no more likely to give birth to a baby with a major birth defect than other women. While one study did show a slightly greater risk of miscarriage among women on the drug, many others have not.

It's also unlikely that your baby will suffer from withdrawal symptoms if you use Prozac during your pregnancy. Why? The drug leaves the bloodstream very gradually, giving even small bodies time to adapt to its absence. Although some newborns of mothers on Prozac have shown symptoms such as irritability, shaking, or increased crying, most have not had these problems. Trials conducted by the drug's manufacturer, Eli Lilly, on more than 100 women exposed to the drug in the third trimester showed no increased risk for problems in newborns, including prematurity.
..............

[Beth]

Sorry. I wasn't thinking about Prozac. Ask the doctor if the prozac is risky to use with the pill.

[RevDahlia]

NuvaRing! NuvaRing! I must sing its praises -- check it out, Moose. Like you, I have a really hard time with most hormonal methods of BC. The patch and the pill turned me into a raving maniac with no libido. NuvaRing, on the other hand, has given me no trouble at all. It did make me gain a little weight, but no more than six or seven pounds, and you only have to think about it twice a month (once to put in, once to take out.)

Topic? This is so un-PC, but an ex and I used the pull-and-pray method for two years and no uninvited guests showed up. Looking over this thread, though, I'm realizing how lucky I was.

[MooseIBe]

....(wait, it MUST be safe because .....
Oh, man. MooseIBe, I really like you as a person, but you must develop a bit more caution, please.

Anyway:
From here (http://www.babycentre.co.uk/expert/2343.html)

Question: Is it safe to take Prozac during pregnancy?
BabyCentre Editorial Team: It appears to be. Researchers have examined the effects of Prozac (commonly used to treat depression and other problems) in more than 1,000 pregnant women and found that those women were no more likely to give birth to a baby with a major birth defect than other women. While one study did show a slightly greater risk of miscarriage among women on the drug, many others have not.

It's also unlikely that your baby will suffer from withdrawal symptoms if you use Prozac during your pregnancy. Why? The drug leaves the bloodstream very gradually, giving even small bodies time to adapt to its absence. Although some newborns of mothers on Prozac have shown symptoms such as irritability, shaking, or increased crying, most have not had these problems. Trials conducted by the drug's manufacturer, Eli Lilly, on more than 100 women exposed to the drug in the third trimester showed no increased risk for problems in newborns, including prematurity.
..............

Well but I was right though .. it IS safe :D. THough obviously I would have checked that rather more thoroughly, had I been planning to become pregnant..

[MooseIBe]

What IS Nuva ring? /me looks intrigued

[RevDahlia]

What IS Nuva ring? /me looks intrigued
It's Googlable, but in a nutshell it's a soft plastic ring that contains low-dosage hormones. You put it in like a diaphragm, and it hangs out around your cervix for three weeks. You take it out the fourth week and get your period. Then you unwrap a new one. It's as effective as the pill, but since the distribution of hormones is so localized less get into your bloodstream, hence fewer side effects.

The first month I used it I got some spotting, but it went away pretty quickly. My husband says he doesn't notice the Gizmo, as we call it around here, at all. The downside is it's pretty expensive if your insurance doesn't cover it, but I get mine at a local women's clinic for dirt cheap.

[MooseIBe]

well all contraception is free here :). I would have to see if it was available in this country though .. I've never heard of it! Is it difficult to insert though? I know where my cervix is, obviously, but it's not like I can get up there with a flashlight and one of the reasons I've always been wary of the cap is that I figured it must be a real bitch to get it in place properly.

[RevDahlia]

well all contraception is free here :). I would have to see if it was available in this country though .. I've never heard of it! Is it difficult to insert though? I know where my cervix is, obviously, but it's not like I can get up there with a flashlight and one of the reasons I've always been wary of the cap is that I figured it must be a real bitch to get it in place properly.
No, it pretty much just snaps in place. It's less of a PITA than diaphragms because the placement is less important. Provided it's back there somewhere, it'll work.

[MooseIBe]

heeheee I'll just get my bf to take a running jump and pitch it, then :D

[Talulah]

A guy I was with for quite some time used withdrawal (a couple of years on and off) and I wasn't on BC and no little ones came of it. He was very disciplined though and never had any "mishaps." Probably because he knew I would have killed him.

[MooseIBe]

Well that is what I think .. people say that men leak sperm before ejaculation and I know that to be true but it still does seem to me that if you do do it properly, you are gonna lessen your chances of pregnancy quite a lot. Not as much as with other methods of birth control perhaps, but still well enough.

[Crumb]

you are gonna lessen your chances of pregnancy quite a lot.
Not enough though.

[MooseIBe]

True and I guess better to be safe than sorry. I only see my bf once every few months right now though anyway :(

[TomJoe]

Look into Natural Family Planning. Sympto-thermal methods have been scientifically proven to be as reliable as the birth control pill.

http://www.ccli.org

[Dingfod]

Link to study please?

[TomJoe]

Link to study please?

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=7025639

Of the 90 pregnancies that occurred during training (59 OM and 31 STM) and 62 during the study phase (42 OM and 20 STM), only 6 OM and none of the STM pregnancies were considered strictly method failures.

The Couple to Couple League International gives a summary starting here (http://ccli.org/nfp/basics/effectiveness-p02.php) of the various studies examining the sympto-thermal method employed in Natural Family Planning as well.

[Clutch Munny]

MooseIBe, a lot hinges on the prior probability of your becoming pregnant. Lots of couples can use the guess-and-gush method without conceiving because their chances of conceiving are independently very low, whether they know it or not. Of course some couples find it difficult or impossible to conceive no matter what; they will find (and perhaps report) that coitus interruptus worked for them. But you presumably don't know that that's you. Without knowing which demographic you're in, ease-of-conception-wise, it makes sense to assume that you are a virtuoso conceiver and your partner a source of super-swimmer sperm. In which case withdrawal as a regular strategy is next to useless, minus the "next to".

[Dingfod]

Your latter link says "couples who followed these simple rules achieved a 100% effectiveness rate in avoiding pregnancy, i.e., zero unplanned pregnancies." which I think is most likely complete bullshit, but I'll concede them that one as follows. The first link you posted says "Both methods showed high dropout rates at 12 months (including training) 74% for OM and 64% for STM." 64% dropout rate? That means 64% can't "follow these simple rules", which means those 64% fall back to 85% pregnancy rate of using no birth control method at all, (http://www.fda.gov/fdac/features/1997/conceptbl.html) which means that, even at 100% effectiveness of those that stay in, the overall pregnancy rate of those who try using STM is as high as 54%, about 10 times the highest expected pregnancy rate of those using "the pill". According to the FDA, coitus interruptus is more effective than any of the other natural methods.

[TomJoe]

Your latter link says "couples who followed these simple rules achieved a 100% effectiveness rate in avoiding pregnancy, i.e., zero unplanned pregnancies." which I think is most likely complete bullshit, but I'll concede them that one as follows.

In a small study (~1,300 individual couples) it's entirely possible to have 100% efficiency. If you read the CCLI article, they stated that it is impossible to maintain a 100% effectiveness in a population, so the FDA states that it must be listed as 99% effective. Otherwise, to call it bullshit is to claim that either the authors fudged their data, or the peer review process made a major mistake in overlooking the claim. The only other option is that you're unfamiliar with the study (obviously) and what the claims were and why the scientific community considers the claims valid. I'd go with the latter.


The first link you posted says "Both methods showed high dropout rates at 12 months (including training) 74% for OM and 64% for STM." 64% dropout rate? That means 64% can't "follow these simple rules", which means those 64% fall back to 85% pregnancy rate of using no birth control method at all, (http://www.fda.gov/fdac/features/1997/conceptbl.html) which means that, even at 100% effectiveness of those that stay in, the overall pregnancy rate of those who try using STM is as high as 54%, about 10 times the highest expected pregnancy rate of those using "the pill". According to the FDA, coitus interruptus is more effective than any of the other natural methods.

That's an extremely tortured way to try to disprove NFP. Incorrect too. If NFP is followed correctly, it results in 99% effectiveness, as the studies all indicate (notice, there is more than one study that proves that STM (sympto-thermal method) if used properly is extremely effective). If people do not follow NFP as designed, there can be failures. Same as people who fail to properly and consistently wear condoms, fail to properly take their birth control pills, fail to properly use a diaphragm, etc etc.

Are there caveats to using STM? Sure there are. That does not disqualify it from being a suitable birth control method however. Many men have problems wanting to use condoms, but I doubt I'd see you arguing that proper condom use doesn't cut down on the number of unwanted pregnancies. Anecdotally, my ex-wife and I used NFP for five years. No unplanned pregnancy, no other form of birth control. Properly utilized, we didn't even have a "pregnancy scare". Documenting basal body temperature and cervical mucous does take some time to get a handle of and get a routine started, which makes it a bit more "hands on" for all involved and it also does require about 7 to 10 days of abstinence from sexual intercourse during the fertile period, but the upside is its effectiveness if utilized properly, its immediate reversal (if you do want a child, no waiting for hormones/chemicals to clear the body), it's dual utility to document prime fertile periods for planning pregnancy, and natural, spontaneous sex without fiddling with condoms, placing spermicidal jelly or diaphragms what have you.

[Dingfod]

You insert a big IF in there, one that apparently most cannot get past, therefore the study is invalid. IF over half your study participants are dropping out because they can't do it or it didn't work for them then there are serious flaws in the study. They're reporting what they want to see and ignoring that which they don't want to see. I applaud them for enough honesty to report the dropout rates.

[Dingfod]

It's like saying abstinence works. It does work IF you actually abstain, but the facts are, that many cannot abstain.

[TomJoe]

You insert a big IF in there, one that apparently most cannot get past, therefore the study is invalid. IF over half your study participants are dropping out because they can't do it or it didn't work for them then there are serious flaws in the study. They're reporting what they want to see and ignoring that which they don't want to see. I applaud them for enough honesty to report the dropout rates.

The study is invalid eh? Since the studies (note plural) have been peer-reviewed, I wouldn't say the studies are invalid. The STM method may not be for everyone, but it is effective (extremely) and it is available, and its free too.

If I were you, I would not hinge my objections to NFP on a conspiracy (reporting only what they want to see and ignoring other things).

[TomJoe]

It's like saying abstinence works. It does work IF you actually abstain, but the facts are, that many cannot abstain.


And some men won't wear condoms, and some women won't use the pill (hence the whole point of this OP warrenly). So your point is?

[Dingfod]

Fucking yourself in the ass is 100% effective birth control.

[TomJoe]

Fucking yourself in the ass is 100% effective birth control.
...

[Clutch Munny]

If NFP is followed correctly, it results in 99% effectiveness, as the studies all indicate (notice, there is more than one study that proves that STM (sympto-thermal method) if used properly is extremely effective). If people do not follow NFP as designed, there can be failures. Same as people who fail to properly and consistently wear condoms, fail to properly take their birth control pills, fail to properly use a diaphragm, etc etc.

That's not how this sort of procedure is properly measured, TomJoe. The effectiveness of anything like this is measured over the "intent to treat" group -- that is, the group that you initially set out to have implement the treatment or procedure.

The reason for this is precisely to rule out trimming the measured class in order to get a desired result.

Bear in mind that the relevant probability is not that of "success given correct use of method". Nobody can guarantee in advance that they will use the method correctly. All they can promise is to try. So for the decision-process of someone examining bc options, the relevant probability is that of "success given good intentions and a reasonable effort". If good intentions and a reasonable effort are insufficient, in a wide class of cases, to ensure correct use of method, that is crucial information for someone to know before choosing that method -- crucial information that gets filtered out if one chooses only to report the rate of success given correct use.

Of course pregnancy becomes a high risk for "people who fail to properly and consistently wear condoms, fail to properly take their birth control pills, fail to properly use a diaphragm, etc etc." But that tells us nothing about how likely one is to misapply those methods, in comparison with how likely they are to misapply NFP. The data, manifest in the dropout rate, suggest that the latter probability is remarkably high, undermining the rationality of choosing NFP over other available options.

[TomJoe]

If NFP is followed correctly, it results in 99% effectiveness, as the studies all indicate (notice, there is more than one study that proves that STM (sympto-thermal method) if used properly is extremely effective). If people do not follow NFP as designed, there can be failures. Same as people who fail to properly and consistently wear condoms, fail to properly take their birth control pills, fail to properly use a diaphragm, etc etc.

That's not how this sort of procedure is properly measured, TomJoe. The effectiveness of anything like this is measured over the "intent to treat" group -- that is, the group that you initially set out to have implement the treatment or procedure.

The reason for this is precisely to rule out trimming the measured class in order to get a desired result.

Bear in mind that the relevant probability is not that of "success given correct use of method". Nobody can guarantee in advance that they will use the method correctly. All they can promise is to try. So for the decision-process of someone examining bc options, the relevant probability is that of "success given good intentions and a reasonable effort". If good intentions and a reasonable effort are insufficient, in a wide class of cases, to ensure correct use of method, that is crucial information for someone to know before choosing that method -- crucial information that gets filtered out if one chooses only to report the rate of success given correct use.

Of course pregnancy becomes a high risk for "people who fail to properly and consistently wear condoms, fail to properly take their birth control pills, fail to properly use a diaphragm, etc etc." But that tells us nothing about how likely one is to misapply those methods, in comparison with how likely they are to misapply NFP. The data, manifest in the dropout rate, suggest that the latter probability is remarkably high, undermining the rationality of choosing NFP over other available options.


Like I said, the STM method won't be for everyone, and the biggest factor for dissuasion is the higher level of "hands on" at least initially until people become familiar and comfortable with the technique. Like I said, I used the method with my ex-wife for five years and it took several months for us to fully trust the method (ie: have a large window in which to have sex, rather than restricting ourselves to the last week or so before her period, which we knew would be safe). I could hazard a guess that a lot of dropouts are due to this sort of factor ... but that indicates a lack of willingness to follow the procedure reasonably ... because frankly they've ditched the procedure altogether.

Now MooseIBe indicated that her and her bf don't have many "opportunities" which I think would mean that getting a suitable schedule established would not be possible, which would be a strike against using the STM method ... however, I think a disciplined couple could use this method with the 99% effectiveness indicated in the several studies performed on this method.

[Crumb]

Another drawback of STM is that it only works in a long term, monogamous relationship.

[TomJoe]

Another drawback of STM is that it only works in a long term, monogamous relationship.

True. Though, IMO, I don't consider that a drawback. :)

[TomJoe]

NFP article.

[Dingfod]

I just want to say to TomJoe and anyone else that might have been offended by my previous post, I'm sorry. I'm operating on about 2 hours of sleep and had just gotten a phone call from my daughter wanting to be excused from school for the umpteenth time this quarter. I'm too tired to be participating in a serious thread like this. Again, I apologize.

[TomJoe]

No problems warrenly. Apology accepted. And I likewise offer an apology for my uncharitable comments, and my "shoot first, attempt to understand my opponents POV later (if at all)" attitude as well.

[Clutch Munny]

Like I said, the STM method won't be for everyone, and the biggest factor for dissuasion is the higher level of "hands on" at least initially until people become familiar and comfortable with the technique.

Fair enough. The point is just that there's evidence that people in general will not become familiar and comfortable with the technique.

I could hazard a guess that a lot of dropouts are due to this sort of factor ... but that indicates a lack of willingness to follow the procedure reasonably ... because frankly they've ditched the procedure altogether.

A hazarded guess indeed. There is no reason to suppose that the dropout rate was particularly due to any blameworthy "lack of willingness" or antecedent decision to "ditch the procedure" on the part of the participants; it might just be a very difficult method for lots of people to adopt.

Now MooseIBe indicated that her and her bf don't have many "opportunities" which I think would mean that getting a suitable schedule established would not be possible, which would be a strike against using the STM method ... however, I think a disciplined couple could use this method with the 99% effectiveness indicated in the several studies performed on this method.

This could hardly fail to be true if lack of discipline is used to explain failures in effectiveness. But I have granted, arguendo, that criteria for correct use are definable independently. Nevertheless, it is not standard -- it is a version of the multiple endpoints fallacy -- to report a more specific success rate than the "intent to treat" group. Whatever your preferred conjectural explanation (they were lazy, they were too busy, they were stupid, or whatever), the percentage of people for whom the method failed because they could not do it correctly must be factored into the final results if the statistic is to be relevant to someone's rational choice about birth control. It's essential information.

[TomJoe]

This could hardly fail to be true if lack of discipline is used to explain failures in effectiveness. But I have granted, arguendo, that criteria for correct use are definable independently. Nevertheless, it is not standard -- it is a version of the multiple endpoints fallacy -- to report a more specific success rate than the "intent to treat" group. Whatever your preferred conjectural explanation (they were lazy, they were too busy, they were stupid, or whatever), the percentage of people for whom the method failed because they could not do it correctly must be factored into the final results if the statistic is to be relevant to someone's rational choice about birth control. It's essential information.
50 pregnancies out of ~625 individuals (1,247 couples randomly assigned into two groups) assigned to the STM group. That corresponds to a 8% failure rate for whatever possible reason, which is still a 92% success rate of the STM method.

[Dingfod]

They didn't report how many pregnancies there were among the dropouts. If, after they left the study, didn't use any method at all, that rate among the dropouts could be as high as 85%.

[TomJoe]

Actually, the highest it could get is 72%, and that's assuming that every single couple (64% or 400 of the 625 couples in the STM group) who dropped out of the study wound up pregnant (as well as the 50 who did get pregnant during the study), which is highly unlikely. Also, dropping out of the study does not show a consistent and proper use of the method, which is what people (pharmaceutical companies for example) use when reporting the success rate of any particular method anyways.

So yes, the study shows that a lot of people who use STM find it difficult to maintain, but it also shows that those who do maintain it, achieve results similar to other contraceptive methods.

[Clutch Munny]

As I do the math, TomJoe, the failure rate among couples still enroled in the STM component of the study could be as high as 23%. (51 pregnancies, ~225 subjects after 64% dropout rate). Seems to me that it could only be as low as 8% if all the dropouts happened after all the pregnancies, so that the pregnancy rate could still be calculated against the maximum possible number of participants. We don't know from the abstract, because we don't know when during the year the dropouts and pregnancies occurred.

In any case, though, this does not address the central point I've been making: The percentage of people who find the method unworkable is relevant information, since each dropout counts as a failure in a key respect. The question is whether people can use STM to avoid pregnancy; but if you can't use STM, then a fortiori you can't use it to avoid pregnancy.

[TomJoe]

Fair enough.

On another note, I suppose I could run over to the library to see if they carry this journal to see what the actual pregnancy rate is.