The main risk of coitus interruptus is that it's not a very effective method of birth control. First, it relies heavily on the genetic male partner’s ability to recognize the timing of ejaculation and withdraw in time, which may be difficult to do during intercourse. Withdrawing prior to ejaculation can interrupt sexual pleasure abruptly and end up reducing satisfaction for both partners. Additionally, even when performed correctly, there may be small amounts of sperm in the pre-ejaculate fluid that could result in pregnancy before withdrawing.
Another important risk of coitus interruptus is that it doesn’t prevent sexually transmitted infections (STIs), such as chlamydia, gonorrhea, or trichomoniasis. Among all contraceptive methods, abstinence or condoms are the only methods that protect against STIs. Condoms are the method of choice for individuals who have a new sexual partner or have multiple sexual partners.
Even with its risks, some individuals may rely on the withdrawal method because it can be used without any preparation and it is completely free, as it does not require any devices, medications, or prior medical appointments. Unlike hormonal methods (e.g., birth control pills, patches, vaginal rings), coitus interruptus doesn’t interfere with the menstrual cycle, so couples trying to conceive can easily decide to try for pregnancy.