QUESTION
When my wife has sex with other men, she makes them pull out and cum in her pubic hair or just outside her vagina. She won't use condoms. What is the risk of pregnancy from this practice?

ANSWER
Pulling out (the “withdrawal method”) is not a good way to prevent pregnancy. Sperm is present in pre-cum before ejaculation. Also, if a man ejaculates just outside the vagina, there is still a possibility for sperm to make its way inside. Although pulling out may make pregnancy less probable than cumming inside, the chance is still there to get pregnant. Doctors estimate that about 1 in 4 women who use the withdrawal method for a year will get pregnant.

Even if your wife does not like to use condoms, there are other methods of birth control she might be willing to try, such as the female condom or diaphragm. The birth control pill is a very effective way to prevent pregnancy, but it will not protect her from getting STDs.

For more information on the female condom, visit http://www.femalehealth.com/.

Also, since your wife is not using condoms, it is a good idea for both of you to get tested for STDs and HIV. For more information about where, visit City Clinic for places in San Francisco or check out HIVtest.org to do a zip code search for testing sites in your area.

To your health,
Dr. K