Dear Dr G,

I am in my late twenties and currently in an active relationship with my girlfriend. Although the relationship is going well, we are focusing on our careers before thinking about marriage and children.

I have two problems with my sex life and hoping Dr G can help to resolve them.

First of all, I have these issues with pre-ejaculatory fluid (pre-cum).

Even though I am not thinking about sex or engaging in sex activity, I get pre-cum when I am with my girlfriend.

Sometimes, I also produce copious amounts of pre-ejaculate just when talking to her.

Although the emissions can be embarrassing at times, I understand it is completely harmless and will resolve with time.

That leads me to my second questions relating to the pre-cum.

Both my partner and I do not enjoy the use of condoms, as it just feels so unnatural and also dampens sensitivity during sex.

I am also not keen on my girlfriend going on the pill, as I am worried about complications and the costs of the medications.

So far, I have been trying the withdrawal technique, and this works well for me as I have good control before ejaculating.

However, I gather the pre-cum might be a real threat to continue withdrawal to avoid pregnancy.

I am really sorry to put Dr. G on the spot for two problems.

Firstly, can you tell me what exactly is pre-cum? And why I am producing so much even without sexual thoughts?

Secondly, how safe is the withdrawal technique when it comes to pregnancy and infection prevention?

Does pre-cum contain any sperms than can induce pregnancy?

Is the pre-ejaculatory fluid a drawback in the withdrawal technique?

Withdrawing William

Pre-ejaculatory fluid or pre-seminal fluid, colloquially known as pre-cum, is the penile secretion emitted by the Cowper’s gland near the tip of the penis.

The emission is generally clear, colourless and slightly viscous. The secretion is also medically termed Cowper’s secretion, and occurs at different stages of arousal, either during foreplay, masturbation or penetrative intercourse.

The most copious amount of pre-cum is emitted just prior to climax and the propulsion of semen.

It is generally believed that pre-ejaculate functions as lubricant during penetration, and as an acid neutraliser for the optimisation of sperm passage.

The constituent of pre-ejaculatory fluid is similar to semen, which contains acid phosphatase responsible for neutralising the urethral acidity caused by urine and the hostile environment of the cervix.

The exact amount of pre-cum is rather variable between individuals and various state of arousal.

Although for most men, the emission is hardly noticeable, others can emit as much as 5ml of pre-cum even without sexual thoughts.

Such excessive pre-cum is commonly observed in younger men, and the problem diminishes with advancing age.

On the other hand, the withdrawal, or pulling out, technique is a manoeuvre of ejaculation outside the partner’s vagina, just at the point of achieving climax.

This is the most “natural” and one of the commonest forms of birth control adopted by couples for the prevention of pregnancy.

The technique is also called coitus interruptus, and is only achievable if the ejaculation is precisely timed to occur outside the vulva or vagina.

Although many couples successfully avoid pregnancies with the withdrawal technique, such moves do not ensure protection from sexually transmitted infections.

The famous sexologists from the 1960s, Masters and Johnson, observed that pre-ejaculate contains enough sperm to cause pregnancy.

Therefore, it has been long proposed that pulling out is an ineffective form of contraception. In recent years, publications had demonstrated that 41% of the pre-ejaculatory fluids of volunteers contained sperm, and this can be as few as 1 million and as many as 35 million sperm.

Indeed, the study revealed sperm leaks into the pre-ejaculatory fluid prior to climax. However, many critics also believe the sperm-positive samples may actually be due to volunteer-submitted ejaculates instead, as they may be too embarrassed at not producing the proper amount of pre-cum.

In reality, the withdrawal technique may be an effective modality of contraception for some couples, especially in combination with the avoidance of fertile intervals of the female partners.

When the withdrawal technique of contraception is compounded by the virility of youth and copious production of pre-cum, the odds are simply stacked against you.

Miguel de Cervantes, widely regarded as the greatest writer in the Spanish language once said: “To withdraw is not to run away, and to stay is no wise action, when there’s more reason to fear than hope.”

When Dr G is put on the spot by risk-taking couples with coitus interruptus, despite the drawbacks in withdrawals with pre-cum, his message is: “There is simply more reason to fear than hope!”

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