April 28, 2026
Birth control is a personal choice. But it can also be an overwhelming one. The idea of wading through the options to understand the risks and benefits and how each method works can be a lot. However, we can all agree, birth control is a decision that is best made proactively before the deed is done, so to speak.
"There is a birth control out there for everyone," says MU Health Care OB/GYN Ella Speichinger, MD. "If you are thoughtful, read about your options and partner with your doctor, you'll figure out the best plan for you."
To help you narrow down your options, Dr. Speichinger suggests reflecting on your lifestyle, needs, habits and desire for children. Asking yourself these six questions will get you started:
Do You Want Your Birth Control to Contain Hormones?
There are many options for birth control. But thinking in categories can make an overwhelming decision feel more manageable. An easy way to narrow down your choices is to decide whether you want your birth control to contain hormones.
Hormonal birth control methods use estrogen and/or progesterone to prevent ovulation or control your menstrual cycle. They may also help with acne, prevent ovarian cysts and lower the risk of some cancers. If you are looking at birth control for reasons beyond just preventing pregnancy, hormonal birth control may be a good option.
Keep in mind that hormonal birth control may have side effects, such as mood changes, weight gain or nausea. "All birth control methods will have some side effects, but hormonal options tend to have more," Dr. Speichinger says. "Everyone is affected differently, and you may need to weigh your birth control goals against your tolerance of side effects."
Nonhormonal birth control methods prevent pregnancy using a barrier, spermicide or natural family planning. Examples include condoms, copper intrauterine devices (IUDs) and the rhythm method — timing sexual intercourse to avoid ovulation. These birth control methods can often be used spontaneously (aside from the copper IUD) and avoid the side effects of hormonal options. However, some nonhormonal birth control is considered less effective.
Are You Looking for Birth Control That Is Easily Reversible, Longer-Acting or Permanent?
Your life stage and future family plans are an important factor when choosing a birth control method. If you think you may want pregnancy in the future, there are options that allow for that or are easily reversible, including:
- Barrier devices, such condoms and diaphragms
- Hormonal methods, including pills, patches and vaginal rings
- IUDs and implants, which are longer-acting but reversible
If you are sure that you do not want children and have gotten proper counseling on the topic, sterilization is another option. Bilateral salpingectomy is a minimally invasive operation that removes the fallopian tubes. The procedure permanently prevents pregnancy with the added advantage of reducing the risk for ovarian cancer, which often begins in the fallopian tubes. Other options for sterilization include tubal ligation ("tying your tubes") or vasectomy (for a male partner).
"If you are done having kids or definitively do not want children, there are permanent things you or a partner can do," Dr. Speichinger says. "If you are not sure what the future holds, we have highly reliable choices that you can reverse if needed."
How Involved Do You Want to Be With Your Birth Control?
Are you someone who would rather take a hands-on approach or set-it-and-forget-it? There are some methods you barely have to think about, such as IUDs and implants — birth control types that are placed inside your body. If you’re nervous about pain, specifically with IUD insertion, there are pain control options available. Pills and external methods, such as condoms or patches, tend to be more user-dependent.
"The more you have to engage with your birth control, the more likely it is going to fail," Dr. Speichinger says. "Your lifestyle and habits matter, and it's important that you choose a method you can realistically maintain."
When you are making your choice, remember that you may be better off choosing birth control that is less effective if it means you'll use it correctly and consistently. Highly effective methods are not effective at all if you don't use them or don't use them the right way.
Do You Have Any Health Conditions?
Your health history, family health history and medications can all play a major role in determining your birth control options.
Conditions that may limit your birth control choices include:
- Certain cancers
- Family history of certain cancers
- High blood pressure
- History of stroke
- Migraines with aura
- Smoking
On the flip side, there are some circumstances and conditions that can be helped by certain birth control methods.
"Symptoms of catamenial migraines, heavy or painful periods, or polycystic ovary syndrome (PCOS) can be provoked by having periods," Dr. Speichinger says. "Contraception that offers continuous ovulation suppression benefits people with those conditions."
How Important Is It to Have a Period?
It's completely normal not to have a period while taking hormonal birth control. You don't need to have a period unless you are trying to get pregnant, Dr. Speichinger says. It's medically safe.
However, some people are uncomfortable with the idea of not getting a period each month. They may not want the anxiety of worrying about whether their period hasn't arrived because of birth control or pregnancy.
"If someone appreciates the rhythm of having a monthly period and feels connected that way, that may guide their birth control choice," says Dr. Speichinger. "When we start to manipulate the menstrual cycle with hormones, we are thinning the uterine lining, which can reduce or eliminate your period. For some people, not having a period is just as important as preventing pregnancy."
This question really comes down to personal preference and comfort — although your doctor may recommend birth control for period control if you have menstruation issues or need help balancing your hormones.
Have You Talked to Your Doctor About Your Birth Control Options?
Working with your primary care doctor or OB/GYN helps ensure that the options you consider are medically appropriate for you. Choosing a birth control method may also take some trial and error depending on personal preferences and the side effects that you experience.
"This is a big decision, and it may warrant experimenting to see if you feel better on a different type of birth control," Dr. Speichinger says. "Taking ownership and making decisions about your family planning can be empowering. Your doctor is the perfect partner to help you achieve that goal."
Next Steps and Useful Resources
- Want to discuss more with a doctor? Find a primary care doctor or OB/GYN today.
