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    Four Decades of the Birth Control Pill


    Many women find that the pill controls premenopausal symptoms like hot flashes or irregular periods, according to data from the American College of Obstetricians and Gynecologists.

    Roberts, who has monitored the pill phenomenon during the past 20 years, says that public health threats have changed since the early days of oral contraception. "We now have a situation where pregnancy is not the major concern that people have, with HIV and HPV infection. Studies have suggested that the pill would increase cervical cancer because there would be less concern about having intercourse with multiple partners."

    Today, there are nearly 50 different oral contraceptive pills from which doctors can choose. An emergency birth control pill -- the so-called "day-after pill" -- has been quietly used for more than 20 years, although it only received official FDA approval for that purpose in 1998, Feldt says.

    "We've found that as soon as we could advertise availability of the emergency contraceptive, we've seen very dramatic increases in ... people seeking information about it, so they would be informed should they need it, but also dramatic usage," she says. "Research indicates that unintended abortion could be reduced by half if every woman could have emergency contraception."

    Of the myriad of oral contraceptives on the market, all are variations of the basic structure, fine-tuned to give the effects women want -- protection from pregnancy -- and minimize side effects.

    "Like some of these targeted estrogen replacement therapies, they're trying to find drugs that interact with estrogen receptors that don't make people have headaches, don't make them gain weight, don't affect clotting," Roberts says.

    "Maybe we want to catch just the ovum and not make it mature. Or make a minor change in the uterus so the ovum can't implant. Most of the research is on trying to refine them, to do just exactly what you want, like 'smart bombs.'"

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