Oral contraception: From birth control to pregnancy prevention with noncontraceptive benefits

Considerable changes have occurred in oral contraceptives since their introduction in the 1960s. Initial reductions in sex steroid dosing were followed by alterations in dosing regimens that allowed for the minimization, reduction or elimination of scheduled vaginal bleeding episodes. More recently, oral contraceptives have incorporated novel progestins or estrogens other than ethinylestradiol, many of which are now associated with noncontraceptive benefits. The 21/7 regimen, developed to maximize the likelihood of a monthly withdrawal bleed, is likely to no longer be the pre-eminent dosing regimen used in new pill formulations, which can be expected to feature lower doses of new progestins and novel estrogens combined in dosing regimens that will reduce withdrawal bleeding, provide new noncontraceptive benefits and possibly be associated with an improved safety profile.