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- ArticleLaw B.Int J Gynaecol Obstet. 1978-1979;16(6):556-60.Whenever a medication is prescribed, the lowest effective dose should be selected when possible. This recommendation is particularly important when oral contraception is being considered. In the years since the pill became available, there has been a steady decline in the dosages used. Contemporary "low-dose" varieties are those containing less than 50 micrograms of estrogen. Although they provide equal reliability, low estrogen formulations contain only a fraction of the quantities used in the original varieties. Subjective side effects are reported far less frequently with lower dose pills, and metabolic effects are reduced. The only associated disadvantage is a tendency to more spotting and breakthrough bleeding in early cycles. No matter how low the dose, there will always be some women for whom this method is not suitable. Fortunately, the progestogen-only pill--a consideralby underused contraceptive measure--can often be highly acceptable.