Birth control pills were approved for use in Japan Wednesday, ending decades of bureaucratic delay over questions of morals and culture, the spread of AIDS and potential lost profits to physicians in one of the world's busiest abortion markets.

Japanese women's rights activists have demanded official certification of the pill for years, asserting that women should have more options and control over their reproductive health. They argued also that Japan's heavy reliance on condoms for contraception, a less effective method than the pill, has led to millions of unwanted pregnancies and the acceptance of abortion as a routine form of birth control.

Even though it must still be formally approved by the health minister -- an action regarded here as pro forma -- certification of the pill by a key Health Ministry panel was greeted with relief by women's rights groups. Since its introduction here was proposed in the 1960s, they have battled arguments put forth by male bureaucrats that the pill would lead to a decay in women's morals and spread sexually transmitted diseases.

But the struggle of women in this male-dominated society is far from over: The same ministry that took nine years to sanction use of the pill in its current low-dose form recently took just six months to approve the anti-impotence drug Viagra.

"Viagra's approval showed clearly that what the Health Ministry is doing is incoherent; women in Japan have been unable to plan their lives because they haven't had control over childbirth," said Midori Ashida, spokeswoman for a women's health group. "Who takes responsibility for the 1,000 abortions in Japan every day, or for the desperate women with unwanted pregnancies?"

Public demand for the pill, which could be on the market here as early as this fall, is expected to be limited at first, largely because of a general lack of understanding of it. Japanese women, and men, are reluctant to discuss birth control or other sexual matters with doctors, and many women still say they are worried about potential side effects of the pill. A pharmaceutical industry study last year showed that only 7.2 percent of women surveyed said they would use the pill if it were approved.

The Health Ministry has also decided to conduct a 10-year post-approval study of the effects of the pill, rather than its usual six-year monitoring of new medications. Moreover, the ministry will require doctors who prescribe the pill to advise women that using it, rather than condoms, may heighten their chances of contracting AIDS or other sexually transmitted diseases.

"The Health Ministry must be worried that nymphomaniac women will use the pill and transmit HIV to men," Ashida said. "Scientific data shows no link between increased pill usage and the spread" of sexually transmitted diseases.

It is unlikely that the birth control pill will be covered by Japan's national health insurance, adding a further burden to women who want to use it.