The effect on sexual desire is varied, with increase or decrease in some but with no effect in most.[43] Combined oral contraceptives reduce the risk of ovarian cancer and endometrial cancer and do not change the risk of breast cancer.[44][45] They often reduce menstrual bleeding and painful menstruation cramps.[33] The lower doses of estrogen released from the vaginal ring may reduce the risk of breast tenderness, nausea, and headache associated with higher dose estrogen products.[44]