***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective : To investigate the effect of a combiphasic oral contraceptive containing ethinylestradiol and desogestrel ( combiphasic EE/DSG ) on  acne  , compared with a preparation containing ethinylestradiol and cyproterone acetate ( EE35/CPA ) . Methods : An open , r and omized , group-comparative , multicenter study was carried out , with 172 women r and omized to treatment with either combiphasic EE/DSG ( 25 μg desogestrel and 40 μg ethinylestradiol for 7 days followed by 125 μg desogestrel and 30 μg ethinylestradiol for 15 days ) or EE35/CPA ( 2.0 mg cyproterone acetate and 35 μg ethinylestradiol for 21 days ) . Assessment s were performed at pretreatment and after cycles 3 and 6 . Results : The number of comedones , papules , pustules and nodules significantly decreased in both groups over the 6-month study . Compared with pretreatment (= 100 % ) , the relative numbers of comedones , papules , pustules and nodules at cycle 6 significantly decreased to 37 % , 38 % , 19 % and 12.5 % in the combiphasic EE/DSG group and to 24 % , 36 % , 17 % and 1 % in the EE35/CPA group , respectively . All reductions were statistically significant ( p ≤ 0.003 ) at both cycles 3 and 6 , except for nodules at cycle 6 with combiphasic EE/DSG , which probably result ed from differences between the treatment groups at baseline . There were no statistically significant differences between the two treatments . In both groups , the majority of women with severe acne shifted to a less severe acne category . Conclusions : Combiphasic EE/DSG progressively reduced the number and severity of acne lesions during the six cycles of treatment . The reduction in acne with the combiphasic oral contraceptive was comparable to a preparation containing the anti and rogen cyproterone acetate To evaluate and compare the contraceptive efficacy , bleeding pattern , side effects and other positive effects of a combined oral contraceptive ( COC ) containing drospirenone ( DRSP ) [ Yasmin ] with those of a COC containing desogestrel ( DSG ) in healthy Chinese women . This was a r and omized , open-label , controlled , multicentre study of 768 healthy Chinese women requiring contraception . The subjects were r and omized to ethinylestradiol ( EE ) 30 microg/DRSP  3 mg ( n = 573 ) or EE 30 microg/ DSG 150 microg ( n = 195 ) , at a ratio of 3 : 1 . Each individual was treated for 13 cycles . Further visits were required at cycle 4 , cycle 7 , cycle 10 and cycle 13 of treatment . Weight , height and body mass index were evaluated at each visit . The Menstrual Distress Question naire ( MDQ ) was administered at baseline , visit 3 ( cycle 7 ) and visit 5 ( after cycle 13 ) . Baseline characteristics were similar between the two groups ( p > 0.05 ) . The Pearl Index ( method failure ) for EE/DRSP was 0.208 per 100 women-years , which was lower than that for EE/DSG ( 0.601 per 100 women-years ) . There were no significant differences between the treatment groups with regard to bleeding patterns . According to the MDQ subscale , improvements in water retention and increases in appetite during the intermenstrual period and in water retention and general well-being during the menstrual period in the EE/DRSP group ( -0.297 , -0.057 , 0.033 and 0.150 , respectively ) were significantly improved compared with the EE/DSG group ( -0.108 , 0.023 , 0.231 and -0.023 , respectively ) [ all p < 0.05 ] . Other values that improved in both groups , particularly improvement in breast pain and tenderness and skin condition , were more evident in the EE/DRSP group ( 18.0 % , 89/494 ; 12.6 % , 62/494 ) than in the EE/DSG group ( 11.3 % , 19/168 ; 5.4 % , 9/168 ) . Mean weight increased in the EE/DSG group ( 0.57 kg ) while there was a significant decrease in mean weight ( -0.28 kg ) in the EE/DRSP group ( p < 0.01 ) . Both EE/DRSP and EE/DSG have good contraceptive efficacy and a comparable bleeding pattern .  EE/DRSP had a more favourable effect on weight and premenstrual symptoms than EE/DSG This was an open-label multicenter study to compare the cycle control and effect on well-being of two oral contraceptives containing gestodene and one containing desogestrel . A total of 2419 healthy women ≤ 41 years of age were r and omized to receive oral contraceptives containing monophasic gestodene ( Minulet ® ; n = 806 , mean age 24.5 years ) , triphasic gestodene ( Tri-Minulet ® ; n = 808 , mean age 24.6 years ) or monophasic desogestrel ( Mercilon ® ; n = 805 , mean age 24.6 years ) . Subjects were to participate in the study for up to 13 treatment cycles . A modified Moos Menstrual Distress Question naire was used to evaluate menstrual symptoms and to assess overall well-being . A total of 698 women were withdrawn from the study , 154 due to adverse events . Cycle control with gestodene was superior to that with desogestrel at almost all time points , particularly for breakthrough bleeding and /or spotting , which occurred significantly less frequently with gestodene than with desogestrel at cycles 1–1 and 9–11 ( p < 0.05 ) . Generally , the proportion of subjects with breakthrough bleeding and /or spotting was almost twice as great with desogestrel as with gestodene . The duration of bleeding was not consistently different between the gestodene and desogestrel groups ; however , the intensity of bleeding was greater with gestodene at all time points ( p < 0.05 ) . The latent period before withdrawal bleeding was significantly longer for monophasic gestodene at cycles 1–5 and 8–10 ( p < 0.05 ) . Treatment significantly improved overall well-being at cycles 6 and 9 with triphasic gestodene and at cycle 13 with desogestrel ; however , no statistically significant differences among treatment groups in overall well-being scores or individual factors of well-being could be identified . All three treatments were well tolerated . The most common drug-related adverse events were headache ( 14.2 % ) , breast pain ( 6.2 % ) , nausea ( 4.1 % ) , metrorrhagia ( 5.9 % ) and abdominal pain ( 3.5 % ) . The incidence of adverse events in all treatment groups was similar , with the exception of metrorrhagia , which occurred in more patients in the desogestrel group than in the gestodene treatment groups ( p < 0.05 ) To study the question of whether one br and of oral contraceptives may be as acceptable as another for use of publicly-assisted family planning programs , a double blind study of two well-known br and s , Ovral and Norinyl  , was undertaken in Costa Rica and Trinidad . The pills were r and omly assigned to 1,200 women . Common side effects - nausea , dizziness , vomiting , headaches - were associated with both Norinyl and Ovral . Differences in event rates for these conditions were much more marked by country than by the pill used . Ovral was associated with increases in skin problems , notably chloasma , in Cost Rica . A higher percentage of women using Norinyl reported intermenstrual bleeding and spotting in both countries . In Costa Rica continuation rates for Norinyl were adversely affected by this . With these exceptions there appear to be no important differences between the br and s that would affect their use in family planning programs BACKGROUND Oral contraceptive is the most commonly used method of fertility control . Yasmin is a combination of a novel progestogen with anti- and rogenic and anti-mineralcorticoid activities ( 3 mg Drospirenone ( DRSP ) and 30 microg ethinylestradiol ( EE ) ) . It has been shown in many clinical trials that Yasmin is an efficacious oral contraceptive , lacking undesired effects as with other oral contraceptives such as weight gain . However the effects of Yasmin on sexual desire and libido have not been intensively investigated so far OBJECTIVE Investigate the effects of Yasmin on sexual desire , libido and changes in the free and rogen index ( FAI ) compare to  Meliane  ( 75 microg gestodene + 20 microg ethinylestradiol ) . MATERIAL AND METHOD The authors ' report the results of a double blind r and omized controlled study using a translated version of the Female Sexual Function Index question naire ( FSFI ) for the assessment of the sexual function . The free and rogen index was calculated from measurements of testosterone and sexual hormone binding globulin . RESULT The result shows statistically significant improvements regarding sexual desire , arousal and overall satisfaction in the Yasmin group . Additionally , an increased frequency of orgasms in the Meliane group was reported . Statistically significant differences between the two treatments regarding changes in the FSFI score and changes in the free and rogen index have not been observed . CONCLUSION The novel oral contraceptive containing drospirenone ( Yasmin ) and the non-anti- and rogenic progestin containing oral contraceptive ( Meliane ) do not show unfavorable effects on sexual response and libido Side effects of  combined oral contraceptives  are the most common reason why women discontinue them . Over the past half century , an elaborate mythology about these ill effects has evolved , fueled by rumor , gossip and poor- quality research . In contrast , placebo-controlled r and omized trials document that nonspecific side effects are not significantly more common with combined oral contraceptives than with inert pills . These reported nonspecific side effects may reflect the nocebo phenomenon ( the inverse of a placebo ) : if women are told to expect noxious side effects , these complaints occur because of the power of suggestion . Alternatively , nonspecific complaints may simply reflect their background prevalence in the population . Because Level I evidence documents no important increase in nonspecific side effects with oral contraceptives , counseling about these side effects or including them in package labeling is unwarranted and probably unethical . When in doubt , clinicians should err on the side of optimism Three hundred thirteen women participated in an open , multicenter comparison of the incidence of intermenstrual bleeding ( breakthrough bleeding and or spotting )  associated with the use of three triphasic oral contraceptives . Triphasil ( n = 107 ) , containing levonorgestrel and ethinyl estradiol , and Ortho-Novum 7/7/7 ( n = 97 ) and Tri-Norinyl ( n = 109 ) , both of which contain norethindrone and ethinyl estradiol , were administered over four cycles for a total of 1141 cycles . The total incidence of intermenstrual bleeding was significantly lower with Triphasil ( 17.2 % ) than with Ortho-Novum 7/7/7 ( 39.5 % ) or Tri-Norinyl ( 49.0 % ) . The pattern remained the same when findings were analyzed cycle by cycle and for breakthrough bleeding and spotting separately . The incidence of other side effects was comparable for all regimens . Results of this study demonstrate superior cycle control with Triphasil compared with Ortho-Novum 7/7/7 and Tri-Norinyl during the first four cycles of use Norgestimate ( NGM ) , a derivative of 19‐nortestosterone with very specific affinity for the progesterone receptor , has been used in combination with ethinyl estradiol ( EE ) at low doses in both monophasic and triphasic oral contraceptives ( OCs ) . An open‐label comparative clinical trial was conducted with 4,234 healthy women using triphasic levonorgestrel (LNG)/EE and NGM/EE through a total of 22,312 menstrual cycles .  Contraceptive efficacy was excellent with both preparations , with no statistically significant between‐regimen differences in pregnancy rates . The theoretical Pearl index was 0.12 for the NGM/EE triphasic , and 0.34 for the LNG/EE triphasic . Adverse experiences in both groups were typical of those that may occur among women taking low‐dose OC agents . The percentage of subjects discontinuing treatment because of use‐related adverse experiences was similar with the two preparations : 8.6 % for the NGM/EE triphasic and 6.8 % for the LNG/EE triphasic . In a separate mechanism of action study , specific endocrine parameters were investigated in 20 subjects using the NGM/EE triphasic for 4 cycles . Ovulation suppression was demonstrated in statistically significant decreases from pre‐treatment values in serum levels of luteinizing hormone , follicle‐stimulating hormone , progesterone , and estradiol . Significant on‐treatment increases in serum levels of sex hormone binding globulin evidence d minimal and rogenicity . All hormonal values returned to or toward normal in the post‐treatment cycle . The study results support those obtained in large noncomparative studies of the NGM/EE triphasic . This phased‐dose combination 
    Output:
    
Women using COCs containing second-generation progestogens may be less likely to discontinue than those using COCs containing first-generation progestogens .