***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: Depression , headaches , and libido were rated in 272 women before starting a contraceptive method  and at intervals during the first year of use—54 were fitted with an intrauterine device ( I.U.D. ) and 218 used one of three oral contraceptives .  Side effects caused 25 % of the oral contraceptive group and 13 % of the I.U.D. group to stop the method . Depression , headaches , and loss of libido were the most common reasons for stopping oral contraceptives and breakthrough bleeding was the most common reason for stopping the I.U.D. The group of women who stopped or changed their oral contraceptives during the survey were compared with the group who remained on the same oral contraceptive throughout . The former had higher mean depression and neuroticism scores at the first clinic visit and contained more women with a history of premenstrual weepiness , depression during pregnancy , outpatient psychiatric treatment , and treatment with antidepressants . Changes in the depression , headache , and libido ratings throughout the survey are presented OBJECTIVE The study was undertaken to determine the side effects , including depression , of oral contraceptives ( OCs ) in adolescent girls . METHODS We conducted a r and omized trial of OCs for dysmenorrhea , which assessed side effects and depression . Seventy-six adolescents received an OC ( 20 microg of ethinyl estradiol/100 mg of levonorgestrel ) or a placebo in a double-blind fashion for 3 months . We ascertained OC side effects using open-ended and closed question formats . Participants self-administered the Center for Epidemiologic Studies Depression Scale ( CES-D ) to assess depressive symptoms . RESULTS Fifty-seven participants ( 77 % ) reported at least one side effect ( median=2 , range=0 - 8 , interquartile range=1.0 - 3.25 ) . The number and the type of side effects reported in the OC group and in the placebo group were similar . Mean exit CES-D scores were comparable between groups [ OC group , 14.0 ( SD=9.2 ) ; placebo group , 14.4 ( SD=8.1 ) ; p=.86 ] . CONCLUSION Adolescents treated with an OC or a  placebo experienced similar numbers and types of OC side effects , as well as depressive symptoms OBJECTIVE Because many women who receive pharmacologic therapy with antidepressants are also prescribed oral contraceptives , it is important to assess the risk of clinical ly significant drug interactions . We review ed the United States fluoxetine clinical trial data base , specifically analyzing women ages 18 to 45 years , for differences in safety , antidepressant efficacy , and unplanned pregnancies that were associated with oral contraceptive use . STUDY DESIGN Data from 17 double-blind , placebo-controlled clinical trials in 1698 women were analyzed retrospectively . A subgroup of women with oral contraceptive use was compared with a subgroup of women with no  oral contraceptive use . Differences in treatment-emergent adverse events , unplanned pregnancies , and 17-item Hamilton Depression Scale ( HAMD-17 ) scores were analyzed . RESULTS The only treatment-emergent adverse events that showed a statistically significantly different odds ratio for oral contraceptive use versus no oral contraceptive use were headache , asthenia , and pain . There was not a statistically significant interaction in the incidence of unintended pregnancies ( P = .111 ) or in the changes from baseline in HAMDD-17 scores . CONCLUSION There is no clinical evidence that concomitant use of oral contraceptives and fluoxetine affects the safety or efficacy of either agent 
    Output:
    
Limited evidence from six studies found that OC , levonorgestrel-releasing IUD and DMPA use among women with depressive or bipolar disorders was not associated with worse clinical course of disease compared with no hormonal method use