***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 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 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 suppresses ovulation and is a very effective , minimally and rogenic contraceptive agent with a good safety profile The efficacy and acceptability of two third generation oral contraceptives in Thai women were evaluated in a prospect i ve , open , group-comparative , r and omized , multicenter trial of women asking for contraception . In six Family Planning Centers and Outpatient Gynaecological Clinics in urban areas in Thail and , 783 healthy women who were at risk for pregnancy and did not have contraindications to oral contraceptive use were r and omly allocated to one of the two study groups . An oral contraceptive containing 30 mcg ethinylestradiol and 150 mcg desogestrel was given to 394 women and an oral contraceptive with the same amount of ethinylestradiol and 75 mcg gestodene to 389 women during 6 cycles . Criteria of cycle control , side effects and the presence and severity of acne vulgaris were assessed and blood pressure and body weight measured at pretreatment and after cycles 1 , 3 and 6 . Furthermore , the efficacy was evaluated after the last cycle . No pregnancies occurred with either of the contraceptives . The incidences of irregular bleeding and minor side effects in both groups were very low and decreased after an initial increase in the first cycle . Acne improved in both groups . Blood pressure and body weight remained unchanged . The two oral contraceptives were found to be effective and acceptable in Thai women . Compared to Caucasian women , the incidences of irregular bleeding and side effects were apparently lower in these Asian women . Furthermore , the effects of both oral contraceptives were comparable Two monophasic oral contraceptives containing gestodene ( GTD , 75 micrograms ) and ethinylestradiol ( EE , 30 micrograms ) or norgestimate ( NGS , 250 micrograms ) and EE ( 35 micrograms ) were compared during the first six cycles of use . The subjects were r and omly assigned to receive either type : 97 received GTD/EE and 92 NGS/EE . Six women in the  GTD/EE  group and nine in the NGS/EE group withdrew from the study ; three ( 3 % ) and two ( 2 % ) , respectively , withdrew because of adverse reactions . A total of 562 cycles for GTD/EE and 523 for NGS/EE were available . No woman became pregnant during the study . Overall , 94.4 % of cycles in the GTD/EE group and 92.8 % in the NGS/EE group were normal . A similar incidence of breakthrough bleeding ( 0.2 % of cycles for GTD and 1.6 % for NGS ) and spotting ( 5.4 % vs. 5.6 % ) was observed . Amenorrhea was never reported . Duration of withdrawal bleeding tended to be slightly longer in the NGS/EE group , significantly so for cycles 2 ( 0.5 days , p = 0.016 ) , 4 ( 0.5 days , p = 0.031 ) and 5 ( 0.4 days , p = 0.045 ) . Cycle 2 was significantly longer in the GTD/EE group ( 0.3 days , p = 0.027 ) . Side-effects were reported by 12 ( 12 % ) women in the GTD/EE group and 13 ( 14 % ) in the NGS/EE group . The most common side-effects were headache ( five cases ( 5 % ) in the GTD/EE group and two ( 2 % ) in the NGS/EE group ) and breast pain ( three ( 3 % ) and eight ( 9 % ) cases respectively ) . There were no statistically significant differences between the two groups with respect to change in body weight or changes in blood pressure and in laboratory data . ( ABSTRACT TRUNCATED AT 250 WORDS This trial was design ed to determine the differences in effectiveness , clinical acceptability , and one-year discontinuation rates of two low-dose oral contraceptives : Lo-Estrin ( norethindrone acetate 1.5 mg plus ethinyl estradiol 0.030 mg ) and Lo-Femenal ( norgestrel 0.30 mg plus ethinyl estradiol 0.030 mg ) in 148 Mexican women . In addition , the effects of both oral contraceptive preparations on blood lipids were prospect ively evaluated in a subgroup of 41 women . The results indicated that there were no differences in pregnancy rates , discontinuation or clinical acceptability between the two groups . The lipid changes observed were minimal for the Lo-Femenal subgroup and somewhat greater for the Lo-Estrin group , mainly an increase in serum triglycerides . These changes were interpreted as estrogen induced effects of norethindrone-containing oral contraceptives . Overall , the data indicate that both Lo-Femenal and Lo-Estrin are effective and safe combined oral contraceptives . RésuméCette étude , menée auprès de 148 Mexicaines avait pour but de déterminer les différences entre deux contraceptifs oraux faiblement dosés : Lo-Estrin ( 1,5 mg d'acétate de noréthindrone plus 0,030 mg d'éthynil oestradiol ) et Lo-Femenal ( 0,30 mg de norgestrel plus 0,030 mg d' 
    Output:
    
REVIEW ERS ' CONCLUSIONS Based on data from one trial , compared to pills containing LNG , those containing GSD may be associated with less intermenstrual bleeding although they show similar patterns of spotting , breakthrough bleeding and the absence of withdrawal bleeds .
GSD is also comparable to DSG .
Regarding acceptability , all the indices show that third- and second-generation progestogens are preferred over first-generation preparations .