***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: BACKGROUND Many women discontinue their use of hormonal contraception , and even those who continue so may have difficulty using oral contraceptive pills consistently . New delivery systems , including the vaginal ring , may be easier to use , but user acceptability and satisfaction with these new methods may be affected by women 's experience with their bodies . MATERIAL S AND METHODS Data for this study were collected as part of a r and omized clinical trial on 201 women comparing immediate start of vaginal ring use with immediate start of low-dose oral contraceptive use .  We assessed user satisfaction and method continuation 3 months after ring or pill initiation . RESULTS At 3 months , 174 of 201 subjects ( 87 % ) had follow-up interviews . Among the 174 study participants with follow-up data , 61 % of ring subjects and 34 % of pill subjects were very satisfied with their methods ( p=.003 ) . For posttrial contraception , 79 % of ring subjects chose to continue with the ring whereas 59 % of pill subjects chose to continue with the pill ( p<.001 ) . Women who reported greater comfort in touching their genitals , greater frequency of masturbation , more comfort with intercourse and past use of vaginal contraceptives and products were not more likely than others to be satisfied with the ring or to continue using it for birth control . CONCLUSION Women who were allocated to vaginal ring use , regardless of their baseline characteristics or behavior , were likely to be highly satisfied with the method and to continue its use 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 ) The early days of oral contraceptives showed some evidence that these medications may have caused undesirable side effects on the voice , mainly in terms of virilization . In a r and om study carried out at the university hospitals of Jena and Berlin ( Charité ) , two more recent drugs were tested in this regard , one containing cyproterone acetate ( Diane-35 ) and the other one levonorgestrel ( Microgynon ) , both from Schering . Ninety-one patients took part in extensive clinical and instrumental phoniatric investigations of voice function over a period of one year . No significant side effects on the voice could be proven for the two preparations . Gynecological and clinical effects of both Diane-35 and Microgynon were similar during the one-year study period . Women taking Diane-35 had less intracyclic bleedings and amenorrhea . Also , acne was more favorably influenced by Diane-35 The aim of this study was to compare contraceptive reliability , cycle control , and tolerance of an oral contraceptive containing 20 micrograms ethinylestradiol ( EE2 ) and 75 micrograms gestodene ( GSD ) , with a reference preparation containing a similar dose of gestodene but in combination with 30 micrograms ethinylestradiol . A higher incidence of intermenstrual bleeding was apparent under the 20 micrograms EE2 oral contraceptive . For the 20 micrograms EE2 preparation , 47.4 % of all women reported spotting at least once over a period of 12 treatment cycles , whereas this figure was 35.5 % for the 30 micrograms EE2 pill ( p < 0.05 ) . However , the incidence was within a range that corresponds to that of other OCs . The cumulative breakthrough bleeding rates ( at least once during the one year of treatment ) of 14.5 % ( 20 micrograms EE2 ) and 11.8 % ( 30 micrograms EE2 ) of women were not significantly different . In relation to all cycles , the intermenstrual bleeding rates were remarkably lower , indicating that the majority of the volunteers experienced such events only in few cycles under treatment : the spotting rate was 11.5 % ( 20 micrograms EE2 ) and 7.2 % ( 30 micrograms EE2 ) of all cycles , and the breakthrough bleeding rate was 2.6 % and 1.6 % of all cycles , respectively . Three pregnancies were recorded during the study ( one in the 20 micrograms EE2 + 75 micrograms GSD group , two in the 30 micrograms EE2 + 75 micrograms GSD group ) . All three could be explained either by intake irregularities or by circumstances impairing the contraceptive effect . The influence of both treatments on the blood pressure and body weight proved to be extremely slight . Adverse events in both groups were rare and differences in the frequency of adverse events were not apparent . The discontinuation rate due to adverse events , including intermenstrual bleeding , was low ( 9.8 % for 20 micrograms EE2 + 75 micrograms GSD , and 7.2 % for 30 micrograms EE2 + 75 micrograms GSD ) and was in the lower range known for other oral contraceptives . Both preparations were well accepted by the volunteers . The data obtained demonstrate clinical ly acceptable cycle control , good tolerance , and a high st and ard of contraceptive reliability for both drugs . Prescription of the 20 micrograms EE2 preparation could be the first-line therapy in order to provide the lowest amount of EE2 possible . In case of persistent cycle control problems , a switch to the 30 micrograms EE2 drug should be considered BACKGROUND The aim of this prospect i ve study was to evaluate the changes in olfactory sensitivity of oral contraceptive ( pill ) users . METHODS Sixty women underwent rhinomanometric and olfactometric determinations during the follicular , periovular and luteal phases of the menstrual cycle , and at day 7 , 14 and 21 of contraceptive intake . Thirty-one women used 30 microg ethinyl oestradiol plus 75 microg gestodene and 29 women used 20 microg ethinyl oestradiol plus 150 microg desogestrel . RESULTS Rhinomanometry showed higher but not statistically significant values during the periovular phase than in the follicular and luteal phases . Olfactometry showed a higher sensitivity during the follicular and periovular phases than during the luteal phase of the menstrual cycle . The rhinomanometric surveys in pill users were statistically different from those of the luteal phase ( P < 0.02 ) and the follicular and periovular phases ( P < 0.001 ) . The olfactometric thresholds during the period of contraceptive use were statistically different from those of the follicular phase for a few odorous substances , and from those of the periovular phase for each odorous substance , but similar to those of the luteal phase ( P = NS ) . CONCLUSIONS Unlike the rhinomanometric airflow and trans-nasal pressure , the olfactory threshold to odours seems to depend on the variations of the ovarian steroids during the menstrual cycle and on the iatrogenic effects of oral contraceptives OBJECTIVE -- To describe the technique of hysterosalpingography with endocervical placement of the balloon of the catheter rather than endometrial placement . PATIENTS -- 48 consecutive patients undergoing hysterosalpingography in the course of infertility work-up at a university hospital . METHOD -- With the patient in the lithotomy position , the cervix is visualized and cleansed . The catheter and balloon are inserted in the cervical canal and inflated with the contrast agent . The contrast agent is injected slowly at low pressure , and three to six spot films are obtained . Only gentle traction can be applied by this method , so oblique views are obtained early in the examination . RESULTS -- Balloon placement was atraumatic . Although good views were obtained more frequently than with traditional techniques , about one-quarter of the studies were unsatisfactory . CONCLUSION -- This method is easy , atraumatic , and allows excellent visualization of the entire endometrial cavity and upper intracervical canal A r and omised cross-over trial was performed to compare the pharmacodynamic actions of three low-dose oral contraceptives ( OCs ) : Marvelon  ( 150 micrograms desogestrel (DSG)+ 30 micrograms ethinyloestradiol ( EE ) ) , Mercilon ( 150 micrograms DSG + 20 micrograms EE ) and Microgynon ( 150 micrograms levonorgestrel ( LNG ) + 30 micrograms EE ) . None of the OCs produced any significant changes in serum cholesterol , LDL-C and apoprotein B. Triglycerides were increased by the desogestrel OCs but not by Microgynon . The latter however increased the glucose and insulin responses to a glucose tolerance test whereas Marvelon and Mercilon had no effect . HDL-C increased with Marvelon , was unchanged with Mercilon and was decreased with Microgynon . Apoprotein AII was increased by all three OCs but only the DSG OCs increased apoprotein AI . All OCs produced similar increases in caeruloplasmin but the increase in SHBG was much greater with Marvelon and Mercilon than with Microgynon . Testosterone was reduced more with Microgynon than with the DSG OCs . Many of the changes reflect the strong anti-oestrogenic action of LNG on metabolic parameters compared to DSG . Except for the effect on HDL-C , there was little difference between Marvelon and Mercilon on metabolic parameters and this complements the findings from large-scale clinical trials of the two OCs . Mercilon , therefore provides a very satisfactory alternative to Marvelon OBJECTIVES Our purpose was to define the frequency and reasons for oral contraceptive discontinuation and subsequent contraceptive behavior . STUDY DESIGN A nationwide prospect i ve study of 1657 women initiating or switching to the use of a new contraceptive from private practice s , clinics , and a health maintenance organization was performed . RESULTS Six months after a new oral contraceptive prescription , 68 % of new starts and 84 % of switchers still used oral contraceptives . Of women who discontinued , 46 % did so because of side effects , whereas 23 % had no continuing need . More than four fifths of women who discontinued oral contraceptives but remained at risk of unintended pregnancy either failed to adopt another method or adopted a less effective method . Fifteen percent of women who discontinued oral contraceptives resumed their use within the 7-month follow-up period . CONCLUSIONS Counseling should emphasize the possibility of side effects , stressing the fact that most will be transient , and the need to identify a backup method . Follow-up visits should be scheduled for 1 to 2 months after a prescription is written In a double-blind , controlled , r and omized , four-arm , bicentric clinical study , the effect of four oral contraceptives ( OCs ) on thyroid hormone parameters , cortisol , aldosterone , endothelin-1 and angiotensin II was investigated . Four groups composed of 25 volunteers each ( ages between 18 and 35 years ) were treated for six cycles with monophasic combinations containing 21 tablets with either 30 microg ethinylestradiol ( EE ) + 2 mg dienogest ( DNG ) ( 30EE/DNG ) , 20 microg EE + 2 mg DNG ( 20EE/DNG ) , 10 microg EE + 2 mg estradiol valerate ( EV ) + 2 mg DNG ( EE/EV/DNG ) or 20 microg EE + 100 microg levonorgestrel ( LNG ) ( EE/L 
    Output:
    
MAIN RESULTS No differences were found in contraceptive effectiveness for the 13 COC pairs for which this outcome was reported .
Compared to the higher-estrogen pills , several COCs containing 20 μg EE result ed in higher rates of early trial discontinuation ( overall and due to adverse events such as irregular bleeding ) as well as increased risk of bleeding disturbances ( both amenorrhea or infrequent bleeding and irregular , prolonged , frequent bleeding , or breakthrough bleeding or spotting ) .
Low-dose estrogen COCs result ed in higher rates of bleeding pattern disruptions .