title: Efficacy, cycle control, and side effects of low- and lower-dose oral contraceptives: a randomized trial of 20 micrograms and 35 micrograms estrogen preparations.
abstract: Estrogen content represents a tradeoff between cycle control and side effects, but few direct comparisons of 20 and 30/35 micrograms preparations are available. To address this issue, we conducted a randomized, open-label multicenter clinical trial comparing Alesse (20 micrograms ethinyl estradiol [EE]), Mircette (20 micrograms EE), and Ortho Tri-Cyclen (35 micrograms EE) among 463 OC starters or switchers. Bloating, breast tenderness, and nausea were approximately 50% more common in women using 35 micrograms EE as compared to 20 micrograms EE preparations. Cycle control was similar in all products, although during the first two cycles among starters; users of Mircette and Ortho Tri-Cyclen (Tri-Cyclen) exhibited better cycle control than Alesse users. Discontinuation and pregnancy rates were not significantly higher in 35 micrograms EE users.
authors.affiliation: Health Decisions, Inc, Chapel Hill, North Carolina, USA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Rosenberg
authors.forename: A
authors.initials: A
authors.lastname: Meyers
authors.forename: V
authors.initials: V
authors.lastname: Roy
mesh_terms: D000293:Adolescent; D000328:Adult; D001940:Breast / Q000187:drug effects; D003277:Contraceptives, Oral, Combined / Q000009:adverse effects / Q000592:standards*; D017135:Desogestrel / Q000009:adverse effects / Q000592:standards; D004338:Drug Combinations; D004967:Estrogens / Q000008:administration & dosage / Q000009:adverse effects / Q000592:standards*; D004997:Ethinyl Estradiol / Q000009:adverse effects / Q000592:standards; D005260:Female; D006728:Hormones / Q000008:administration & dosage / Q000009:adverse effects / Q000592:standards; D006801:Humans; D008597:Menstrual Cycle / Q000187:drug effects* / Q000502:physiology; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D009644:Norgestrel / Q000009:adverse effects / Q000031:analogs & derivatives / Q000592:standards; D011247:Pregnancy; D018709:Statistics, Nonparametric; D014592:Uterine Hemorrhage / Q000139:chemically induced
chemical_list: D003277:Contraceptives, Oral, Combined; D004338:Drug Combinations; D004967:Estrogens; D006728:Hormones; C109079:norgestimate, ethinyl estradiol drug combination; D009644:Norgestrel; D004997:Ethinyl Estradiol; C034653:Oviol; D017135:Desogestrel