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COC use is associated with increased rates of cardiovascular events and is not recommended in nonbreastfeeding women in the immediate postpartum period or in breastfeeding women during the initial 6 months of breastfeeding. Moreover, estrogen-related adverse effects, such as headache, are common. Estrogen-free progestin-only pills (POPs) are a valuable option in women who prefer to take an oral hormonal contraceptive, but are ineligible for, or choose not to use, COCs. Although some POPs have been associated with lower contraceptive effectiveness than COCs, the POP containing desogestrel has shown similar contraceptive effectiveness to COCs. The most commonly reported complaints in women using all POPs are bleeding problems. Counseling women interested in using POPs about the variable bleeding patterns associated with this method may improve compliance and acceptance. <\/jats:p>","DOI":"10.2217\/whe.10.36","type":"journal-article","created":{"date-parts":[[2010,11,16]],"date-time":"2010-11-16T15:45:08Z","timestamp":1289922308000},"page":"721-735","source":"Crossref","is-referenced-by-count":17,"title":["Estrogen-Free Oral Hormonal Contraception: Benefits of the Progestin-Only Pill"],"prefix":"10.1177","volume":"6","author":[{"given":"Nilson Roberto","family":"de Melo","sequence":"first","affiliation":[{"name":"Federa\u00e7ao Brasileira das Sociedades de Ginecologia e Obstetricia (FEBRASGO), Rua Dr Diogo de Faria, 1087 conj.1103\/1105, Vila Clementino 04037-003, S\u00e3o Paulo SP, Brazil, Tel.: +11 5573 4919, Fax: +11 5082 1473,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2010,9,1]]},"reference":[{"key":"bibr0101-WHE.10.36","unstructured":"Papers of special note have been highlighted as:"},{"key":"bibr0102-WHE.10.36","unstructured":"of interest"},{"key":"bibr1-WHE.10.36","volume-title":"A Clinical Guide for Contraception","author":"Speroff L","year":"1996","edition":"2"},{"key":"bibr2-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1783\/147118908786000451"},{"key":"bibr3-WHE.10.36","first-page":"747","volume-title":"Contraceptive Technology","author":"Trussell J","year":"2007"},{"key":"bibr4-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1016\/S0010-7824(98)00135-8"},{"key":"bibr5-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c927"},{"issue":"25","key":"bibr6-WHE.10.36","first-page":"1","volume":"23","author":"Chandra A","year":"2005","journal-title":"Vital Health Stat"},{"key":"bibr7-WHE.10.36","volume-title":"Modern oral contraception: Updates from the Contraception Report","author":"Wallach M","year":"2000"},{"key":"bibr8-WHE.10.36","first-page":"181","volume-title":"Contraceptive Technology","author":"Raymond EG","year":"2007"},{"key":"bibr9-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.3109\/13625189809167250"},{"key":"bibr01012-WHE.10.36","unstructured":"In this double-blind, randomized comparative trial, 989 subjects were randomized to desogestrel 75 \u03bcg\/day and 331 subjects to levonorgestrel 30 \u03bcg\/day, and observed during 13 consecutive 28-day treatment periods. Desogestrel demonstrated superior contraceptive efficacy and similar overall acceptability compared with levonorgestrel."},{"key":"bibr10-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2001.117415"},{"key":"bibr11-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(94)90286-0"},{"key":"bibr12-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-200060040-00003"},{"key":"bibr13-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2006.12.019"},{"key":"bibr01017-WHE.10.36","unstructured":"A total of 58,674 women were followed for 142,475 women-years. Combined oral contraceptive (COC) use was associated with a risk of venous thromboembolism that ranged from approximately 8\u201310 per 10,000 woman-years; this level of risk was higher than that associated with non-COC use, but lower than that associated with pregnancy. Cardiovascular risk appeared to be similar among women using COCs containing drospirenone and those using other COCs."},{"key":"bibr14-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(95)91928-7"},{"key":"bibr15-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(95)91929-5"},{"key":"bibr16-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(95)91927-9"},{"key":"bibr17-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.312.7023.83"},{"key":"bibr18-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/5.6.746"},{"key":"bibr19-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.323.7305.131"},{"key":"bibr20-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1016\/S0010-7824(01)00309-2"},{"key":"bibr21-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2125.2000.00198.x"},{"key":"bibr22-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1016\/S0010-7824(97)00119-4"},{"key":"bibr23-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/14.6.1493"},{"key":"bibr24-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/5.6.707"},{"key":"bibr25-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1080\/13625180008500392"},{"key":"bibr26-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/15.4.817"},{"key":"bibr27-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/14.6.1500"},{"key":"bibr28-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)07496-X"},{"key":"bibr29-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1016\/S0010-7824(98)00002-X"},{"key":"bibr30-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1080\/13625180008500383"},{"key":"bibr31-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1160\/TH04-11-0759"},{"key":"bibr32-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2004-1958"},{"key":"bibr33-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.709204"},{"key":"bibr34-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.09.042"},{"key":"bibr35-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.98.11.1058"},{"key":"bibr36-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1016\/S0010-7824(03)00073-8"},{"key":"bibr37-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)91334-3"},{"key":"bibr38-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.312.7023.88"},{"key":"bibr39-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1016\/S0010-7824(97)00118-2"},{"key":"bibr40-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(97)02358-1"},{"key":"bibr41-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.318.7198.1579"},{"key":"bibr42-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa003216"},{"key":"bibr43-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/17.9.2307"},{"key":"bibr44-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1001\/jama.284.1.72"},{"key":"bibr45-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.164.7.741"},{"key":"bibr46-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1995.00540260031012"},{"key":"bibr47-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.318.7175.13"},{"key":"bibr48-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1007\/s11883-008-0065-4"},{"key":"bibr49-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38302.504063.8F"},{"key":"bibr50-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2005.08.005"},{"issue":"24","key":"bibr51-WHE.10.36","first-page":"e873","volume":"113","author":"Goldstein LB","year":"2006","journal-title":"Circulation"},{"key":"bibr52-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1136\/jech.52.12.775"},{"key":"bibr53-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1016\/S0010-7824(98)00019-5"},{"key":"bibr54-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199011153232003"},{"key":"bibr55-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(79)92949-0"},{"key":"bibr56-WHE.10.36","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(90)90587-W"},{"key":"bibr57-WHE.10.36","first-page":"892","volume":"31","author":"Wynn V","year":"1986","journal-title":"J. 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