Patient case (clinical description): A 43-year-old woman, gravida 3 para 3, comes to the clinic complaining of recently painful menstrual cycles.  The patient's last menstrual period was 2 weeks ago. Urine β-hCG is negative. Menarche was at age 12, and menstrual periods occur every 28 days and lasts for 5 days.  She is sexually active with her husband and does not have pain with intercourse. BMI is 23 kg/m2 and Vital signs are normal.  On physical examination, the uterus is uniformly enlarged and tender. She is candidate for hysterectomy with the diagnosis of adenomyosis.

Patient's own account: I'm 43, and I paid a visit to my doctor because my last few periods were insanely painful. My last periods were 2 weeks ago. I already had three pregnancies that gave me the three lovely children. I did a urine test to check for potential pregnancy, and it came back negative. I started to have my periods at the age of 12, and I have been pretty regular with periods every 28 days for 5 days. I'm sexually active with my husband and I do not have any pain when we have sex. My BMI is 23 and my vitals were normal. The doctor performed a physical exam and found that my uterus was tender and enlarged. She proposed me a hysterectomy and diagnosed me with adenomyosis.

Clinical trial: Effect of Norgestrel 75 mcg on Cervical Mucus and Ovarian Activity During Perfect Use, After One Delayed Intake and After a Missed Pill

Eligibility criteria:
Inclusion Criteria:

          -  Women in good overall health with no chronic medical conditions that result in
             periodic exacerbations that require significant medical care

          -  Women between 18 and 35 years inclusive at the screening visit

          -  BMI< 32 kg/m²

          -  Regular menstrual cycles between 21 and 35 days when not using hormonal contraception.

               -  Subjects postpartum or post-abortal must have one normal menstrual cycle (2
                  menses) prior to enrollment.

               -  Subjects previously using Intra-Uterine Device (IUD) or taking hormonal
                  contraception (or any other hormonal treatment, except an injectable treatment)
                  need to have at least one menstrual cycle (2 menses) without the treatment before
                  screening.

               -  Subject previously using an injectable (DMPA), must have had their last injection
                  at least 9 months before screening.

          -  Women not at risk of pregnancy: not sexually active, or willing to protect all acts of
             intercourse with condoms, or have a sterile partner or have undergone previous tubal
             ligation (including validated Essure), or be in a same sex relationship.

          -  Women able to give informed consent form to participate in the study and in the
             opinion of the investigator able to follow all study requirements, use the study
             medication and record the requested information appropriately

          -  Intact uterus and both ovaries

          -  At least one progesterone concentration > 3 ng/mL (>10 nmol/L) during the luteal phase
             of the screening period

        Exclusion Criteria:

          -  Pregnant as confirmed by positive high-sensitivity urine pregnancy test at enrollment
             visit

          -  Trying to conceive or desire to conceive in the next 3 months

          -  Currently breastfeeding, or within the last 2 months

          -  Known Polycystic Ovarian Syndrome (PCOS)

          -  Cancer (or past history of any carcinoma or sarcoma)

          -  Known abnormal thyroid status, if in clinical judgment of the investigator it cannot
             be controlled during the study

          -  Known hypersensitivity to the ingredients of the test active substances or its
             excipients

          -  Current acute liver disease and/or benign liver tumors

          -  Have vaginal or cervical infection including clinical evidence of bacterial vaginosis

          -  Evidence of abnormal cervical lesion

          -  History of excisional or ablative treatment procedure on cervix (ie. Loop
             Electrosurgical Excision Procedure (LEEP), Cryotherapy, Cold Knife Cone)

          -  Undiagnosed abnormal uterine bleeding

          -  Prior malabsorptive-type bariatric surgery

          -  Known or suspected alcoholism or illicit drug abuse

          -  Use of any hormonal contraception or IUD other than the study medication during the
             study (including ulipristal acetate for emergency contraception in the past 5 days)

          -  Use of any medications that can interfere with the metabolism of progestin-based
             contraceptives (e.g CYP3A4 enzymes inducers or inhibitors, etc)

          -  Unstable diabetes mellitus

          -  Current participation in any other trial of an investigational medicine or
             participation in the past two months (or within 5 elimination half-lives for chemical
             entities or 2 elimination half-lives for antibodies, whichever is the longer) before
             screening

          -  Abnormalities in laboratory results or TVUS performed at screening visit recognized as
             clinically significant by the investigator

          -  Conditions not suitable for frequent TVUS examinations, (e.g. virgo intacta)

          -  In custody or submitted to an institution due to a judicial order

          -  Relative or household member of the investigator's or sponsor's staff
Female
Accepts Healthy Volunteers
Subject must be at least 18 Years old.
Subject must be at most 35 Years

Eligibility (NLI label): Contradiction